New study findings may make it easier for OCD patients to choose between exposure, stress management therapies


In a recent study, a group of researchers at the University of Michigan indicate that it may soon be possible to find the right and more personalised therapy for OCD patients.

Obsessive-compulsive disorder or OCD is a mental health condition wherein a person has repeated unwanted thoughts (obsessions) that urge them to do certain things many times like, for example, washing hands due to fear of germs. The repeated activities and thoughts can sometimes interfere with the everyday life of the person, making social interactions difficult.

Even when a person with OCD knows their obsessions are not true, they find it hard to get over them. Brain scans show abnormalities in certain areas of the brain in OCD patients.

Serotonin uptake inhibitors and exposure therapy, which is a type of cognitive behavioural therapy are generally used to treat OCD patients.

Exposure therapy vs stress management

The latest study published in the American Journal of Psychiatry compared the effects of exposure therapy with stress management therapy.

In exposure therapy, the patient is made to face the subject of their obsessive thoughts so they can learn to not respond to them, while stress management aims for stress reduction in general and a problem-solving approach.

Stress reduction is often used in the control arm for studies done to check the effectiveness of exposure therapy and is not shown to have much of a benefit so far. Though, experts say that it may have some non-specific benefits for patients.

Exposure therapy is considered to be the go-to therapy for OCD. Studies have shown that it can improve the effects of serotonin uptake inhibitors and can be given to those whose symptoms do not improve after taking the medicines for a while.

The latest study

For the latest study, researchers studied 87 OCD patients within the age range of 12 and 45 years. Of these, 57 were females and 39 had been taking medications for their condition. The individuals were randomly assigned to a 12-week exposure therapy or stress management therapy.

Those with exposure therapy showed better improvement over time than those who got stress management therapy.

The scientists also did brain scans on all the volunteers prior and found something interesting when the patients were given monetary reward on completing a simple cognitive task, which was to correctly pick out a letter from a display.

It was found that those who had pretreatment activation of certain areas in the brain during cognitive processing and reward control responded better to exposure therapy while those who did not show activation in the overlapping areas showed better response to stress management therapy.

This meant that having a monetary reward helped some OCD patients be motivated to let go of the fears that control their repetitive behaviour.

The concerned brain areas are strongly linked to OCD and the effects noted did not vary in different age groups.

The researchers also suggested that while doing brain scans might be impractical in real-life situations for every OCD patient, we should try to decipher who would respond better to cognitive therapy with reward responsiveness and who would fare better when they are taught relaxation methods, and accordingly, focus on problem-solving.

For more information, read our article on Obsessive-Compulsive Disorder.

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