An Intensive Acceptance and Commitment Therapy Intervention’s Effect on Obsessive
Compulsive Symptomatology in At-Risk Adolescents
Michelle L. Miller, B.A., Emily B. Kroska, B.A., Rosaura Orengo-Aguayo, M.A., & James Marchman, PhD
University of Iowa, Department of Psychology
Background
 Obsessive Compulsive Disorder (OCD) is an anxiety disorder
characterized by presence of obsessions and/or compulsions that
are time-consuming, cause significant distress, and can impair
multiple areas of functioning.
14
 The lifetime prevalence of OCD in the general population worldwide
is approximately 2–3%.
10
 The prevalence of OCD in adolescents has been found to be 3%
with subclinical OCD (OC) symptoms estimated at 19%.
 A large majority (80%) of adult OCD cases have been found to
have developed during childhood or adolescence.
 Acceptance and Commitment Therapy (ACT) has been shown to
be effective in treating OCD across several studies.
 Prevention research is a necessary next step in the ACT literature,
given its success in treating a wide variety of disorders.
 The present study seeks to increase mindfulness and acceptance
skills, as well as to clarify valued life directions, in an at-risk sample,
before symptoms present and interfere with quality of life.
 The goal of ACT treatment is not symptom reduction, but an
increased ability to live a rich, meaningful life.
Methods
Results
Avoidance from Pre- to Post-
12
Avoidance decreased
significantly from Pre
(M=13.11) to one-month
follow-up (M=2.08),
t(37.11)=-5.73, p<.001.
8
6
4
Objective:
• To determine the effectiveness of a brief ACT intervention with atrisk adolescents in changing the frequency and severity of intrusive
thoughts and OCD symptoms from pre-intervention to one-month
follow-up.
• To measure change in mindfulness and acceptance skills from preintervention to one-month follow-up.
Hypothesis:
• There will be an increase in mindfulness skills reported from preintervention to one-month follow-up.
• There will be a decrease in self-reported experiential avoidance from
pre-intervention to one-month follow-up.
• Participants may experience a reduction in severity and frequency of
OCD symptoms.
Demographics:
• Age: M = 16.34 (SD=1)
• Exploration of the relation between pain and
values
• Gender: 32 F, 21 M
2
• Caucasian: 18
• Creative hopelessness exercises
• African-American: 22
• Mindfulness and noticing exercises
• Other: 7
• Difference between internal and external
experiences
0
Pre
40
One-Month Post
Measures:
 Obsessive-Compulsive Inventory-Revised
Mindfulness from Pre- to Post-
35
Mindfulness increased
significantly from Pre
(M=25.53) to one-month
follow-up (M=35.49),
t(35.9)=5.71, p<.001.
30
• Sexual Orientation:
• Heterosexual: 70.59%
• Homosexual,
Bisexual,
Transgender: 29.41%
• Does your family receive
food stamps?
 Child Adolescent Mindfulness Measure
• Yes: 45.3%
 Acceptance and Fusion Questionnaire
• No: 54.7%
Conclusions
 OCI-R scores did not significantly change from Pre-Intervention to
One-Month Post.
20
 Mindfulness significantly increased, and avoidance significantly
decreased from Pre-Intervention to One-Month Post.
15
Pre
18
16
14
12
10
8
6
4
2
0
• Racial Distribution:
• How can we move toward what matters?
• Willingness and acceptance experiential
exercises
25
Objectives & Hypotheses
Treatment Protocol:
• Values identification and clarification
One-Month Post
 Increased mindfulness and decreased avoidance may be accounting
for the lack of significant change in OCI-R scores and suggest a
willingness to experience OC symptoms in a different way.
OCD Symptoms from Pre- to Post16.26
13.29
Pre
One-Month Post
OCI-R scores were not
significantly different
from to one-month
follow-up, F(1,98)=0.81,
p=.37.
 As this is a prevention study, OC symptoms were low at baseline and
reduction in symptoms was secondary to learning different skills to
address the distress caused by intrusive thoughts.
The means of groups at
Pre:
M=16.26(13.17),N=46
One-month follow-up:
M=13.29(16.00),N=34
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