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Repugnant obsessions are a common theme of intrusions in obsessive-compulsive disorder and are typically ego-dystonic. Exposure and response prevention (ERP) is the first-line intervention and involves in vivo and/or imaginal exposures. Many therapists are however reluctant to conduct ERP and the reasons remain unclear. Similarly, little is known about therapist preference for in vivo versus imaginal exposure for repugnant obsessions. To address these gaps, 200 therapists read vignettes of an in vivo and imaginal exposure for each repugnant obsession subtype and indicated whether they would have clients complete it. If not, they selected their primary refusal reason. Therapists were more likely to refuse in vivo (versus imaginal) exposures related to intentional/accidental harm, religion, and sexual orientation. There were no differences in willingness for pedophilic obsessions, with both forms receiving more refusals than approvals. 'Dangerous/harmful to client/others' and 'not necessary for therapeutic success' were most frequently selected as refusal reasons., Author(s): Jean-Philippe Gagné [sup.1] [sup.2] , Christina Puccinelli [sup.3] [sup.2] , Dubravka Gavric [sup.3] [sup.2] , Irena Milosevic [sup.3] [sup.2] , Randi McCabe [sup.3] [sup.2] , Noam Soreni [sup.3] [sup.2] [...]

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Cognitive behavioural therapy (CBT) including exposure and response prevention is the first‐line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in‐person delivery, few studies have assessed the role of therapist‐guided, manual‐based CBT for OCD delivered in real‐time via videoconferencing methods. The present study sought to fill this gap by comparing in‐person and online delivery of group‐based CBT for the treatment of OCD. A convenience sample of participants with moderate to severe OCD (n = 144) were recruited from a naturalistic database from two large OCD specialty assessment and treatment centres. Patients received group‐based CBT that was provided in‐person (pre‐COVID‐19 pandemic; March 2018 to March 2020) or online via videoconferencing (during the COVID‐19 pandemic; March 2020 to April 2021). In both delivery methods, treatment consisted of 2‐h weekly sessions led by trained clinicians. Analyses revealed that, regardless of treatment modality, both in‐person and online groups demonstrated significant, reliable, and statistically equivalent improvements in OCD symptoms post‐treatment. Videoconferenced, clinician‐led CBT may be a promising alternative to in‐person delivery for those with moderate to severe OCD symptoms. [ABSTRACT FROM AUTHOR]

This study examined cannabis use motives in individuals with anxiety disorders and compared motives between infrequent and frequent cannabis users. It was hypothesised that coping motives would be endorsed at a significantly higher rate than other motives, and that frequent cannabis users would endorse coping motives significantly more than infrequent users. Participants were 144 adults seeking clinical services for anxiety disorders who reported using cannabis. Cannabis use was categorized by infrequent (n = 54) and frequent (n = 90) use. Anxiety symptoms were assessed and deemed clinically significant. Participants completed measures of cannabis use motives, cannabis use patterns, and cannabis use disorder symptoms, cross-sectionally. Cannabis use motives were examined for the entire sample and compared between frequent and infrequent users. In general, cannabis users endorsed coping (i.e., use for managing distress) and enhancement (i.e., use for fun, pleasant feeling, or the high) motives at equal rates (p =.265) and more than other motives (p <.001). Frequent users reported using cannabis for coping and expansion motives (i.e., use to change one's thinking) significantly more than infrequent users. These results indicate that individuals with anxiety disorders use cannabis for various reasons, some of which may not be directly related to their mental health symptoms. Future research is needed to compare motives for cannabis use in those with anxiety disorders, other mental health populations, and the general population, as well as examine motives for cannabis use within specific anxiety disorders. [ABSTRACT FROM AUTHOR]

Although much is known about how intrusive thoughts become obsessions, the factors that determine which particular thoughts do so is not. The degree to which intrusions are personally significant may be such a determinant. Obsessive-compulsive disorder (OCD) is heterogeneous; thus, it is possible that contradictions of personal values may play a varying role in the development of obsessions depending on which OCD symptoms manifest and may change differentially following treatment. Archival data were examined. Patients with a diagnosis of OCD (N = 62) reported their most upsetting obsession and the degree to which it violated values both pre- and postparticipation in group cognitive-behavioral therapy for OCD. At pretreatment, contradiction ratings differed across symptom domains, such that participants with primary symptoms of obsessions/checking exhibited contradiction ratings that were significantly greater than did participants with other primary symptoms. Contradiction ratings did not change posttreatment. Implications for the conceptualization of OCD are discussed. [ABSTRACT FROM AUTHOR]

This article discusses issues related to the development and dissemination of evidence-based assessment strategies for anxiety disorders and associated problems. It begins with a review of the criteria that should be considered when determining whether particular assessment procedures are evidence-based. These include such factors as reliability, validity, cost-effectiveness, consumer acceptability, utility across different populations, and ease of dissemination. The importance of considering the purpose of the assessment process when deciding whether a procedure is evidence-based is emphasized. Next, the major assessment domains that are particularly important in the area of anxiety disorders (e.g., triggers for anxiety symptoms, avoidance behaviors) are reviewed. Finally, some potential obstacles to the dissemination of evidence-based assessment procedures are discussed along with suggestions for managing these obstacles.

Objectives: Those close to people with mental health difficulties (e.g., family members, romantic partners and close friends) are often involved in their care decisions. Research shows that criticism by close others and accommodation of symptoms are associated with symptom severity and treatment response. Recent research has found that those close to someone with an anxiety disorder report a range of concerns about their loved one starting cognitive‐behaviour therapy (e.g., that treatment will cause the person to change in undesirable ways). The purpose of this study was to examine the relationship between close others' criticism and symptom accommodation and their treatment concerns, hypothesizing that these relationships would be significant. Design: Close others to those with notable anxiety (N = 287) completed self‐report measures online. Multiple regression was used to test our hypothesis. Methods: Respondents who identified as being close to someone with notable anxiety completed measures of their accommodation of anxiety symptoms, feelings of criticism/hostility towards them, concerns about them starting treatment, perceived impairment due to anxiety, and their own and their loved ones' treatment history. Results: Greater criticism and accommodation significantly predicted greater treatment concerns, with a medium effect size, controlling for degree of impairment due to anxiety and treatment history. Conclusions: Criticism and accommodation may reflect appraisal of the person with anxiety as weak or fragile, which may evoke concerns about treatment success. Implications for clinicians and anxiety treatment are discussed. [ABSTRACT FROM AUTHOR]

Background: Safety behaviours are hypothesized to play a vital role in maintaining social anxiety disorder (SAD), in part by orienting socially anxious individuals to adopt an avoidance-based mindset focused on self-protection and self-concealment. Evidence suggests an association between safety behaviour use and negative social outcomes for individuals with SAD. However, research has largely focused on the broad group of safety behaviours, whereas specific subtypes have received less attention. Aim: The present study aimed to further our understanding of the negative interpersonal consequences of specific types of safety behaviours for individuals with SAD by examining whether active, inhibiting/restricting, or physical symptom management safety behaviour use affects perceived likeability and authenticity during a conversation with a stranger. Method: Individuals with SAD (n = 29; mean age 35.5 years) and healthy control (non-SAD) participants (n = 40; mean age 18.6 years) engaged in a semi-structured social interaction with trained confederates. Results: Participants with SAD were perceived as significantly less likeable and authentic by the confederates, and rated themselves as significantly less authentic compared with those without SAD. The association between group status and likeability was mediated by the use of inhibiting/restricting safety behaviours and the association between group status and participant-rated authenticity was mediated by the use of both inhibiting/restricting and active safety behaviours, but not physical symptom management strategies. Conclusions: These results contribute to a growing literature suggesting that some, but not all, safety behaviours may play an important role in creating the negative social outcomes that individuals with SAD experience. [ABSTRACT FROM AUTHOR]