"Association Splitting" in Obsessive-Compulsive Disorder (OCD)
Recruitment status was Recruiting
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Purpose
Over a period of 3 weeks, association splitting is compared to cognitive remediation (CogPack training) as an add-on intervention to cognitive-behavioral therapy (CBT). Blind to treatment assignment, both groups are assessed before intervention and eight weeks as well as six months later with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Obsessive-Compulsive Inventory (OCI-R) and cognitive tests. OCD severity as measured by the Y-BOCS total score serves as the primary outcome parameter. It is assumed that association splitting will improve OCD severity to a greater extent than cognitive remediation.
| Condition | Intervention |
|---|---|
|
Obsessive-Compulsive Disorder |
Behavioral: "association splitting" Behavioral: cognitive remediation |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | "Association Splitting" Compared With Cognitive Remediation (CR) in Obsessive-compulsive Disorder (OCD): a Randomized Controlled Trial |
- Total score of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) [ Time Frame: 8 weeks, 6 months ] [ Designated as safety issue: No ]
- Obsession subscore of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the total score of the Obsessive-Compulsive Inventory (OCI-R) [ Time Frame: 8 weeks, 6 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 150 |
| Study Start Date: | March 2009 |
| Estimated Study Completion Date: | December 2011 |
| Estimated Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: "association splitting"
Association splitting (6 sessions) delivered by psychologists.
|
Behavioral: "association splitting"
"Association splitting" is a cognitive intervention which aims at reducing obsessive thoughts. Association splitting is based on the so called fan effect (Anderson, 1974) and aims at reducing the strength of obsessive cognitions. For this purpose core intrusive thoughts are identified with the patient (such as "cancer - illness" or "blood - contamination") and the patient is encouraged to find non-OCD associations that are (semantically or phonologically) related to the OCD cognition (such as "cancer - (zodiac) sign", "cancer - great crab"; "blood - Snow White ("lips as red as blood")", or "blood - blood bond"). To strengthen the novel connections, these associations are elaborated by the use of pictures, music, or smells. By enhancing OC-unrelated associations it is assumed that the influence of OC-related concepts is weakened.
|
|
Active Comparator: cognitive remediation
CogPack training(6 sessions) delivered by either psychologists or psychology students at an advanced master level.
|
Behavioral: cognitive remediation
Computerized cognitive remediation (CogPack training). A fixed sequence is administered, which covers a wide range of neuropsychological exercises involving memory, reasoning, selective attention and psychomotor speed. The difficulty level for each patient is adapted automatically depending on to the subject's performance on prior exercises. At the end of each session, the patient receives individual feedback on his or her performance. To match with association splitting, six sessions are administered. Each session lasts approximately 45-60 minutes.
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Detailed Description:
Association splitting is a new cognitive technique which aims at reducing obsessive thoughts. It draws upon the so-called "fan effect" of associative priming. Transposing this principle to the treatment of obsessive-compulsive disorder (OCD), we hypothesized that the sprouting of new and the strengthening of existing neutral associations to core OCD cognitions will reduce their fear-evoking properties by depriving the chain of OCD-related cognitions of associative strength. Patients with OCD are randomly allocated to either associations splitting (AS) or cognitive remediation (CogPack training). Blind to treatment assignment, both groups are assessed before intervention and eight weeks as well as six months later with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Obsessive-Compulsive Inventory (OCI-R) and cognitive tests. OCD severity derived from the Y-BOCS and the OCI-R serves as the main outcome parameters. We also explore if AS changes the OCD-related semantic networks with cognitive tasks. It is assumed that association splitting will improve OCD severity to a greater extent than CogPack training.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Obsessive-Compulsive Disorder (OCD) with an Y-BOCS obsession subscore ≥ 8
Exclusion Criteria:
- intellectual disability (IQ < 70); unable to provide informed consent; severe neurological illness, psychotic symptoms or substance dependence.
Contacts and Locations| Contact: Lena Jelinek, PhD | +49407410 ext 57539 | ljelinek@uke.uni-hamburg.de |
| Contact: Steffen Moritz, PhD | +49407410 ext 56565 | moritz@uke.uni-hamburg.de |
| Germany | |
| University Medical Center Hamburg Eppendorf | Recruiting |
| Hamburg, Germany, 20246 | |
| Contact: Lena Jelinek, PhD +49407410 ext 57539 | |
| Principal Investigator: | Lena Jelinek, PhD | Universitätsklinikum Hamburg-Eppendorf |
| Principal Investigator: | Steffen Moritz, PhD | Universitätsklinikum Hamburg-Eppendorf |
More Information
Additional Information:
No publications provided
| Responsible Party: | Lena Jelinek, PhD and Steffen Moritz, PhD, Universitätsklinikum Hamburg-Eppendorf |
| ClinicalTrials.gov Identifier: | NCT01035242 History of Changes |
| Other Study ID Numbers: | JE 540/3-1 |
| Study First Received: | December 17, 2009 |
| Last Updated: | December 17, 2009 |
| Health Authority: | Germany: Ministry of Health |
Keywords provided by Universitätsklinikum Hamburg-Eppendorf:
|
OCD obsessions cognitive |
Additional relevant MeSH terms:
|
Obsessive-Compulsive Disorder Anxiety Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 23, 2013