Introduction: Inference-based cognitive-behavioral therapy (I-CBT) is a specialized psychological treatment for obsessive-compulsive disorder (OCD) without deliberate and prolonged exposure and response prevention (ERP) that focuses on strengthening reality-based reasoning and correcting the dysfunctional reasoning giving rise to erroneous obsessional doubts and ideas. Objective: The present study aimed to evaluate the effectiveness of I-CBT through a comparison with appraisal-based cognitive behavioral therapy (A-CBT) and an adapted mindfulness-based stress reduction (MBSR) intervention. Methods: This was a two-site, parallel-arm randomized controlled trial (RCT) comparing I-CBT with A-CBT. The MBSR intervention acted as a non-specific active control condition. Following formal evaluation, 111 participants diagnosed with OCD were randomly assigned. The principal outcome measure was the Yale-Brown Obsessive-Compulsive Scale. Results: All treatments significantly reduced general OCD severity and specific symptom dimensions without a significant difference between treatments. I-CBT was associated with significant reductions in all symptom dimensions at post-test. Also, I-CBT led to significantly greater improvement in overvalued ideation, as well as significantly higher rates of remission as compared to MBSR at mid-test. Conclusions: I-CBT and MBSR appear to be effective, alternative treatment options for those with OCD that yield similar outcomes as A-CBT. I-CBT may have an edge in terms of the rapidity by which patients reach remission, its generalizability across symptom dimension, its potentially higher level of acceptability, and effectiveness for overvalued ideation. Future research is needed to assess whether additional alternative treatments options can help to increase the number of people successfully treated.
Psychother Psychosom

中文翻译：

---

强迫症基于推理的认知行为疗法的评估：具有三种治疗方式的多中心随机对照试验

简介：基于推理的认知行为疗法（I-CBT）是一种针对强迫症（OCD）的专门心理治疗，无需刻意和长时间的暴露和反应预防（ERP），重点是加强基于现实的推理和纠正功能失调的导致错误的强迫性怀疑和想法的推理。目的：本研究旨在通过与基于评估的认知行为疗法（A-CBT）和适应正念减压（MBSR）干预的比较来评估 I-CBT 的有效性。方法：这是一项比较 I-CBT 与 A-CBT 的两中心平行臂随机对照试验 (RCT)。MBSR 干预充当非特定的主动控制条件。在正式评估后，111 名被诊断患有强迫症的参与者被随机分配。主要结果测量是耶鲁-布朗强迫症量表。结果：所有治疗均显着降低了一般强迫症的严重程度和特定症状维度，而治疗之间没有显着差异。I-CBT 与测试后所有症状维度的显着降低相关。此外，与测试中期的 MBSR 相比，I-CBT 显着改善了被高估的想法，以及显着更高的缓解率。结论：对于 OCD 患者，I-CBT 和 MBSR 似乎是有效的替代治疗选择，其产生与 A-CBT 相似的结果。I-CBT 可能在患者达到缓解的速度、其在症状维度上的普遍性、其潜在的更高水平的可接受性以及对高估观念的有效性方面具有优势。未来的研究需要评估额外的替代治疗方案是否有助于增加成功治疗的人数。
心理治疗师