{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:49:32Z","timestamp":1792464572450,"version":"4.5.0"},"reference-count":33,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"abstract":"<jats:p>Introduction: Brief concentrated exposure and response prevention (cERP) has shown promise as an efficacious treatment for obsessive-compulsive disorder (OCD) with higher response and remission rates compared to the first-line treatment. However, the mechanisms driving this success remain unclear. Methods: This longitudinal study included 56 patients with OCD who underwent cERP (Bergen 4-day treatment). Treatment mechanisms (e.g., willingness to engage in exposure and response prevention (ERP), confidence in future self-guided ERP, leaning into anxiety) were assessed before and after each of the 4 treatment days by the Pre- and Post-Session Questionnaire (PPSQ-cERP). Changes in the PPSQ-cERP were used to predict treatment response assessed from baseline to post-treatment and 3-month follow-up. Results: All variables assessed by the PPSQ-cERP showed improvement throughout the cERP, as calculated using linear mixed models. Several variables, including willingness to engage in ERP and self-efficacy, improved after day 3, with small to medium effects (0.34\u20130.70). Confidence in future self-guided ERP improved on day 4 (the day on which it was addressed), with a small effect (0.31). Leaning into anxiety during ERP tasks on day 3 was identified as a predictor of OCD symptom improvement (\u03b2 = 0.516, p = 0.050) by least absolute shrinkage and selection operator regression, while group cohesion reached trend level (\u03b2 = 0.239, p = 0.081). Conclusion: This study highlights day-specific effects across all treatment mechanism variables. Notably, leaning into anxiety during ERP tasks was a key predictor of symptom improvement, offering new insights into refining OCD treatment strategies and enhancing clinical outcomes. <\/jats:p>","DOI":"10.1159\/000545178","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T18:37:06Z","timestamp":1743187026000},"page":"162-174","source":"Crossref","is-referenced-by-count":9,"title":["Exploring the Black Box: What Happens during Brief Concentrated Exposure and Response Prevention for Obsessive-Compulsive Disorder?"],"prefix":"10.1159","volume":"94","author":[{"given":"Franziska","family":"Miegel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Scheunemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Pampuch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Schultz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjarne","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Hagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Gallinat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Zapf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir H.","family":"Yassari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Jelinek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.19r13085"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1359"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2008.94"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-019-01779-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465810000275"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2010.12.2\/efoa"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2022.104170"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2018.1494750"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2018.1478447"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1887-4"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.00982"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocrd.2024.100913"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.667167"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-024-05780-6"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocrd.2016.04.006"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006x.68.3.438"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097-4679(199905)55:5%3c597::aid-jclp7%3e3.0.co;2-m"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1080\/10401230701334747"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/da.20785"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.02.091"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1037\/pst0000173"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1989.01810110048007"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20299"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1159\/000072184"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2876"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2008.12.002"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v033.i01"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2024.2365949"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1037\/\/0033-2909.99.1.20"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2007.10.003"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1177\/21677026221101379"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.03.089"}],"container-title":["Psychotherapy and Psychosomatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000545178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000545178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T16:04:33Z","timestamp":1748966673000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000545178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,6,3]]},"published-print":{"date-parts":[[2025,6,4]]}},"URL":"https:\/\/doi.org\/10.1159\/000545178","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.28668485","asserted-by":"subject"}]},"ISSN":["0033-3190","1423-0348"],"issn-type":[{"value":"0033-3190","type":"print"},{"value":"1423-0348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}