The Efficacy of Self-Administered Danger Ideation Reduction Therapy for a 50-year Old Woman with a 20 Year History of Obsessive- Compulsive Disorder: A Case Study
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 32797
The Efficacy of Self-Administered Danger Ideation Reduction Therapy for a 50-year Old Woman with a 20 Year History of Obsessive- Compulsive Disorder: A Case Study

Authors: Mairwen K. Jones, Lynne Harris, Lisa D. Vaccaro

Abstract:

Obsessive-Compulsive Disorder (OCD) is a common and disabling condition. Therapist-delivered treatments that use exposure and response prevention have been found to be very effective in treating OCD, although they are costly and associated with high rates of attrition. Effective treatments that can be made widely available without the need for therapist contact are urgently needed. This case study represents the first published investigation of a self-administered cognitive treatment for OCD in a 50-year old female with a 20 year history of OCD. The treatment evaluation occurred over 27 weeks, including 12 weeks of self-administration of the Danger Ideation Reduction Therapy (DIRT) program. Decreases of between 23% to 33% on measures from pre-treatment to follow-up were observed. Bearing in mind the methodological limitations associated with a case study, we conclude that the results reported here are encouraging and indicate that further research effort evaluating the effectiveness of self-administered DIRT is warranted.

Keywords: Anxiety Treatment, Cognitive Therapy, Danger Ideation Reduction Therapy, Obsessive–Compulsive Disorder, Self- Administered Danger Ideation Reduction Therapy.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1056094

Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 1719

References:


[1] Australian Bureau of Statistics, Australian Social Trends: Future population growth and ageing, Cat. no. 4102.0. Canberra: Author, 2009.
[2] L. M. Drummond, A. Pillay, P. Kolb, and S. Rani, "Specialised inpatient treatment for severe, chronic, resistant obsessive-compulsive disorder," Psychiatric Bulletin, vol. 31, pp. 49-52, 2007.
[3] C. Mathers, T. Vos, and C. Stevenson, The burden of disease and injury in Australia. Canberra: Australian Institute of Health and Welfare, 1999.
[4] American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 4th ed., text revised, Washington, DC: Author, 2000.
[5] H. Ghassemzadeh, A. Khamseh, and N. Ebrahimkhani, "Demographic variables and clinical features of Obsessive-Compulsive Disorder in Iran: a second report," in Obsessive Compulsive Disorder research, B. E. Ling, Ed, pp. 243-271, 2005.
[6] H. Matsunaga, K. Maebayashi, K. Hayashida, K. Okino, T. Matsui, T. Iketani, et al., Symptom Structure in Japanese Patients With Obsessive- Compulsive Disorder. Am. J. Psychiatry, vol. 165, pp. 251-253, 2008.
[7] H. J. Watson and C. S. Rees, "Meta-analysis of randomized, controlled treatment trials for pediatric obsessive-compulsive disorder," J.Child Psychol.Psychiatry Allied Disciplines, 49(5), 489-498. 2008
[8] I. Gava, C. Barbui, E. Aguglia, D. Carlino, R. Churchill, M. De Vanna, and H. F. McGuire, "Psychological treatments versus treatment as usual for obsessive compulsive disorder (OCD)," Cochrane Database of Syst. Rev., Issue 2, Art. No.: CD005333, April 2007, DOI: 10.1002/14651858.CD005333.pub2.
[9] E. B. Foa, M. L. Liebowitz, M. J. Kozak, S. Davies, R. Campeas, M. E. Franklin, et al., "Randomized, Placebo-Controlled Trial of Exposure and Ritual Prevention, Clomipramine, and Their Combination in the Treatment of Obsessive-Compulsive Disorder," Am. J. Psychiatry, vol. 162, pp. 151-161, 2005.
[10] G. P. J. Keijsers, C. A. L. Hoogduin, and C. P. D. R. Schaap, "Predictors of treatment outcome in the behavioural treatment of obsessivecompulsive disorder," Br. J. Psychiatry, vol. 152, pp. 781-786, 1994.
[11] M. L. Whittal, M. Robichaud, D. S. Thordarson, and P. D. McLean, "Group and individual treatment of Obsessive-Compulsive Disorder using Cognitive Therapy and Exposure Plus Response Prevention: a 2- Year follow-up of two randomized trials," J. Consul. Clin. Psychol., vol, 76, pp. 1003-1014, 2008.
[12] M. K. Jones and R. G. Menzies, "Danger Ideation Reduction Therapy (DIRT) for obsessive-compulsive washers. A controlled trial," Behav. Res. Ther., vol, 36, pp. 959-970, 1998.
[13] T. St Clare, R. G. Menzies, and M. K. Jones, Danger Ideation Reduction (DIRT) for obsessive-compulsive washers: A comprehensive guide to treatment. Bowen Hills QLD: Australian Academic Press, 2008.
[14] M. K. Jones and R. G. Menzies, "The role of perceived danger in the mediation of obsessive-compulsive washing," Depress. Anxiety, vol. 8, pp. 121-125, 1998.
[15] A. Krochmalik, M. K. Jones, R. G. Menzies, and K. Kirkby, "The Superiority of Danger Ideation Reduction Therapy (DIRT) over Exposure and Response Prevention (ERP) in Treating Compulsive Washing," Behav. Change, vol. 21, pp. 251-268, 2004.
[16] A. Krochmalik, M. K. Jones, and R. G. Menzies, "Danger Ideation Reduction Therapy (DIRT) for treatment-resistant compulsive washing," Behav. Res. Ther., vol, 39, pp. 897-912, 2001.
[17] M. K. Jones and R. G. Menzies, "Danger Ideation Reduction Therapy (DIRT): preliminary findings with three obsessive-compulsive washers," Behav. Res. Ther., vol, 35, pp. 955-960, 1997.
[18] J. Hambridge and M. Loewenthal, "Treating Obsessive Compulsive Disorder: a new role for infectious diseases physicians?" Int. J. Infectious Diseases, vol. 7, pp. 152-155, 2003.
[19] M. O-Brien, M. K. Jones and R. G. Menzies, "Danger Ideation Reduction Therapy (DIRT) for intractable, adolescent compulsive washing: a case study," Behav. Change, vol. 21, pp. 57-65, 2004.
[20] T. St Clare, "Danger Ideation Reduction Therapy (DIRT) for atypical Obsessive-Compulsive Disorder: a case study," Behav. Change, vol. 21, pp. 186-196, 2004.
[21] S. Govender, L. M. Drummond and R. G. Menzies, "Danger Ideation Reduction Therapy for the treatment of severe, chronic and resistant Obsessive-Compulsive Disorder," Behav. Cogn. Psychother., vol. 34, pp. 477-480, 2006.
[22] L. M. Drummond and P. Kolb, "Obsessive-compulsive contamination fears and Anorexia Nervosa: the application of the new psychoeducational treatment of Danger Ideation Reduction Therapy (DIRT)," Behav. Change, vol. 25, pp. 44-50, 2008.
[23] L. D. Vaccaro, M. K. Jones, R. G. Menzies, and T. St. Clare, Danger Ideation Reduction Therapy for Obsessive- Compulsive Checkers: A Comprehensive Guide to Treatment, Bowen Hills, QLD: Australian Academic Press, 2010.
[24] L. D. Vaccaro, M. K. Jones, R. G. Menzies, and B.M. Wootton, "Danger Ideation Reduction Therapy for obsessive-compulsive checking: preliminary findings," Cogn. Behav.Therapy, vol. 39, no. 4, pp. 293-301, 2010.
[25] M. Kenwright, I. Marks, C. Graham, A. Franses, and D. Mataix-Cols, "Brief scheduled phone support from a clinician to enhance computeraided self-help for obsessive-compulsive disorder: randomized controlled trial," J. Clin. Psychology, vol. 61, no. 12, pp. 1499-1508, 2005.
[26] B. Fireman, L. M. Koran, J. L. Leventhal and A. Jacobson, "The prevalence of clinically recognized Obsessive-Compulsive Disorder in a large health maintenance organization," Am. J. Psychiatry, vol. 158, pp. 1904-1910, 2001, DOI: 10.1176/appi.ajp.158.11.1904
[27] G. S. Steketee, "Disability and family burden in obsessive-compulsive disorder," Canadian J. Psychiatry, vol. 42, pp. 919-928, 1997.
[28] L. Marques, N. J. LeBlanc, H. M. Weingarden, K. R. Timpano, E. A. Jenike, and S. Wilhelm, "Barriers to treatment and service utilization in Internet sample of individuals with obsessive-compulsive symptoms," Depress. Anxiety, vol. 27, pp. 470-475, 2010.
[29] I. M. Marks, Living with fear. New York: McGraw-Hill, 1978.
[30] I. M. ÔÇÿMarks, "Behaviour therapy for obsessive-compulsive disorder: a decade of progress, Canadian J. Psychiatry, vol. 42, pp. 1021-1027, 1997.
[31] L. Harris and R.G. Menzies, "Training, resources and service provision," in Obsessive-Compulsive Disorder: Theory, research and treatment, R.G. Menzies and P. de Silva, Eds., UK: Wiley, pp. 349-359, 2003.
[32] J. H. Barlow, D. R. Ellard, J. M. Hainswoth, F. R. Jones, and A. Fisher, "A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders," Acta Psychiatr. Scand., vol. 111, pp. 272-285, 2005.
[33] K. M. Griffiths and H. Christensen, "Review of randomised controlled trials of Internet interventions for mental disorders and related conditions," Clin. Psychologist, vol. 10, pp. 16-29, 2006, doi: 10.1080/13284200500378696
[34] N. L. McKendree-Smith, M. Floyd, and F. R. Scogin, "Self-administered treatments for depression: A review," J. Clin. Psychology, vol. 59, pp. 275-288, 2003, doi: 10.1002/jclp.10129
[35] J. H. Greist, I. M. Marks, L. Baer, K. A. Kobak, K. W. Wenzel, M. J. Hirsch, et al., "Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control," J. Clin. Psychiatry, vol. 63, no. 2, pp. 138-145, 2002.
[36] D.F. Tolin, S. Hannan, N. Maltby, G.J. Diefenbach, P. Worhunsky, and R.E. Brady, "A randomized controlled trial of self-directed versus therapist-directed cognitive-behavioral therapy for obsessive- compulsive disorder patients with prior medication trials," Behav. Therapy, vol. 38, pp. 179-191, 2007.
[37] M. Bachofen, A. Nakagawa, I. M. Marks, J. M. Park, J. H. Greist, L. Baer, et al., "Home self-assessment and self-treatment of obsessive- compulsive disorder using a manual and a computer-conducted telephone interview: replication of a U.K.-U.S. study," J. Clin. Psychiatry, vol. 60, no. 8, pp. 545-549, 1999.
[38] B. M. Wootton, N. Titova, B. F. Dear, J. Spence, G. Andrews, L. Johnston, and K. Solley, "An Internet administered treatment program for obsessive-compulsive disorder: A feasibility study," J. Anxiety Disorders, vol. 25, pp. 1102- 1107, 2011.
[39] World Health Organisation, Composite International Diagnostic Inventory, Core, Version 2.1, Geneva: Author, 1997.
[40] W. K. Goodman, L. H. Price, S. A. Rasmussen, C. Mazure, R. L. Fleischmann, C. L. Hill, et al., "The Yale-Brown obsessive-compulsive scale: Part 1 development, use and reliability," Arch. Gen. Psychiatry, vol. 46, pp. 1006-1011, 1989.
[41] W. K. Goodman, L. H. Price, S. A. Rasmussen, C. Mazure, P. Delgado, G. R. Heninger, et al., "The Yale-Brown obsessive-compulsive scale: Part 2. Validity," Arch. Gen. Psychiatry, vol. 46, pp. 1012-1016, 1989.
[42] D S. Thordarson, A.S. Radomsky, S. Rachman, R. Shafran, C. N. Sawchuk and A. R. Hakstian, "The Vancouver Obsessional Compulsive Inventory (VOCI)," Behav. Res. Ther., vol. 42, pp. 1289-1314, 2004.
[43] C. L., Parrish, A. J., Ouimet, A. R., Ashbaugh, A. S., Radomsky, and K. P. O-Connor, "Psychometric properties of the Vancouver Obsessional- Compulsve Inventory and the Symmetry, Ordering and Arranging Questionnaire: French Translations," poster presented at the European & British Associations of Behavioural and Cognitive Psychotherapies Joint Conference, Manchester, UK, September, 2004.
[44] A. T. Beck, R. A. Steer, and G. K. Brown, Beck Depression Inventory - Second Edition manual, San Antonio, TX: The Psychological Corporation, 1996.
[45] A. T. Beck, R. A. Steer, R. Ball, and W. F. Ranieri, "Comparison of the Beck Depression Inventories-IA and -II in psychiatric outpatients," J. Personality Assessment, vol. 67, pp. 588-797, 1996.
[46] M. K. Jones, L. Harris, L. D. Vaccaro, R. G. Menzies, and T. St. Clare, Danger Ideation Reduction Therapy (DIRT) for Obsessive-Compulsive Washing: A Self-Help Guide to Treatment, unpublished manuscript.
[47] T.D. Borkovec and S. D. Nau, "Credibility of analogue therapy rationales," J. Behav Ther. Exp. Psychiatry, vol. 3, pp. 257-260, 1972.
[48] N., Kazantzis, F. Dean, and K.R. Ronan, "Homework assignments in Cognitive and Behavioural Therapy: A meta-analysis," Clin. Psychology: Sci. Practice, vol. 7, pp. 189-202, 2000.
[49] P. L., Fisher and A. Wells, "How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis," Behav. Res. Ther., vol. 43, no. 12, pp. 1543-1558, 2005.
[50] Clomipramine Collaborative Study Group, "Clomipramine in the treatment of patients with obsessive compulsive disorder," Arch. Gen. Psychiatry, vol. 48, pp. 730-738, 1991.