title: Change in obsessive beliefs as predictor and mediator of symptom change during treatment of obsessive-compulsive disorder - a process-outcome study.
abstract: Cognitive models of obsessive-compulsive disorder suggest that changes in obsessive beliefs are a key mechanism of treatments for obsessive-compulsive disorder. Thus, in the present process-outcome study, we tested whether changes in obsessive beliefs during a primarily cognitive behavioral inpatient treatment predicted treatment outcome and whether these changes mediated symptom changes over the course of treatment.
  
  
  
  Seventy-one consecutively admitted inpatients with obsessive-compulsive disorder were assessed with the Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire at treatment intake, after six weeks of treatment and at discharge, and with the Beck-Depression-Inventory-II at intake and discharge.
  
  
  
  Changes in obsessive beliefs during the first six weeks of treatment predicted obsessive-compulsive symptoms at discharge when controlling for obsessive-compulsive and depressive symptoms at intake in a hierarchical regression analysis. Multilevel mediation analyses showed that reductions in obsessive beliefs partially mediated improvements in obsessive-compulsive symptoms over time.
  
  
  
  Our findings indicate that decreasing obsessive beliefs in inpatient cognitive behavioral therapy for obsessive-compulsive disorder might be a promising treatment approach.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nußbaumstr. 7, 80336, Munich, Germany. alice.diedrich@med.uni-muenchen.de.
authors.forename: Alice
authors.initials: A
authors.lastname: Diedrich
authors.affiliation: Department of Psychology, University of Munich (LMU), Leopoldstr. 13, 80802, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sckopke
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nußbaumstr. 7, 80336, Munich, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Schwartz
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nußbaumstr. 7, 80336, Munich, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Schlegl
authors.affiliation: Schön Clinic Bad Bramstedt, Birkenweg 10, 24576, Bad Bramstedt, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Osen
authors.affiliation: Schön Clinic Bad Bramstedt, Birkenweg 10, 24576, Bad Bramstedt, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Stierle
authors.affiliation: Schön Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany.|Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, 79104, Freiburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Voderholzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D003469:Culture; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult
keywords: Change mechanism; Cognitive behavioral therapy; Inpatient treatment; Mediator; Obsessive beliefs; Obsessive-compulsive disorder