Investigating obsessive-compulsive intrusions in psychosis
Research type
Research Study
Full title
Investigating obsessive-compulsive intrusions in psychosis: An observational study and Imagery Rescripting case series
IRAS ID
290114
Contact name
Amy Hardy
Contact email
Sponsor organisation
King’s College London
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
It is common to experience intrusions, which consist of visions, sounds, smells, tastes and sensations that pop into our minds when we do not want them to, that have upsetting content (e.g. imagining harm coming to someone). The meaning (or appraisal) the person attaches to the intrusion has been found to predict whether intrusions persist (i.e. become obsessive), are distressing and lead to behaviors that attempt to prevent any feared harm occurring (i.e. compulsions). Distressing intrusions which are associated with fears of harm and compulsive behaviours are called ‘obsessive-compulsive intrusions’. Psychosis is a mental health condition that it characterized by having experiences like seeing, hearing, tasting, smelling or sensing things that other people cannot, or having worries about intentional harm from others.
Research suggests that obsessive-compulsive intrusions are associated with psychosis. However, little is known about how common obsessive-compulsive intrusions are in psychosis and the psychological factors that are associated with their maintenance. Understanding the psychological factors associated with obsessive-compulsive intrusions in psychosis can help to improve treatments. Further, there have been few studies specifically investigating therapeutic techniques that have been found to be helpful for obsessive-compulsive intrusions in other mental health conditions. Imagery-rescripting is a powerful tool where people are supported by a therapist to use their imagination to change obsessive-compulsive intrusions to make them less upsetting. Research therefore needs to examine whether techniques, like imagery rescripting, are possible and safe for people with psychosis to do.
Phase one of this study will therefore recruit 40 people with a psychosis diagnosis to complete questionnaires, to find out whether they experience obsessive-compulsive intrusions and psychosis symptoms. They will also be asked about their meta-cognitive beliefs (i.e. or beliefs about their thinking, such as ‘my thoughts are dangerous’, ‘my thoughts can come true’), traumatic experiences, and post-traumatic stress symptoms, to explore whether these factors are associated with the maintenance of obsessive compulsive intrusions in psychosis.
Phase two of the study will examine whether it is possible to deliver an imagery rescripting intervention for obsessive compulsive intrusions in psychosis. Participants who have identified an obsessive-compulsive intrusion in phase one will be invited to participate, with a maximum of 6 participants recruited. Participants will select an obsessive-compulsive intrusion to target during a 4 session imagery rescripting intervention, and will be compared pre- and post-therapy using their assessment data from phase one and a post-therapy follow-up assessment. They will also complete weekly ratings of their target obsessive compulsive intrusions during the intervention to monitor change over time.
REC name
London - Dulwich Research Ethics Committee
REC reference
20/LO/1309
Date of REC Opinion
1 Mar 2021
REC opinion
Further Information Favourable Opinion