Willingness to experience unpleasant thoughts, emotions, and bodily sensations at admission does not predict treatment outcome in inpatients with obsessive–compulsive disorder

Abstract

Abstract Background: Willingness to experience unpleasant thoughts, emotions, and bodily sensations (WTE) has been found to predict treatment outcome in patients with obsessive–compulsive disorder (OCD). Yet, these findings are limited to few studies. Methods: We examined whether WTE at admission predicted treatment outcome in a sample of 324 inpatients with OCD who received a multimodal treatment that included cognitive-behavioral therapy with exposure and response prevention sessions. Results: Obsessive–compulsive symptoms (based on OCD-specific self-report questionnaires) decreased and global functioning (based on therapist ratings) increased from admission to discharge. In contrast to previous findings, however, WTE did not predict treatment outcome. Conclusions: On the one hand, these results indicate that higher WTE at the beginning of inpatient treatment does not facilitate improvements in obsessive–compulsivesymptoms from admission to discharge. On the other hand, they also indicate that lower WTE at the beginning of inpatient treatment does not adversely affect treatment outcome, that is, even patients who indicate that they are unwilling to face the negative experiences associated with exposure and response prevention can still achieve considerable symptom reductions. While the current findings suggest that WTE at the beginning of treatment only plays a minor role at most in treating OCD, future studies may examine session-to-session changes in WTE and obsessive–compulsive symptoms during treatment which may reveal a dynamic interplay as therapy progresses.