Comparing Exposure v Imagery Rescripting in People With OCD: a SCED

Comparing Exposure v Imagery Rescripting in People With Obsessive Compulsive Disorder (OCD): a Single Case Experimental Design (SCED)

Individuals with OCD may experience intrusive future orientated thoughts and images, which are extremely distressing and interfering in life. This project aims to explore whether imagery rescripting or exposure may be a more effective intervention for individuals with OCD experiencing such images.

Study Overview

• Status: Recruiting
• Conditions: Obsessive-Compulsive Disorder (OCD)
• Intervention / Treatment: Other: Imagery intervention

• Study Type: Interventional
• Enrollment (Estimated): 10
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Talana Adams; Phone Number: +44 20 7848 0002; Email: talana.e.adams@kcl.ac.uk

Study Locations

• United Kingdom
  • London, United Kingdom
    • Recruiting
    • Centre for Anxiety Disorders and Trauma
    • Contact: Talana Adams; Phone Number: +44 20 7848 0002; Email: talana.e.adams@kcl.ac.uk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 18 years or over
• Main diagnosis of OCD (assessed by the Structured Clinical Interview for ICD11)
• Must report future orientated images that are distressing and ego-dystonic

Exclusion Criteria:

• Psychosis, bipolar disorder, or trauma disorder
• Current stimulant or hallucinogenic misuse, alcohol or substance misuse or dependence
• Intellectual disability, dementia, serious cognitive impairment, or organic brain disorder
• Personality Disorder as the main problem
• Active suicidality
• Concurrent engagement in other psychotherapy
• A patient may be taking anti-depressant medication so long as the dose has been stable for 6 weeks and there is no plan to increase the dose.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ImR; ImR completed as first intervention then ImExp	Other: Imagery intervention; Imagery rescripting or imaginal exposure
Experimental: ImExp; ImExp completed then ImR	Other: Imagery intervention; Imagery rescripting or imaginal exposure

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Obsessive Compulsive Inventory (OCI).	A 42-item self-report scale to assess the severity and type of OCD symptoms; the OCI uses a 5-point Likert scale ranging from 0 (not at all) to 4 (extremely) and measures distress relating to 7 different subscales (washing, checking, doubting, ordering, obsessions, hoarding, and mental neutralizing). The total summed score of all items ranged between zero and 168. This measure will be completed at the beginning and end of each phase. Higher scores suggest more severe OCD symptomology.	From the start of treatment until the end of treatment at 12 weeks.
Yale-Brown Obsessive-Compulsive scale (Y-BOCS).	A 10-item self-rated scale used to measure the severity of obsessive-compulsive symptoms and response to treatment; each item is scored from 0 (no symptoms) to 4 (extreme symptoms), with a total ranging from zero to 40. It will be completed at the beginning and end of each phase. Higher scores suggest more severe OCD symptomatology.	From the start of treatment until the end of treatment at 12 weeks.
The Impact of Future Events Scale (IFES).	A 24-item self-rating scale used to measure the impact of intrusive prospective, personally relevant imagery. Each item is scored from 0 (no symptoms) to 4 (extreme symptoms), with a total ranging from zero to 96. Higher scores indicate greater symptomatology. This will be completed at the beginning and end of each phase.	From the start of treatment until the end of treatment at 12 weeks.
The Florida Obsessive Compulsive Inventory (FOCI).	Designed to measure the severity and frequency of obsessive-compulsive symptoms in individuals. The severity scale (Part B) of the FOCI was used in the project. Part B is a 5-item self-rating scale used to measure the frequency, severity, and impact of obsessive-compulsive symptoms; each item is scored from 0 (no symptoms) to 4 (extreme symptoms), with a total ranging from zero to 20. Higher scores indicate greater symptomology.	From the start of treatment until the end of treatment at 12 weeks.
Visual Analogue Scales (VAS).	Five daily self-report scales to be designed by the researchers using fixed scale (0=not at all; 10=extremely) answers to measure the following: Frequency of future orientated imagery Severity of future orientated imagery Vividness of future orientated imagery Degree of distress and aversive emotions associated with such imagery The urge to engage in compulsions/to neutralise the imagery.	From the start of treatment until the end of treatment at 12 weeks.

Collaborators and Investigators

• Sponsor: King's College London

Study record dates

Study Major Dates

• Study Start (Actual): August 30, 2024
• Primary Completion (Estimated): April 30, 2025
• Study Completion (Estimated): May 20, 2025

Study Registration Dates

• First Submitted: April 3, 2025
• First Submitted That Met QC Criteria: April 22, 2025
• First Posted (Actual): April 25, 2025

Study Record Updates

• Last Update Posted (Actual): April 25, 2025
• Last Update Submitted That Met QC Criteria: April 22, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Personality Disorders; Anxiety Disorders; Compulsive Personality Disorder; Obsessive-Compulsive Disorder
• Other Study ID Numbers: IRAS Project ID: 342003

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No