Experiences of Inaccuracy in Persons with Obsessive-Compulsive Disorder: Clinical Manifestation

A recent study sheds light on the impact of Not-Just-Right Experiences (NJREs) in individuals with Obsessive-Compulsive Disorder (OCD). The research, which employed both clinical and non-clinical control groups, focused on examining NJREs in a treatment-seeking OCD sample and assessing changes with a well-established intervention - Cognitive Behavioural Therapy (CBT).

The study found that explicitly targeting NJREs may optimize outcomes, particularly for patients with predominant incompleteness symptoms who may be less responsive to standard CBT. This research emphasises the importance of addressing dysfunctional beliefs and uncertainty intolerance associated with NJREs using cognitive-behavioral approaches. Specific questionnaires were used to assess these dimensions, helping to inform treatment planning.

The findings underscore the significance of assessing for NJREs and considering incompleteness motivations in the conceptualization and treatment of OCD. However, the study did have some limitations. These included a modest size of the OCD sample, reliance on self-report, only a small subset completing the CBT protocol, the lack of a control treatment condition, and the CBT protocol being NJRE-informed, making it unclear what effects standard CBT might have.

Despite these limitations, the study suggests that CBT can effectively target both classic anxiety/harm-avoidance symptoms and incompleteness-related symptoms, leading to significant reductions in NJREs. Interestingly, individuals with OCD were found to experience more frequent and severe NJREs than controls, and these experiences were associated with overall OCD severity, especially in terms of incompleteness-related and ordering/arranging symptoms.

The study serves to highlight the under-recognized role of NJREs in the clinical presentation of OCD. Future research, such as randomized controlled trials comparing standard CBT to NJRE-focused CBT, would provide valuable information about the incremental benefits of targeting NJREs and help guide treatment decision-making for individuals with incompleteness-related OCD symptoms. Furthermore, future research should examine if standard CBT produces similar NJRE improvements.

Experiences of Inaccuracy in Persons with Obsessive-Compulsive Disorder: Clinical Manifestation