What Drives OCD Symptom Change During CBT Treatment? Temporal Relationships Among Obsessions and Compulsions

Judith M. Laposa, Lance L. Hawley, Kevin J. Grimm, Danielle E. Katz, Neil A. Rector

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Cognitive behavior therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD). However, less is known about how obsessions and compulsions change during treatment, either in tandem, sequentially, or independently. The current study used latent difference score analysis to show path-analytic dynamic modeling of OCD symptom change during CBT. Four competing models of the temporal relationship between obsessions and compulsions were examined: no coupling (obsessions and compulsions are not dynamically related), goal directed (obsessions lead to subsequent changes in compulsions), habit driven (compulsions lead to subsequent changes in obsessions), and reciprocal. Treatment seeking participants (N = 84) with a principal diagnosis of OCD completed 12 weeks of CBT group therapy and completed measures assessing obsession and compulsion severity at pretreatment, Sessions 4 and 8, and end of treatment. Bivariate results supported the goal directed traditional CBT model, where obsession scores are temporally associated with subsequent changes in compulsion scores. These results have implications for theoretical and treatment modelling of obsessions and compulsions in OCD treatment.

Original languageEnglish (US)
Pages (from-to)87-100
Number of pages14
JournalBehavior Therapy
Issue number1
StatePublished - Jan 2019


  • cognitive behavior therapy
  • compulsion
  • obsession
  • obsessive-compulsive disorder

ASJC Scopus subject areas

  • Clinical Psychology


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