Abstract

Accurate assessment of obsessions and compulsions is a crucial step in treatment planning for Obsessive-Compulsive Disorder (OCD). In this clinical case study, we sought to determine if the use of Ecological Momentary Assessment (EMA) could provide additional symptom information beyond that captured during standard assessment of OCD. We studied three adults diagnosed with OCD and compared the number and types of obsessions and compulsions captured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) compared to EMA. Following completion of the Y-BOCS interview, participants then recorded their OCD symptoms into a digital voice recorder across a 12-h period in reply to randomly sent mobile phone SMS prompts. The EMA approach yielded a lower number of symptoms of obsessions and compulsions than the Y-BOCS but produced additional types of obsessions and compulsions not previously identified by the Y-BOCS. We conclude that the EMA-OCD procedure may represent a worthy addition to the suite of assessment tools used when working with clients who have OCD. Further research with larger samples is required to strengthen this conclusion.

Highlights

  • Obsessive-Compulsive Disorder (OCD) is a disabling anxiety disorder characterized by upsetting, unwanted cognitions and intense and time consuming recurrent compulsions (American Psychiatric Association, 2000)

  • Number of reported symptoms Table 2 provides a summary of the frequency and type of symptoms recorded during both the face-to-face session, which will be referred to as the YaleBrown Obsessive Compulsive Scale (Y-BOCS) data and the EMA-OCD phase for the study, which will be referred to as the EMA–OCD data

  • As can be seen when comparing the data contained in the two columns, there are variations between the Y-BOCS data and the EMA-OCD data

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Summary

Introduction

Obsessive-Compulsive Disorder (OCD) is a disabling anxiety disorder characterized by upsetting, unwanted cognitions (obsessions) and intense and time consuming recurrent compulsions (American Psychiatric Association, 2000). The idiosyncratic nature of the symptoms of OCD (Whittal et al, 2010) represents a challenge to completing accurate and comprehensive assessments, which if not achieved, can have a deleterious effect on the provision of effective treatment for the disorder (Kim et al, 1989; Taylor, 1995; Steketee and Barlow, 2002; Deacon and Abramowitz, 2005). Assessing the full range of symptoms of OCD requires reliable and psychometrically sound diagnostic instruments and measures (Taylor, 1995, 1998; Rees, 2009) alongside the standard clinical interview. PARTICIPANTS AND SETTING Participants were recruited through clients presenting to the OCD clinic at Curtin University. They were assessed using the Structured Clinical Interview for DSM-IV (SCID-IV) (First et al, 1997). In order to ensure that participants remain anonymous, pseudonyms have been used

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