Background

1. An Intensive Acceptance and Commitment Therapy Intervention’s Effect on Obsessive Compulsive Symptomatology in At-Risk Adolescents Michelle L. Miller, B.A., Emily B. Kroska, B.A., Rosaura Orengo-Aguayo, M.A., & James Marchman, PhD University of Iowa, Department of Psychology Methods Background Results • Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterized by presence of obsessions and/or compulsions that are time-consuming, cause significant distress, and can impair multiple areas of functioning. • The lifetime prevalence of OCD in the general population worldwide is approximately 2–3%. • The prevalence of OCD in adolescents has been found to be 3% with subclinical OCD (OC) symptoms estimated at 19%. • A large majority (80%) of adult OCD cases have been found to have developed during childhood or adolescence. • Acceptance and Commitment Therapy (ACT) has been shown to be effective in treating OCD across several studies. • Prevention research is a necessary next step in the ACT literature, given its success in treating a wide variety of disorders. • The present study seeks to increase mindfulness and acceptance skills, as well as to clarify valued life directions, in an at-risk sample, before symptoms present and interfere with quality of life. • The goal of ACT treatment is not symptom reduction, but an increased ability to live a rich, meaningful life. • Treatment Protocol: • Values identification and clarification • Exploration of the relation between pain and values • How can we move toward what matters? • Creative hopelessness exercises • Mindfulness and noticing exercises • Difference between internal and external experiences • Willingness and acceptance experiential exercises • Demographics: • Age: M = 16.34 (SD=1) • Gender: 32 F, 21 M • Racial Distribution: • Caucasian: 18 • African-American: 22 • Other: 7 • Sexual Orientation: • Heterosexual: 70.59% • Homosexual, Bisexual, Transgender: 29.41% • Does your family receive food stamps? • Yes: 45.3% • No: 54.7% Avoidance decreased significantly from Pre (M=13.11) to one-month follow-up (M=2.08), t(37.11)=-5.73, p<.001. • Measures: • Obsessive-Compulsive Inventory-Revised • Child Adolescent Mindfulness Measure • Acceptance and Fusion Questionnaire Mindfulness increased significantly from Pre (M=25.53) to one-month follow-up (M=35.49), t(35.9)=5.71, p<.001. Conclusions • OCI-R scores did not significantly change from Pre-Intervention to One-Month Post. • Mindfulness significantly increased, and avoidance significantly decreased from Pre-Intervention to One-Month Post. • Increased mindfulness and decreased avoidance may be accounting for the lack of significant change in OCI-R scores and suggest a willingness to experience OC symptoms in a different way. • As this is a prevention study, OC symptoms were low at baseline and reduction in symptoms was secondary to learning different skills to address the distress caused by intrusive thoughts. Objectives & Hypotheses • Objective: • To determine the effectiveness of a brief ACT intervention with at-risk adolescents in changing the frequency and severity of intrusive thoughts and OCD symptoms from pre-intervention to one-month follow-up. • To measure change in mindfulness and acceptance skills from pre-intervention to one-month follow-up. • Hypothesis: • There will be an increase in mindfulness skills reported from pre-intervention to one-month follow-up. • There will be a decrease in self-reported experiential avoidance from pre-intervention to one-month follow-up. • Participants may experience a reduction in severity and frequency of OCD symptoms. OCI-R scores were not significantly different from to one-month follow-up, F(1,98)=0.81, p=.37. References The means of groups at Pre: M=16.26(13.17),N=46 One-month follow-up: M=13.29(16.00),N=34 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Angst, J. (1993). Comorbidity of anxiety, phobia, compulsion and depression. International Clinical Psychopharmacology, 8, 21–25. Biglan, A., et al. (2008). Acceptance and commitment: Implications for prevention science. Prevention Science, 9, 139-152. Hayes, S.C., Strosahl, K., & Wilson, K.G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press. Levin, M.E., et al. (2012). The impact of treatment components suggested by the Psychological Flexibility Model: Meta-analysis of laboratory-based component studies. Behavior Therapy, 43, 741-756. Pauls, D. L., Alsobrook, J. P., Goodman, W., Rasmussen, S., & Leckman, J. F. (1995). A family study of obsessive-compulsive disorder. American Journal of Psychiatry, 152, 76–84. Valleni-Basile, L.A., Garrison, C. Z., Jackson, K.L., Waller, J.L., McKeown, R.E., Addy, C.L., & Cuffe, S.P. (1994). Frequency of obsessive-compulsive disorder in a community sample of young adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 33(6), 782-791.