Our lab has several research grants that support numerous research studies on the cognitive-behavioral processes involved in anxiety/OCD and the treatment of OCD. Some of our major grant-funded projects are described below.
The most effective treatment for OCD is ERP, which entails confronting obsessional triggers (i.e., exposure) and resisting urges to ritualize (response prevention). But these techniques are challenging and anxiety-provoking, and between 25% and 50% of patients with access to ERP refuse it, drop out prematurely, or do not adhere to the treatment instructions. As a result, they show attenuated response. Given the effectiveness of ERP, it is important to develop ways to make it more tolerable and increase patient adherence. In this study, we consider Acceptance and Commitment Therapy (ACT), which has recently been studied for OCD, as a way to address the tolerability and adherence issues with ERP. ACT fosters a willingness to experience unwanted inner experiences (e.g., obsessional thoughts, anxiety) and is consistent with ERP. We are comparing traditional ERP to ERP+ACT and hypothesize that adding ACT to ERP will help patients (a) engage in ERP tasks, (b) confront high levels of anxiety without using escape/avoidance strategies, and (c) resist rituals.
We know that intimate relationships can have a significant impact on OCD symptoms. Some partners accommodate their loved ones with OCD by participating in rituals or assisting with avoidance strategies. In other cases, relationship stress (that might develop from the presence of OCD in the first place) increases the sufferer's OCD symptoms. For example, if there is hostility or personal criticism directed at the person with OCD by his or her partner, this can paradoxically increase OCD symptoms. Our study is in collaboration with Donald Baucom, PhD and the UNC Couples Lab. We are designing and testing a cognitive-behavioral therapy program that addresses OCD and includes the sufferer's partner as a coach. In addition to exposure and response prevention treatment, the couple (both partners attend all 12 treatment sessions) work on developing their relationship in ways that help the OCD sufferer to reduce his or her symptoms.
Hoarding (the acquisition of, and failure to discard, large amounts of unneeded possessions) is quickly becoming a major research interest in the field of anxiety disorders and there are lots of unanswered questions about this problem. What causes it? What is the best way to think about it? Is it a form of OCD? How is hoardig best treated? Mike Wheaton, MA was recently awarded a grant to study emotional and cognitive processing in people with hoarding problems using two novel techniques: (1) startle modulation (AVSM), which is a measure of emotional responses, and (2) prepulse inhibition (PPI), which measures information-processing. Adults with compulsive hoarding and healthy control participants will be recruited, tested, and compared on these two (and other important) variables. The results of this study will help the field to better conceptualize and classify hoarding. The study will begin the the Fall of 2010.
We have recently developed and evaluated a new self-report scale to measure obsessive-compulsive symptoms, called the Dimensional Obsessive-Compulsive Scale (DOCS). The DOCS is a 20-item questionnaire that alleviates some of the limitations of other instruments that assess OC symptoms. We have studies underway to further examine this instrument and develop a child version.
The RCIF is an international group of 17 psychologists and psychiatrists from 12 countries who are conducting research on the nature of intrusive fearful thoughts and images. New research tools to understand the origins, persistence and management of intrusive fear have been developed, and there are a number of key questions directing the our research agenda: Do people from different countries have the same personal fears? What is the most effective way to get rid of intrusive fear? What causes some people to develop an anxiety disorder from their intrusive fearful thoughts? What is the most effective way to treat more extreme and persistent intrusive fear? What do individuals learn from their society about how to deal with intrusive fearful thoughts? Are some religious and cultural teachings more helpful than others? What can we learn from different cultures about the management of fearful intrusive thoughts?
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