Hostname: page-component-848d4c4894-r5zm4 Total loading time: 0 Render date: 2024-07-02T07:34:29.520Z Has data issue: false hasContentIssue false

Expectancy and Compliance as Predictors of Outcome in Obsessive-Compulsive Disorder

Published online by Cambridge University Press:  16 June 2009

Teresa Lax
Affiliation:
Institute of Psychiatry, London
Metin Başoǧlu
Affiliation:
Institute of Psychiatry, London

Extract

Forty-nine obsessive-compulsive ritualizers had clomipramine and live exposure in a randomized controlled design. The effect on outcome of pre-treatment expectations from psychological and from drug treatment and of subsequent compliance with exposure instructions was studied. Exposure instructions led to greater pre-treatment expectations than did anti-exposure instructions, but this did not affect outcome, suggesting that the effect of exposure was not due to expectation. Initially, more ill patients expected more from drug but improved less. Compliance with psychological treatment did not predict better improvement, but most patients were fairly compliant.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baekeland, F. and Lundwall, L. (1975). Dropping out of treatment: a critical review. Psychological Bulletin 82, 738783.CrossRefGoogle ScholarPubMed
Başoǧlu, M., Lax, M. T., Kasvikis, Y. and Marks, I. M. (1988). Predictors of improvement in Obsessive-Compulsive Disorder. Journal of Anxiety Disorders 2, 299317.CrossRefGoogle Scholar
Beck, A. T., Rial, W. Y. and Rickels, K. (1974). Short form of depression inventory: cross validation. Psychological Reports 34, 11841186.CrossRefGoogle ScholarPubMed
Bloch, S., Bond, G., Qualls, B., Yalom, I. and Zimmerman, E. (1976). Patients' expectations of therapeutic improvement and their outcomes. American Journal of Psychiatry 133, 14571459.Google ScholarPubMed
Borkovec, T. D. (1972). Effects of expectancy on the outcome of systematic desensitization and implosive treatments for analogue anxiety. Behavior Therapy 3, 2940.CrossRefGoogle Scholar
Emmelkamp, P. M. G. (1975). Effects of expectancy on systematic desensitization and flooding. European Journal of Behavioural Analysis and Modification 1, 111.Google Scholar
Foa, E. B., Steketee, G., Grayson, J. B. and Doppelt, H. G. (1983). Treatment of obsessive-compulsives: when do we fail? In Foa, E. B. and Emmelkamp, P. M. G. (Eds). Failures in Behavioral Therapy. New York: Wiley.Google Scholar
Foa, E. B., Steketee, G., Turner, R. M. and Fisher, S. C. (1980). Effects of imaginal exposure to feared disasters in obsessive-compulsive checkers. Behavior Research and Therapy 18, 449455.CrossRefGoogle ScholarPubMed
Friedman, H. J. (1963). Patient-expectancy and symptom reduction. Archives of General Psychiatry 8, 6167.CrossRefGoogle ScholarPubMed
Gelder, M. G., Bancroft, J. H. J., Gath, D. H., Johnston, D. W., Mathews, A. M. and Shaw, P. M. (1973). Specific and non-specific factors in behaviour therapy. British Journal of Psychiatry 123, 445462.CrossRefGoogle ScholarPubMed
Gelder, M. G. and Marks, I. M. (1966). Severe agoraphobia: a controlled prospective trial of behaviour therapy. British Journal of Psychiatry 112, 309319.CrossRefGoogle ScholarPubMed
Goldstein, A. P. (1960). Patient expectancies and non-specific therapy as a basis for (un)spontaneous remission. Journal of Clinical Psychology 16, 399403.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Goldstein, A. P. and Shipman, W. G. (1961). Patient expectancies, symptom reduction and aspects of the initial psychotherapeutic interview. Journal of Clinical Psychology 17, 121133.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Greist, J. H., Marks, I. M., Berlin, F., Gournay, K. and Noshirvani, H. (1980). Avoidance versus confrontation of fear. Behavior Therapy 11, 114.CrossRefGoogle Scholar
Hamilton, M. (1969). Standardized assessment and recording of depessive symptoms. Psychiatria, Neurologia, Neurochirurgia 72, 201205.Google ScholarPubMed
Karzmark, P., Greenfield, T. and Cross, H. (1983). The relationship between level of adjustment and expectations for therapy. Journal of Clinical Psychology 39, 930932.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Kazdin, A. E. and Wilcoxon, L. A. (1976). Systematic desensitization and nonspecific treatment effects: a methodological evaluation. Psychological Bulletin 83, 729758.CrossRefGoogle ScholarPubMed
Kirsh, I. and Henry, D. (1977). Extinction vs credibility in the desensitization of speech anxiety. Journal of Consulting and Clinical Psychology 45, 10521059.CrossRefGoogle Scholar
Kirsh, I., Tennen, H., Wickless, C., Saccone, A. J. and Cody, S. (1983). The role of expectancy in fear reduction. Behavior Therapy 14, 520533.CrossRefGoogle Scholar
Lick, J. and Bootzin, R. (1975). Expectancy factors in the treatment of fear: methodological and theoretical issues. Psychological Bulletin 82, 917931.CrossRefGoogle ScholarPubMed
Marks, I. M. (1987). Fears, Phobias and Rituals. New York: Oxford University Press.Google Scholar
Marks, I. M., Connolly, J., Hallam, R. S. and Philpott, R. (1977). Nursing in Behavioural Psychotherapy. Research Series of Royal College of Nursing, London.Google Scholar
Marks, I. M., Hodgson, R. and Rachman, S. (1975). Treatment of chronic obsessive-compulsive neurosis by in vivo exposure. A two-year follow-up and issues in treatment. British Journal of Psychiatry 127, 349364.CrossRefGoogle ScholarPubMed
Marks, I. M., Lelliott, P., Başoǧlu, M., Noshirvani, H., Monteiro, W., Cohen, D. and Kasvikis, Y. (1988). Clomipramine, self-exposure and therapist aided exposure in obsessive-compulsive ritualizers. British Journal of Psychiatry 152, 522534.CrossRefGoogle Scholar
Marks, I. M., Stern, R. S., Mawson, D., Cobb, J. and McDonald, R. (1980). Clomipramine and exposure for obsessive-compulsive rituals: I. British Journal of Psychiatry 136, 125.CrossRefGoogle Scholar
Marks, I. M., Swinson, R., Başoǧlu, M. et al. (1992). Alprazolam and exposure for panic disorder with agoraphobia. Awaiting publication.Google Scholar
Mathews, A. (1978). Fear reduction research and clinical phobias. Psychological Bulletin 85, 390404.CrossRefGoogle ScholarPubMed
Persson, G. and Nordlund, C. L. (1983). Expectations of improvement and attitudes to treatment processes in relation to outcome with four treatment methods for phobic disorders. Acta Psychiatrica Scandinavica 68, 484493.CrossRefGoogle ScholarPubMed
Primakoff, L., Epstein, N. and Covi, L. (1986). Homework compliance: an uncontrolled variable in cognitive therapy outcome research. Behavior Therapy 17, 433446.CrossRefGoogle Scholar
Shapiro, D. A. (1981). Comparative credibility of treatment rationales: three tests of expectancy theory. British Journal of Clinical Psychology 20, 111122.CrossRefGoogle ScholarPubMed
Shelton, J. L. and Levy, R. L. (1979). Home practice activities and compliance: two sources of error variance in behavioural research. Journal of Applied Behaviour Analysis 12, 324.Google Scholar
Southworth, S. and Kirsh, I. (1988). The role of expectancy in exposure-generated fear reduction in agoraphobia. Behavior Research and Therapy 26, 113120.CrossRefGoogle ScholarPubMed
Stern, R. and Marks, I. (1973). Brief and prolonged flooding: a comparison in agoraphobic patients. Archives of General Psychiatry 28, 270276.CrossRefGoogle ScholarPubMed
Trull, T. J., Nietzel, M. T. and Main, A. (1988). The use of Meta-Analysis to assess the clinical significance of behavior therapy for agoraphobia. Behavior Therapy 19, 527538.CrossRefGoogle Scholar
Wilkins, W. (1971). Desensitization: social and cognitive factors underlying the effectiveness of Wolpe's procedure. Psychological Bulletin 76, 311317.CrossRefGoogle ScholarPubMed
Wilkins, W. (1973). Expectancy of therapeutic gain: an empirical and conceptual critique. Journal of Consulting and Clinical Psychology 40, 6977.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.