title: Does imagined exposure to the consequences of not ritualising enhance live exposure for OCD? A controlled study. II. Effect on behavioural v. subjective concordance of improvement.
abstract: BACKGROUND
  This study tested whether adding imagined exposure to live exposure would increase the concordance between behavioural and subjective improvement in obsessive-compulsive disorder (OCD).
  
  
  METHODS
  46 OCD out-patients were randomly allocated to 9 weekly sessions of either combined live+imagined exposure/ritual prevention (Exi, n = 23), or only live exposure/ritual prevention (Ex, n = 23). Patients were asked to do 90 min of daily self-exposure at home (corresponding to Exi or Ex). Measures were: (A) behavioural; (B) subjective; (C) clinical global impression (CGI).
  
  
  RESULTS
  After 9 weeks of treatment, improvement was greater on behavioural than subjective measures (similar for the Exi and Ex groups). At 20 weeks (3-month follow-up) each group had improved slightly more on subjective measures and slightly less on behavioural ones. Two subjective measures improved less during Exi than Ex, but this difference disappeared at follow-up. The greater difference between behavioural and subjective improvement scores in Exi than in Ex did not relate to clinical outcome at the end of treatment or follow-up.
  
  
  CONCLUSIONS
  Compared to live exposure alone, combined imagined plus live exposure did not enhance behavioural/subjective concordance.
authors.affiliation: Institute of Psychiatry, London, UK.
authors.forename: L M
authors.initials: LM
authors.lastname: Ito
authors.forename: I M
authors.initials: IM
authors.lastname: Marks
authors.forename: L A
authors.initials: LA
authors.lastname: de Araujo
authors.forename: D
authors.initials: D
authors.lastname: Hemsley
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003887:Desensitization, Psychologic / Q000379:methods*; D005260:Female; D006801:Humans; D007092:Imagination; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team; D013239:Stereotyped Behavior; D016896:Treatment Outcome