Neural Mechanisms of Obsessive-compulsive Disorder (OCD) Treatment Failure

Study Overview
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Brief Summary
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The aim of this study is to understand why patients with obsessive-compulsive disorder (OCD) fail in therapy. To understand the neural mechanisms involved in exposure therapy that support success and clinical improvement in order to improve therapy outcomes for OCD patients.

Detailed Description
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A course of therapy is recommended for individuals with obsessive-compulsive disorder (OCD). It is usually a type of cognitive behavioural therapy (CBT) with exposure and response prevention (ERP). In this study the investigators assess patients pre-therapy and post-therapy evaluating symptom severity (measured by the Y-BOCS) and decision-making (measured by online questionnaires and computer-based behavioural tasks). To examine how decisions are formed in patients undergoing OCD CBT, how behaviour changes after a non-pharmacological therapy module and how it is associated to the alleviation of OCD symptoms. The study, which will recruit 90 patients, is based at University College London - Wellcome Centre for Human Neuroimaging. This study is a part of the Cognitive and Neural Networks in Psychiatry (CNNP) study.

Official Title
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Cognitive and Neural Networks in Psychiatry (CNNP): Neural Mechanisms of Obsessive-compulsive Disorder (OCD) Treatment Failure (ERP in Silico)

Conditions
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Obsessive-Compulsive Disorder

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of obsessive-compulsive disorder (OCD) Fluent in written and spoken English Normal/corrected to normal vision Expecting to start OCD therapy Exclusion Criteria: Autism spectrum disorder, psychosis, schizophrenia, addiction, substance abuse, bipolar, hoarding, or Tourette disorder Hearing conditions: tinnitus, ear inflammation, hearing sensitivity, hearing loss, requires hearing aids Colour blindness Severe learning disabilities

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Yale-Brown obsessive compulsive scale (Y-BOCS) | The Y-BOCS is a 10-item scale used to assess symptom severity in OCD. | 3 - 9 months | 
| Decision making and learning tasks | Computer-based behavioural task developed by the investigators to understand decision making in OCD. | 3 - 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient EX/RP Adherence Scale (PEAS) | Self-report assessment for patient's therapy adherence. | 3 - 9 months | 
| Short form of Obsessive Beliefs Questionnaire (OBQ) | Self-report assessment for obsessive beliefs. | 3 - 9 months | 
| Brief Experiential Avoidance Questionnaire (BEAQ) | Self-report assessment for experiential avoidance. | 3 - 9 months | 
| International Cognitive Ability Resource (ICAR16) | Measure to assess cognitive ability. | 3 - 9 months | 
| Worry Domains Questionnaire - Short Form (WDQ-SF) | Self-report assessment for worry. | 3 - 9 months | 
| The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) | Self-report assessment for quality of life assessment. | 3 - 9 months | 
| Sheehan Disability Scale (SDS) | Self-report assessment for functional impairment. | 3 - 9 months | 
| State-Trait Anxiety Inventory (STAI) | Measure of trait and state anxiety | 3 - 9 months | 
| Zung Self-Rating Depression Scale (SDS) | Self-report measure of depressive symptomatology. | 3 - 9 months | 
| Anxiety Sensitivity Index (ASI-3) | Self-report measure for anxiety sensitivity symptomatology. | 3 - 9 months |