Internet-delivered CBM-C for OC-symptoms
Condition: Obsessive-compulsive Disorders and Symptoms; Obsessive Thoughts; Obsessive Compulsive Behavior
MeSH terms: Obsessive-Compulsive Disorder; Compulsive Behavior
Study type: Interventional

Summary: 
      A factorial randomised controlled trial comparing internet-delivered combined cognitive bias
      modification intervention (iCBM-C) versus internet-delivered CBM-interpretation intervention
      (iCBM-I), internet-delivered CBM-attention intervention (iCBM-A) and wait-list control on
      obsessive-compulsive (OC) symptoms, OC-beliefs, OC-related interpretation and attention
      biases
    

Detailed description: 
      Cognitive behavioral therapy, consisting of exposure and response prevention and cognitive
      restructuring, is still one of the most effective treatments for obsessive compulsive
      disorder. However, some patients do not fully benefit from the treatment. This condition
      results in more search for novel approaches that can contribute to effectiveness of standard
      treatments. In this regard, the use of technology-based methods in recent researches is
      noteworthy. Cognitive bias modification (CBM) is one of these current efforts of
      technology-based methods. CBM involves computerized tasks designed to modify some cognitive
      biases such as attention and interpretation associated with psychopathology, particularly
      anxiety disorders. Researches have generally demonstrated that cognitive bias modification
      can be effective way to alter cognitive biases and to reduce anxiety symptoms. In recent
      years, there have been also some studies to investigate the potential effects of cognitive
      bias modification for obsessive compulsive disorder.The results of both CBM-Interpretation
      (CBM-I) and CBM-Attention (CBM-A) studies have shown that it is an effective and promising
      method in reducing cognitive biases in obsessive compulsive disorder (OCD). Although these
      studies are highly informative, they do not provide information about the causal role one
      bias has during the operation of another. In recent years, there has been a growing consensus
      that both biases arise from the same system, thereby, it is possible that modifying the
      system to alter one bias (e.g., attention), will also impact on the presence of the other
      bias.). In line with this notion, there are a couple of studies to test the effect of
      Combined Cognitive Bias Modification (CBM-C) which is combination of both CBM-A and CBM-I in
      intervention programs. The results of these studies are generally very positive. Although it
      is well established that attention bias and interpretation bias each have a key role in the
      development and maintenance of OCD, only one bias is targeted in CBM studies of OCD.
      Considering that a "combined cognitive bias" may contribute to the maintenance of several
      disorders, in order to try to maximise the potential clinical impact, the present research
      aims at exploring whether the combination of the CBM-A and CBM-I procedures would be more
      effective in reducing cognitive biases and OC symptoms than either alone. It is expected that
      internet-delivered CBM-C (iCBM-C) will result in superior treatment outcomes as indexed by
      internet-delivered CBM-I intervention only (iCBM-I), internet-delivered CBM-A intervention
      only (iCBM-A), and wait-list control (WLC).
    

Intervention name(s): Internet-delivered Combined Cognitive Bias Modification (iCBM-C); Internet-delivered Cognitive Bias Modification-Interpretation (iCBM-I); Internet-delivered Cognitive Bias Modification-Attention (iCBM-A)
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The iCBM-C is online CBM intervention which is the combination of iCBM-I and iCBM-A interventions for obsessive-compulsive symptoms delivered in eight sessions, twice per week for 4 weeks. The presentation order of the two intervention components will be counterbalanced to allow exploration of any order effects. Thereby, half of the participants in iCBM-C group will complete the iCBM-A task followed by iCBM-I, while the other half will complete the iCBM-I task followed by iCBM-A during each session.; The iCBM-I is online CBM intervention for obsessive-compulsive symptoms comprised of delivery of OCD related scenarios taking place over eight sessions, twice per week for 4 weeks.; The iCBM-A is online CBM intervention for obsessive-compulsive symptoms comprised of delivery of the modified dot-probe task taking place over eight sessions, twice per week for 4 weeks.
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: Factor 1: Cognitive Bias Modification-Interpretation (yes or no)
Factor 2: Cognitive Bias Modification-Attention (yes or no)
Each participant will be randomized to one of four conditions:
Condition 1: Cognitive Bias Modification-Interpretation and Cognitive Bias Modification-Attention
Condition 2: Cognitive Bias Modification-Interpretation and No Cognitive Bias Modification-Attention
Condition 3: No Cognitive Bias Modification-Interpretation and Cognitive Bias Modification-Attention
Condition 4: No Cognitive Bias Modification-Interpretation and No Attention Bias Modification-Attention
Masking: Single (Participant)
Primary purpose: Treatment