Background: Cognitive models of obsessive-compulsive disorder suggest that changes in obsessive beliefs are a\nkey mechanism of treatments for obsessive-compulsive disorder. Thus, in the present process-outcome study, we\ntested whether changes in obsessive beliefs during a primarily cognitive behavioral inpatient treatment predicted\ntreatment outcome and whether these changes mediated symptom changes over the course of treatment.\nMethods: Seventy-one consecutively admitted inpatients with obsessive-compulsive disorder were assessed with\nthe Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire at treatment intake, after six\nweeks of treatment and at discharge, and with the Beck-Depression-Inventory-II at intake and discharge.\nResults: Changes in obsessive beliefs during the first six weeks of treatment predicted obsessive-compulsive\nsymptoms at discharge when controlling for obsessive-compulsive and depressive symptoms at intake in a\nhierarchical regression analysis. Multilevel mediation analyses showed that reductions in obsessive beliefs\npartially mediated improvements in obsessive-compulsive symptoms over time.\nConclusions: Our findings indicate that decreasing obsessive beliefs in inpatient cognitive behavioral therapy\nfor obsessive-compulsive disorder might be a promising treatment approach.
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