국내 일대학병원에서 강박장애 집단 기반 수용전념치료의 효과 검증
Effectiveness of a Group-Based Acceptance and Commitment Therapy for Obsessive-Compulsive Disorder in a University Hospital
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Objectives:Acceptance Commitment Therapy (ACT) was recently introduced to the treatment of the obsessive-compulsive disorder (OCD). Major core components of ACT can be effectively applied to OCD treatment. Cognitive defusion can make to reduce anxiety related to obsessional thought by observing and flowing the thoughts in a non-judgemental manner. Value-based commitment can be helpful to confront situations rather than experiential avoidance. Although several studies verified the effectiveness of ACT treatment on OCD, there is a lack of study in Korea. Methods:Forty-four patients with OCD were randomly assigned to treatment or control groups (22 patients per group). An eight-session, 90-minute ACT program was developed and conducted for 8 weeks for the treatment group. Symptoms were measured before and after 8 weeks, using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Obsessive-Compulsive Inventory (OCI), Beck Depression Inventory (BDI), and Cognitive Fusion Questionnaire (CFQ). Results: After eight-week program, the treatment group showed greater reductions in cognitive fusion score (p= 0.001) as well as obsessive-compulsive symptoms measured by both Y-BOCS and OCI (ps<0.001) compared to the control group. Moreover, changes in cognitive fusion score were significantly correlated with changes of Y-BOCS, OCI, and BDI scores (all ps<0.05) Conclusions:To the best of our knowledge, our study is the first report to verify the effectiveness of a group based ACT program on OCD in Korea. Our ACT program was effective to reduce symptoms of OCD and related cognitive fusion. Future study with longitudinal design and large sample sizes are needed to investigate confirmatory and long-term effects of our ACT program for OCD.
Abstract
Objectives:Acceptance Commitment Therapy (ACT) was recently introduced to the treatment of the obsessive-compulsive disorder (OCD). Major core components of ACT can be effectively applied to OCD treatment. Cognitive defusion can make to reduce anxiety related to obsessional thought by observing and flowing the thoughts in a non-judgemental manner. Value-based commitment can be helpful to confront situations rather than experiential avoidance. Although several studies verified the effectiveness of ACT treatment on OCD, there is a lack of study in Korea. Methods:Forty-four patients with OCD were randomly assigned to treatment or control groups (22 patients per group). An eight-session, 90-minute ACT program was developed and conducted for 8 weeks for the treatment group. Symptoms were measured before and after 8 weeks, using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Obsessive-Compulsive Inventory (OCI), Beck Depression Inventory (BDI), and Cognitive Fusion Questionnaire (CFQ). Results: After eight-week program, the treatment group showed greater reductions in cognitive fusion score (p= 0.001) as well as obsessive-compulsive symptoms measured by both Y-BOCS and OCI (ps<0.001) compared to the control group. Moreover, changes in cognitive fusion score were significantly correlated with changes of Y-BOCS, OCI, and BDI scores (all ps<0.05) Conclusions:To the best of our knowledge, our study is the first report to verify the effectiveness of a group based ACT program on OCD in Korea. Our ACT program was effective to reduce symptoms of OCD and related cognitive fusion. Future study with longitudinal design and large sample sizes are needed to investigate confirmatory and long-term effects of our ACT program for OCD.
참고문헌 (41)
- Stein DJ, "Obsessive-compulsive disorder", Nat Rev Dis Primers, 5, pp.52~ (2019)
- Koran LM, "Quality of life for patients with obsessive-compulsive disorder", Am J Psychiatry, 153, pp.783~788 (1996)
- Bloch MH, "Meta-analysis of the symptom structure of obsessive-compulsive disorder", Am J Psychiatry, 165, pp.1532~1542 (2008)
- Mataix-Cols D, "A multidimensional model of obsessive-compulsive disorder", Am J Psychiatry, 162, pp.228~238 (2005)
- Greenberg D, "Scrupulosity : a unique subtype of obsessive-compulsive disorder", Curr Psychiatry Rep, 12, pp.282~289 (2010)
- Taylor S, "Musical obsessions : a comprehensive review of neglected clinical phenomena", J Anxiety Disord, 28, pp.580~589 (2014)
- Bloch MH, "Meta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder", Mol Psychiatry, 15, pp.850~855 (2010)
- Soomro GM, "Selective serotonin re-uptake inhibitors(SSRIs)versus placebo for obsessive compulsive disorder(OCD)", Cochrane Database Syst Rev (2008)
- Ost LG, "Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014", Clin Psychol Rev, 40, pp.156~169 (2015)
- Ost LG, "Cognitive behavioral and pharmacological treatments of OCD in children : a systematic review and meta-analysis", J Anxiety Disord, 43, pp.58~69 (2016)
- Sanchez-Meca J, "Differential efficacy of cognitivebehavioral therapy and pharmacological treatments for pediatric obsessive-compulsive disorder : a meta-analysis", J Anxiety Disord, 28, pp.31~44 (2014)
- Oconnor K, "Inference processes in obsessive-compulsive disorder-some clinical observations", Behaviour Research and Therapy, 33, pp.887~896 (1995)
- Hayes SC, "Acceptance and commitment therapy: model, processes and outcomes", Behav Res Ther, 44, pp.1~25 (2006)
- Hayes SC, "Acceptance and commitment therapy : the process and practice of mindful change" (2011), Guilford Press
- Abramowitz JS, "Obsessivecompulsive symptoms : the contribution of obsessional beliefs and experiential avoidance", J Anxiety Disord, 23, pp.160~166 (2009)
- Briggs ES, "The relationship between adverse childhood experience and obsessive-compulsive symptoms and beliefs : the role of anxiety, depression, and experiential avoidance", Journal of Anxiety Disorders, 23, pp.1037~1046 (2009)
- Vakili Y, "The effectiveness of acceptance and commitment therapy in treating a case of obsessive compulsive disorder", Iran J Psychiatry, 9, pp.115~117 (2014)
- Philip J, "Acceptance and commitment therapy in the treatment of obsessive-compulsive disorder : a systematic review", J Obsessive Compuls Relat Disord, 28 (2021)
- Twohig MP, "A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder", J Consult Clin Psychol, 78, pp.705~716 (2010)
- Foa EB, "The validation of a new obsessive-compulsive disorder scale : the Obsessive-Compulsive Inventory", Psychol Assess, 10, pp.206~214 (1998)
- Foa EB, "The Obsessive-Compulsive Inventory : development and validation of a short version", Psychol Assess, 14, pp.485~496 (2002)
- Woo CW, "The Obsessive-Compulsive Inventory-Revised(OCI-R) : psychometric properties of the Korean version and the order, gender, and cultural effects", J Behav Ther Exp Psychiatry, 41, pp.220~227 (2010)
- Goodman WK, "The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability", Arch Gen Psychiatry, 46, pp.1006~1011 (1989)
- 설순호, "Korean Self-Report Version of the Yale-Brown Obsessive-Compulsive Scale: Factor Structure, Reliability, and Validity", PSYCHIATRY INVESTIGATION, 10(1), pp.17~25 (2013), 대한신경정신의학회[DOI]
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Lee YH, "A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales", Kor J Clin Psychol, 4, pp.561~571 (1991)
- Gillanders DT, "The development and initial validation of the Cognitive Fusion Questionnaire", Behav Ther, 45, pp.83~101 (2014)
- McCracken LM, "The cognitive fusion questionnaire : a preliminary study of psychometric properties and prediction of functioning in chronic pain", Clin J Pain, 30, pp.894~901 (2014)
- Kim BO, "Psychometric properties of a Korean version of the Cognitive Fusion Questionnaire", Social Behavior and Personality, 43, pp.1715~1724 (2015)
- Ost LG, "The efficacy of Acceptance and Commitment Therapy : an updated systematic review and meta-analysis", Behav Res Ther, 61, pp.105~121 (2014)
- Twohig MP, "A Randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder", J Consult Clin Psychol, 78, pp.705~716 (2010)
- Vakili Y, "Acceptance and commitment therapy, selective serotonin reuptake inhibitors, and their combination in the improvement of obsessive compulsive symptoms and experiential avoidance in patients with obsessive-compulsive disorder", Iranian journal of psychiatry and behavioral sciences, 9 (2015)
- Rohani F, "Preliminary test of group acceptance and commitment therapy on obsessive-compulsive disorder for patients on optimal dose of selective serotonin reuptake inhibitors", J Obsessive Compuls Relat Disord, 16, pp.8~13 (2018)
- Esfahani M, "Evaluation and comparison of the effects of time perspective therapy, acceptance and commitment therapy and narrative therapy on severity of symptoms of obsessive-compulsive disorder", J Indian Acad Appl, 41, pp.148~ (2015)
- Pozza A, "Drop-out and efficacy of group versus individual cognitive behavioural therapy : what works best for obsessive-compulsive disorder? A systematic review and meta-analysis of direct comparisons", Psychiatry Res, 258, pp.24~36 (2017)
- Shabani MJ, "An Iranian study of group acceptance and commitment therapy versus group cognitive behavioral therapy for adolescents with obsessive-compulsive disorder on an optimal dose of selective serotonin reuptake inhibitors (vol 22, 100440, 2019)", J Obsessive Compuls Relat Disord, 30 (2021)
- Xiong A, "Relationship between cognitive fusion, experiential avoidance, and obsessive-compulsive symptoms in patients with obsessive-compulsive disorder", Front Psychol, 12 (2021)
- 이상원, "강박장애 환자에서 체험회피, 인지융합 및 강박증상 간의 관계", 대한불안의학회지, 17(1), pp.19~27 (2021), 대한불안의학회[DOI]
- Twohig MP, "Changes in psychological flexibility during acceptance and commitment therapy for obsessive compulsive disorder", J Contextual Behav Sci, 4, pp.196~202 (2015)
- Bai Z, "Acceptance and Commitment Therapy(ACT)to reduce depression : a systematic review and meta-analysis", J Affect Disord, 260, pp.728~737 (2020)
- Dehlin JP, "Acceptance and commitment therapy as a treatment for scrupulosity in obsessive compulsive disorder", Behavior Modification, 37, pp.409~430 (2013)
