Anxiety Sensitivity Accelerates the Temporal Changes in Obsessions and Compulsions During Cognitive Behavioral Therapy

Background Although obsessive compulsive disorder (OCD) is effectively treated by cognitive behavior therapy (CBT), less is known about mechanisms underlying treatment response. Anxiety sensitivity (AS) may impact symptom change (velocity) and the rate of change in velocity (acceleration) during CBT for OCD. Latent Difference Score (LDS) analysis was used to show path-analytic dynamic modelling of OCD symptom velocity and acceleration during CBT, as a function of baseline AS. Method Eighty-four participants with a principal diagnosis of OCD completed 12 weeks of CBT group therapy, and measures assessing AS at pre-treatment, and obsession and compulsion severity at pre-treatment, sessions 4, 8, and end of treatment. Results LDS velocity models demonstrated that higher levels of baseline AS were associated with subsequent elevations in obsessions throughout treatment, and obsession scores were temporally associated with subsequent changes in compulsion scores. An LDS acceleration model demonstrated that higher levels of baseline AS scores were associated with rapid increases in the severity of obsessions, whereas lower AS scores were associated with rapid decreases in the severity of obsessions. Discussion These results have implications for theoretical and treatment modelling of obsessions and compulsions, as well as AS, in OCD. Conclusion Higher levels of baseline AS negatively impact response to CBT for OCD.