Our lab has several grants that support numerous research studies on the cognitive-behavioral processes involved in anxiety/OCD and the treatment of OCD. Some of our major grant-funded projects are described below.
OCD Treatment Study: Exposure Therapy (ERP) and Acceptance and Commitment Therapy (ACT)
The most effective treatment for OCD is ERP, which entails confronting obsessional triggers (i.e., exposure) and resisting urges to ritualize (response prevention). But these techniques are challenging and anxiety-provoking, and between 25% and 50% of patients with access to ERP refuse it, drop out prematurely, or do not adhere to the treatment instructions. As a result, they show attenuated response. Given the effectiveness of ERP, it is important to develop ways to make it more tolerable and increase patient adherence. In this study, we consider Acceptance and Commitment Therapy (ACT), which has recently been studied for OCD, as a way to address the tolerability and adherence issues with ERP. ACT fosters a willingness to experience unwanted inner experiences (e.g., obsessional thoughts, anxiety) and is consistent with ERP. We are comparing traditional ERP to ERP+ACT and hypothesize that adding ACT to ERP will help patients (a) engage in ERP tasks, (b) confront high levels of anxiety without using escape/avoidance strategies, and (c) resist rituals. This study is a collaboration with colleagues at Utah State University.
Research Consortium on Intrusive Fear (RCIF)
The RCIF is an international group of 17 psychologists and psychiatrists from 12 countries who are conducting research on the nature of intrusive fearful thoughts and images. New research tools to understand the origins, persistence and management of intrusive fear have been developed, and there are a number of key questions directing the our research agenda: Do people from different countries have the same personal fears? What is the most effective way to get rid of intrusive fear? What causes some people to develop an anxiety disorder from their intrusive fearful thoughts? What is the most effective way to treat more extreme and persistent intrusive fear? What do individuals learn from their society about how to deal with intrusive fearful thoughts? Are some religious and cultural teachings more helpful than others? What can we learn from different cultures about the management of fearful intrusive thoughts?
Other Ongoing Research
Our lab is also conducting research in the following areas:
- Intolerance of uncertainty – The most widely used way of assessing this phenomenon is through self-report questionnaires. We are currently developing and evaluating a paradigm for measuring intolerance of uncertainty behaviorally so that we can manipulate variables we believe moderate this phenomenon.
- Mechanisms of exposure therapy – We are very interested in inhibitory learning approaches to exposure and potential ways to optimize long-term outcome of this effective treatment for anxiety. Current studies focus on ways of enhancing exposure therapy using an inhibitory learning approach for obsessional thoughts and for spider fears.
- Attentional biases in OCD and related problems – we just completed two studies examining (a) attentional bias for religion-related words in scrupulosity, and (b) health-related stimuli in health anxiety. We are currently writing up and publishing the results of these dot probe studies.
- Cognitive biases in OCD and other anxiety-related problems – We are interested in the cognitive biases that maintain OCD and other related problems and have published numerous self-report and experimental studies on this topic. A recent study examined biases contributing to health anxiety during the recent Ebola outbreak and scare. Another looked at how perceptions of uncertainty and risk contribute to the perception of threat in common situations. One of our current studies examines whether repeated mirror checking (looking at a disliked facial feature, a neutral feature, or a control condition) causes memory distrust.
- Interpersonal aspects of OCD and related problems – We are presently conducting two studies in this area. One examines the predictors of family accommodation among relatives of those with anxiety disorders and OCD. The second is a treatment study using a couple-based cognitive-behavioral treatment for body dysmorphic disorder.
Check out some of our most recent journal articles based on these studies here.