Work

Effects of Group‐Based CBT/ERP and ACT on Emotion Dysregulation, Sleep, Anxiety Sensitivity and Psychological Flexibility in Adults With OCD

Year: 2026

Type: article

Abstract: INTRODUCTION: Cognitive behavioural therapy with exposure and response prevention (CBT/ERP) is the recommended first-line psychological treatment for obsessive-compulsive disorder (OCD). Acceptance and commitment therapy (ACT) has emerged as a promising alternative, yet treatment comparisons have primarily focused on symptom severity and even less is known about their effects on other domains. STUDY AIM: We examined the effect of group-based ACT and CBT/ERP on emotion regulation, anxiety sensitivity, insomnia and psychological flexibility in adults with OCD. METHODS: 176 adults with OCD were randomized to CBT/ERP or ACT and assessed with the Difficulties in Emotion Regulation Scale (DERS), Sleep Condition Indicator (SCI), Anxiety Sensitivity Index-Revised (ASI-R) and Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQ-OC) at baseline, post-treatment, 6-month and 12-month follow-up and analysed with Mixed-Model Repeated Measures (MMRM). RESULTS: Both treatments showed similar improvements in the four domains across timepoints. CONCLUSIONS: In line with our hypotheses, our results indicated that ACT may be non-inferior to CBT/ERP for all secondary outcomes. However, as the trial was powered for the primary outcome (symptom severity) rather than for these secondary measures, our findings should be interpreted as suggestive. Nonetheless, these findings add to the growing evidence that ACT may be considered a viable treatment for OCD.

Source: Clinical Psychology & Psychotherapy

DOI: 10.1002/cpp.70358