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Schubert, Christiane; Voderholzer, Ulrich; Wolstein, Jörg; Kuelz, Anne Katrin and Schwartz, Caroline (2018): Wirkfaktoren der kognitiven Verhaltenstherapie von Zwangsstörungen: Ein kritischer Überblick über den aktuellen Forschungsstand. In: Verhaltenstherapie, Vol. 28, No. 1: pp. 35-43

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The aim of this review is to summarize the current state of knowledge on process research regarding common factors in psychotherapy of obsessive-compulsive disorders (OCD). A systematic literature search of medical and psychological publications since 2000 was conducted. Only 8 publications fulfilled our inclusion criteria: being a psychotherapy study, investigating potential mediators of change, and respecting the time line issue. Most of them focused on potential cognitive factors. The change of dysfunctional obsessive beliefs, particularly perfectionism and certainty beliefs, seem to be important for a successful reduction of OCD symptoms. Patient adherence also seems to play a certain role as a mediator. Concerning the effect of depression, the analysis leaves us with inconsistent results regarding the direction and extent of the found effect. Exploring 'complexity' as a potential change factor of the therapy process, 1 study found the steepest change gradient before an intervention with exposition-reaction management took place. Case formulation and avoidance did not turn out to be mediators of change. Overall, the limited number of available studies, their focus on different constructs, and their often contradictory results show the need for meaningful, longitudinal research in the field of OCD.

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