• Bibtex: @kuckertz2022
  • Bibliography: Kuckertz, J. M., McNally, R. J., Riemann, B. C., Van Borkulo, C., Bellet, B. W., Krompinger, J. W., Van Kirk, N., & Falkenstein, M. J. (2022). Does the network structure of obsessive-compulsive symptoms at treatment admission identify patients at risk for non-response? Behaviour Research and Therapy, 156, 104151. https://doi.org/10.1016/j.brat.2022.104151

Example citation

Responders and non-responders to intensive ERP differed in their response to emotional distress

Key takeaways

  • n = 1343, intensive treatment for OCD (residential or partial hospital treatment for OCD), McLean Hospital or Rogers Behavioral Healthcare.
  • Separate baseline networks for responders and non-responders
  • R-script on OSF
  • Most important nodes for responders
    • comptime, compinterfer, obinter
  • Most important nodes for non-responders
    • compcont, compinterf, obdis
  • Three network edges differed between responders and non-responders
    • compdis – compcont (p = .002)
    • compdis – compinterf (p = .049)
    • obdis – compdis (p = .037)

Non-responders may have been more reactive to their distress by performing compulsions, thereby worsening their functioning.

Networks using Y-BOCS items, so 5 items each on obs/com

A consistent theme that emerged from our data was that responders and non-responders differed in their responses to the presence of emotional distress. This difference has implications for the ability to benefit from treatment. For example, non-responders demonstrated a strong pattern whereby their level of distress when prevented from completing rituals (compdis) was associated with their perception of limited control over rituals (compcont). Because our data are crosssectional, caution is warranted in generalizing to individuals. Nonetheless, these data correspond with our clinical observations; we often find that patients who experience their rituals as something happening to them or as something that starts “automatically” when they are distressed, rather than something they have active agency over, fare worse in treatment. In the context of ERP, one possibility is that responders may have been better able to tolerate distress while successfully reducing rituals, and to translate these gains to their daily experiences due to greater perceived ability to choose whether to engage in the rituals or not.