Clinicians' perspectives of interfering behaviors in the treatment of anxiety and obsessive-compulsive disorders in adults and children.

Patient behaviors that may interfere with the process and outcome of therapy have been examined in the context of dialectical behavior therapy, but no measures exist to systematically characterize patient (or caregiver) treatment interfering behaviors (TIBs) in cognitive behavioral therapy (CBT) for anxiety disorders and obsessive-compulsive disorder (OCD). Accordingly, the primary aims of this study were to develop preliminary measures of TIBs, asking clinicians who provide CBT for anxiety disorders and/or OCD to adults and/or children to retrospectively reflect on the presence of TIBs in a recent patient (or caregiver of a child patient). These measures assessed the presence of 27 adult patient and 34 caregiver behaviors that may have interfered with treatment. Clinicians were also asked to rate their perception of treatment outcome (i.e. patient symptom improvement). Clinicians' ratings of overall interference with treatment were correlated with their perception of improvement, such that more treatment interference was associated with less symptom reduction. Interference with exposure completion, the process of therapy sessions, and attendance to therapy sessions emerged as potentially important behaviors to assess for in anxiety disorder/OCD treatment. Implications and directions for future research are discussed.

Politically-focused intrusive thoughts and associated ritualistic behaviors in a community sample.

A significant proportion of the U.S. population report increased stress attributed to the political climate following the controversial 2016 United States (U.S.) Presidential election. The political stressors paired with the growth in news consumption and social media-use could be a potential trigger for obsessive-compulsive-like symptoms specific to politics in some individuals. This study aimed to elucidate the rate of Politically-focused Intrusive Thoughts and associated Ritualistic Behaviors (PITRB), their demographic and clinical correlates, and the degree of association with political ideology. Survey data were collected using the crowdsourcing platform Mechanical Turk. A total of N = 484 individuals completed the survey. Measures of politically-focused intrusive thoughts and ritualistic behaviors, general obsessive-compulsive symptoms, depression, anxiety, anxiety control, worry, and disability were administered, as well as a measure of social and economic conservative affiliation. Results showed that a quarter of the sample (25.2%) had at least one PITRB more than once a day. PITRB was associated with all measures of psychopathology and disability. Finally, anxiety control moderated the relationship between PITRB and both anxiety and depression. No differences in psychopathology were found between major party affiliations. The findings suggest that politically-focused intrusive thoughts and ritualistic behaviors are associated with psychopathology domains in a manner comparable to general obsessive-compulsive symptoms.