Feared consequences, fixity of belief, and treatment outcome in patients with obsessive-compulsive disorder

In this study we examined the degree to which the presence of feared conseq uences and poor insight into obsessive-compulsive symptoms influenced the e fficacy of behavior therapy for Obsessive-Compulsive Disorder (OCD). We als o examined whether beliefs associated with patients' obsessions changed fol lowing treatment. Twenty OCD patients, with and without articulated feared consequences, received treatment by exposure and response (ritual) preventi on (EX/RP). Patients' degree of insight into the senselessness of their obs essional beliefs was measured. Those who articulated fears of disastrous co nsequences tended to benefit more from EX/RP than those who did not express such fears. However, patients who were extremely certain that their feared consequences would occur evidenced poorer outcome than patients with mild or moderate certainty, despite the reduction of such certainty at posttest.