title: Further evidence for the efficacy of association splitting as a self-help technique for reducing obsessive thoughts.
abstract: BACKGROUND
  Despite improved treatment options, many people with obsessive-compulsive disorder (OCD) do not seek or even actively avoid therapy due to shame or fear of stigmatization. Self-help treatment is increasingly acknowledged as a means to "treat the untreated" and to motivate patients for face-to-face psychotherapy. Our group has gathered preliminary evidence for the efficacy of a novel self-help approach entitled association splitting (AS) aimed at the reduction of obsessions.
  
  
  METHODS
  For this study, a total of 46 participants with a likely diagnosis of OCD were randomly allocated to either AS or a waitlist control (WL). Treatment consisted of the self-study of a manual sent via e-mail. At baseline and four weeks later symptoms were assessed online using the self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Beck Depression Inventory (BDI).
  
  
  RESULTS
  A total of 74% of the initial sample took part in the re-assessment. Results were in accordance with prior uncontrolled data indicating that AS is a feasible approach leading to a symptom decline of approximately 25% on the Y-BOCS. The technique also exerted a positive effect on depression (BDI) and the OCI-R subscale obsessive thoughts.
  
  
  CONCLUSIONS
  The study confirms the feasibility and efficacy of AS for a subgroup of patients with OCD. Ongoing studies explore whether short-term effects are maintained over time and whether therapist-guided therapy may enhance the efficacy of AS.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. moritz@uke.uni-hamburg.de
authors.forename: Steffen
authors.initials: S
authors.lastname: Moritz
authors.forename: Lena
authors.initials: L
authors.lastname: Jelinek
mesh_terms: D000328:Adult; D001245:Association Learning; D001521:Behavior Therapy / Q000379:methods*; D003463:Cues; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D012648:Self Care / Q000379:methods*; D012660:Semantics; D011795:Surveys and Questionnaires