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Katz DE, Rector NA, McCabe RE, Hawley LL, Rowa K, Richter MA, Ornstein T, Regev R, McKinnon M, Laposa JM. The effect of aerobic exercise alone and in combination with cognitive behavioural therapy on obsessive compulsive disorder: A randomized control study. J Anxiety Disord 2023; 98:102746. [PMID: 37494756 DOI: 10.1016/j.janxdis.2023.102746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/17/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Cognitive behavioural therapy (CBT) has been found to be an effective treatment for OCD, but there remains a significant proportion of individuals who fail to show a treatment response. Aerobic exercise has previously been associated with decreases in anxiety and depression, as well as improvements in OCD symptoms in small-scale studies. The purpose of the present research was to use a randomized control trial design to examine the effects of exercise alone and in combination with CBT, on OCD symptoms and secondary symptoms. METHOD 125 participants were randomly assigned to one of four treatment groups: waitlist control, exercise, CBT, and CBT with exercise. OCD symptom severity was measured at four points over the course of treatment, secondary outcome measures were gathered at three points over treatment. RESULTS CBT alone and combined with exercise was associated with significantly greater OCD symptom reduction than exercise alone or the control groups. Total exercise frequency predicted OCD symptom reduction in the groups in which exercise was measured. Group membership did not significantly predict reductions in secondary outcome measures. CONCLUSION Exercise frequency, rather than the presence or absence of exercise, appears to predict OCD symptom reduction, as did participation in CBT.
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Affiliation(s)
- Danielle E Katz
- Forest Hill Centre for Cognitive Behavioural Therapy, Toronto, Ontario, Canada
| | - Neil A Rector
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada.
| | - Randi E McCabe
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lance L Hawley
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Karen Rowa
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Margaret A Richter
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Tish Ornstein
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Rotem Regev
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
| | - Margaret McKinnon
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Judith M Laposa
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada
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Mayorga NA, Brooks JR, Walker RL, Garey L, Cardoso JB, Garza M, Ochoa-Perez M, Lemaire C, Viana A, Zvolensky MJ. Evaluating the Role of Anxiety Sensitivity on Behavioral Health Outcomes among Latinx Persons. COGNITIVE THERAPY AND RESEARCH 2022; 46:31-42. [PMID: 37800123 PMCID: PMC10552789 DOI: 10.1007/s10608-021-10239-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 11/24/2022]
Abstract
Background Mexican Americans represent the largest subpopulation among Latinx persons and experience numerous health inequalities for psychological symptoms and behavioral health problems. First generation Mexican Americans are particularly vulnerable to such disparities and past work suggests that the experience of acculturative stress may play a vital role in terms of mental and physical health problems among this population. The current study sought to bridge past work on acculturative stress among first-generation Mexican Americans by exploring the role of anxiety sensitivity (AS; fear of the negative consequences of internal sensations) as a potential mediational factor in terms of psychological and behavioral health problems among this group. Methods The current study consisted of 369 first generation Mexican American persons (86.2% female, 40.1 years of age (SD = 11.1) years in the U.S. attending a Federally Qualified Healthcare Center located in an urban southwestern community. We explored whether AS served as a mediator between acculturative stress and some of the most common and disabling clinical problems among this group, including social anxiety, anxious arousal, general depression, insomnia and pain intensity and disability. Result Consistent with prediction, there was a statistically significant indirect effect of acculturative stress via AS across all criterion variables apart from pain intensity (depression [ab = - 0.17, SE = 0.05, 95% CI [0.08, 0.26]], insomnia [ab = 0.07, SE = 0.02, 95% CI [0.03, 0.10]], social anxiety [ab 0.05, SE = 0.02, 95% CI [0.02, 0.08]], anxious arousal [ab = 0.08, SE = 0.03, 95% CI [0.03, 0.12]], pain disability [ab = 0.05, SE = 0.02, 95% CI [0.02, 0.09]]). Comparative models were run to evaluate the specificity of hypothesized statistically significant models. For all models except anxious arousal and general depression, the alternative model was rejected, adding support to the hypothesized pathway. Conclusion Overall, this work provides initial support for the role of AS in terms of the relation between acculturative stress and numerous psychological and behavioral health problems among Mexican American adults in a clinical setting.
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Affiliation(s)
- Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jasmin R. Brooks
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Rheeda L. Walker
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | | | | | | | - Andres Viana
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J. Zvolensky
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
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Hawley LL, Rector NA, Segal ZV. The Relative Impact of Cognitive and Behavioral Skill Comprehension and Use During CBT for Obsessive Compulsive Disorder. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-020-10117-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Thiruchselvam T, Patel A, Daros AR, Jain E, Asadi S, Laposa JM, Kloiber S, Quilty LC. A multidimensional investigation of anxiety sensitivity and depression outcomes in cognitive-behavioral group therapy. Psychiatry Res 2020; 293:113446. [PMID: 32980716 DOI: 10.1016/j.psychres.2020.113446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/05/2020] [Indexed: 12/13/2022]
Abstract
We examined how anxiety sensitivity - the fear of symptoms of anxiety due to their perceived harmful effects - and gender are associated with treatment trajectory and outcomes in a large outpatient sample (N = 278) who received 14-weeks of cognitive-behavioral group therapy (CBGT) for depression. Three dimensions of anxiety sensitivity (cognitive, physical, and social concerns) and depression were assessed at pre-treatment, and the latter was assessed weekly during treatment. Latent growth curve models supported a link between cognitive concerns (fears of losing control over thoughts) and greater improvement in depression near the end of treatment (i.e., weeks 10-14); gender did not moderate trajectory. Gender (i.e., identifying as a woman) and greater physical concerns (fears of physical consequences of arousal symptoms) were associated with completion of < 8 sessions. Results suggest that those with more cognitive concerns might require greater time in treatment and/or benefit most from the focus on maladaptive assumptions and core beliefs in later CBGT sessions. Future research, including investigation of intervening variables, may elucidate the mechanisms through which greater physical concerns and gender are associated with treatment non-completion. Results supported differential associations of anxiety sensitivity dimensions with depression treatment outcomes, though further research attention is needed.
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Affiliation(s)
- Thulasi Thiruchselvam
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Alina Patel
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Alexander R Daros
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Esha Jain
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada
| | - Shayan Asadi
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada
| | - Judith M Laposa
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Stefan Kloiber
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.
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