Obsessive Compulsive Disorder, Article Critique Example

A Randomized Clinical Trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a challenge for many people. It has been shall that certain forms of cognitive-behavioral therapy is helpful to many, but there is a 25% drop-out rate for such therapies (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). Many of the more successful therapies include exposing clients to trigger stimuli in order to extinguish the anxiety associated with them (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). Nevertheless, clinical researchers are looking for improvements to these strategies based upon their drop-out rate alone (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). What they have focused on is the concept of psychological flexibility (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). What this means is finding and implementing new behaviors either internally or externally in presence of a trigger stimulus (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). Exposure therapies touch on this ability, but perhaps, do not go far enough (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010).

To study alternatives, 79 participants were recruited in part based on self-reports OCD scales (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). Researchers set 2 conditions. One was the Acceptance and Commitment Therapy (ACT) condition, and the other was Progressive Relaxation Training (PRT) condition (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). Participants sat through 8 sessions of each therapy and were scored with Yale-Brown Obsessive Compulsive Scale (YBOCS), Beck Depression Inventory-II, Quality of Life Scale, Acceptance and Action Questionnaire, Thought Action Fusion Scale, and Thought Control Questionnaire pretreatment, post treatment, and followed-up at three months by a blind tester (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). The Treatment Evaluation Inventory-Short Form was completed at post treatment (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010).

Hierarchical Linear Modeling (HLM) and Mixed Model Repeated Measures (MMRM) analytics were used (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). HLM was used to investigate the probability in both random and non-random slope-intercepts of quantifiable hierarchies of severity of symptoms (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). MMRM was used to investigate variances using time as one of the categories (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). The analyses were longitudinal because researches wanted to know the relative effectiveness of the therapies over time. What they were able to delineate was three fold: Was there a statistical best-fit trend in the data? How effective were treatments over time? How much did time impact results?

ACT appeared to be more effective over time than PRT (Twohig, Hayes, Plumb, Pruitt, Collins, Hazlett-Stevens, & Woidneck, 2010). The methodology set forth here might be applicable to the study of false memory syndrome (FMS) where composite measures are conducted over time with respect to a dual-condition setup. Initial client scores FMS tendency could be compared to subsequent testing for manifested FMS and compared across therapist measures for suggestivity over time. What we would look for is a trend toward manifestation of symptoms for therapists who scored higher for suggestive techniques. We should expect to see that clients more inclined toward FMS to manifest more FMS symptoms over time with those therapists and less with those who scored low for suggestive techniques. Likewise, we would control for natural statistical trends such as logarithmic distribution.

References

Twohig, M. P., Hayes, S.C., Plumb, J.C., Pruitt, L.D., Collins, A.B., Hazlett-Stevens, H. Woidneck, M.R.. (2010). A Randomized Clinical Trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for Obsessive Compulsive Disorder. J Consult Clin Psychol., 78(5): 705–716.