{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:48:07Z","timestamp":1762051687627,"version":"build-2065373602"},"reference-count":92,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Cognitive\u2013behavioral therapy is a well-established treatment for obsessive\u2013compulsive disorder (OCD). There are a variety of cognitive and behavioral strategies, and it is necessary to analyze the outcomes of the treatments. The aim of the present study is to verify the effectiveness of a treatment that combines evidence-based procedures and specific cognitive interventions highlighting the issue of acceptance. Forty patients with OCD were recruited and underwent a specific treatment procedure. All patients had a psychodiagnostic assessment for OCD using the Y\u2013BOCS (Yale\u2013Brown obsessive\u2013compulsive scale) performed twice: before treatment (t0) and after nine months (t1). Data analysis showed a decrease in the scores between t0 and t1 according to the Y\u2013BOCS in terms of the interference, severity, and impairment of obsessive\u2013compulsive symptoms. A repeated-measures ANOVA showed a significant reduction in symptoms after treatment, with values of F (1, 39) = 137.56, p &lt; 0.001, and \u03b72 = 0.78. The ANOVA results were corroborated by a Wilcoxon signed-rank test. A reliable change index analysis indicated that 33 participants reported improvements in symptoms, of which 23 were clinically significant. The results showed clinical relevance for OCD treatment and highlighted how this cognitive procedure favored positive outcomes.<\/jats:p>","DOI":"10.3390\/jcm11102762","type":"journal-article","created":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T09:27:56Z","timestamp":1652520476000},"page":"2762","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cognitive\u2013Behavioral Treatment of Obsessive\u2013Compulsive Disorder: The Results of a Naturalistic Outcomes Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-8794","authenticated-orcid":false,"given":"Andrea","family":"Gragnani","sequence":"first","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5802-7586","authenticated-orcid":false,"given":"Vittoria","family":"Zaccari","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"},{"name":"Department of Human Sciences, Marconi University, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Femia","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5735-9239","authenticated-orcid":false,"given":"Valerio","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"},{"name":"Department of Social and Developmental Psychology Sapienza, University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8582-1822","authenticated-orcid":false,"given":"Katia","family":"Tenore","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"},{"name":"Department of Human Sciences, Marconi University, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Fadda","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3322-2235","authenticated-orcid":false,"given":"Olga","family":"Luppino","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"},{"name":"Department of Human Sciences, Marconi University, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7079-107X","authenticated-orcid":false,"given":"Barbara","family":"Basile","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3784-8155","authenticated-orcid":false,"given":"Claudia","family":"Perdighe","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Romano","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"},{"name":"Department of Human Sciences, Marconi University, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Saliani","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8765-4047","authenticated-orcid":false,"given":"Francesco","family":"Mancini","sequence":"additional","affiliation":[{"name":"Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), 00185 Rome, Italy"},{"name":"Department of Human Sciences, Marconi University, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1001\/archpsyc.62.6.617","article-title":"Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication","volume":"62","author":"Kessler","year":"2005","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1038\/mp.2008.94","article-title":"The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication","volume":"15","author":"Ruscio","year":"2010","journal-title":"Mol. Psychiatry"},{"key":"ref_3","unstructured":"Barlow, D.H. (2001). Obsessive compulsive disorder. Clinical Handbook of Psychological Disorders, Guilford Press."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5\u00ae), American Psychiatric Pub.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"784","DOI":"10.4088\/JCP.09m05911blu","article-title":"Quality of Life Outcomes in Patients With Obsessive-Compulsive Disorder","volume":"71","author":"Hollander","year":"2010","journal-title":"J. Clin. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.euroneuro.2016.02.006","article-title":"The cost and impact of compulsivity: A research perspective","volume":"26","author":"Hollander","year":"2016","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1001\/archpsyc.1993.01820180023003","article-title":"A 2- to 7-Year Follow-up Study of 54 Obsessive-Compulsive Children and Adolescents","volume":"50","author":"Leonard","year":"1993","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1001\/archpsyc.56.2.121","article-title":"A 40-Year Follow-up of Patients With Obsessive-compulsive Disorder","volume":"56","author":"Skoog","year":"1999","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/j.1600-0447.2004.00302.x","article-title":"Long-term outcome of pediatric obsessive-compulsive disorder: A meta-analysis and qualitative review of the literature","volume":"110","author":"Stewart","year":"2004","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.euroneuro.2019.02.002","article-title":"Early intervention for obsessive compulsive disorder: An expert consensus statement","volume":"29","author":"Fineberg","year":"2019","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1146\/annurev-clinpsy-032210-104533","article-title":"Treatment of Obsessive-Compulsive Disorder","volume":"7","author":"Franklin","year":"2011","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_12","unstructured":"National Institute for Health and Clinical Excellence (2005). Obsessive Compulsive Disorder: Core Interventions in the Treatment of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder, National Institute for Health and Clinical Excellence. Clinical Guideline No. 31."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1891\/0889-8391.15.3.273","article-title":"Mastery of Obsessive-Compulsive Disorder: A Cognitive-Behavioral Approach Therapist Guide","volume":"15","author":"Kozak","year":"2001","journal-title":"J. Cogn. Psychother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"199","DOI":"10.31887\/DCNS.2010.12.2\/efoa","article-title":"Cognitive behavioral therapy of obsessive-compulsive disorder","volume":"12","author":"Foa","year":"2010","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jpsychires.2012.08.020","article-title":"Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators","volume":"47","author":"Olatunji","year":"2013","journal-title":"J. Psychiatr. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.cpr.2015.06.003","article-title":"Cognitive behavioral treatments of obsessive\u2013compulsive disorder. A systematic review and meta-analysis of studies published 1993\u20132014","volume":"40","author":"Havnen","year":"2015","journal-title":"Clin. Psychol. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/j.cpr.2008.07.001","article-title":"Psychological treatment of obsessive\u2013compulsive disorder: A meta-analysis","volume":"28","year":"2008","journal-title":"Clin. Psychol. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1037\/a0036933","article-title":"The efficacy and effectiveness of psychological treatments for mood, anxiety, and related disorders","volume":"55","author":"Hunsley","year":"2014","journal-title":"Can. Psychol."},{"key":"ref_19","unstructured":"Nathan, P.E., and Gorman, J.M. (1998). Cognitive-behavioral treatments for obsessive compulsive disorder. A Guide to Treatments That Work, Oxford University Press."},{"key":"ref_20","unstructured":"Emmelkamp, P.M., and Foa, E.B. (1983). Failures are a change. Failures in Behavior Therapy, Wiley."},{"key":"ref_21","unstructured":"Goodman, W.K. (2000). Cognitive Behavior therapy and pharmacotherapy for obsessive\u2013compulsive disorder: The NIMH-Sponsored collaborative study. Obsessive\u2013Compulsive Disorder, Erlbaum."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1177\/070674370605100702","article-title":"The Psychological Treatment of Obsessive\u2014Compulsive Disorder","volume":"51","author":"Abramowitz","year":"2006","journal-title":"Can. J. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta20430","article-title":"A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive\u2013compulsive disorder in children\/adolescents and adults","volume":"20","author":"Skapinakis","year":"2016","journal-title":"Health Technol. Assess."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"152223","DOI":"10.1016\/j.comppsych.2021.152223","article-title":"Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials","volume":"106","author":"Reid","year":"2021","journal-title":"Compr. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1159\/000056269","article-title":"A Randomized Controlled Trial of Cognitive Therapy versus Intensive Behavior Therapy in Obsessive Compulsive Disorder","volume":"70","author":"Cottraux","year":"2001","journal-title":"Psychother. Psychosom."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.biopsych.2006.12.020","article-title":"D-Cycloserine Augmented Exposure Therapy for Obsessive-Compulsive Disorder","volume":"62","author":"Kushner","year":"2007","journal-title":"Biol. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"102135","DOI":"10.1016\/j.janxdis.2019.102135","article-title":"Patient adherence to cognitive behavioural therapy for obsessive-compulsive disorder: A systematic review and meta-analysis","volume":"68","author":"Leeuwerik","year":"2019","journal-title":"J. Anxiety Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.janxdis.2016.03.006","article-title":"Dropout rates in exposure with response prevention for obsessive-compulsive disorder: What do the data really say?","volume":"40","author":"Ong","year":"2016","journal-title":"J. Anxiety Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1037\/a0037512","article-title":"A treatment by disorder meta-analysis of dropout from psychotherapy","volume":"24","author":"Swift","year":"2014","journal-title":"J. Psychother. Integr."},{"key":"ref_30","first-page":"99","article-title":"Trattamento cognitivo-comportamentale nel Disturbo Ossessivo-Compulsivo:risultati di uno studio di esito naturalistico in aperto con follow-up a 6,12 e 24 mesi","volume":"41","author":"Mancini","year":"2006","journal-title":"Riv Psichiatr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Mancini, F. (2019). Cognitive Processes in Obsessive-Compulsive Disorder. The Obsessive Mind: Understanding and Treating Obsessive-Compulsive Disorder, Routledge.","DOI":"10.4324\/9780429452956"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.3389\/fpsyt.2021.755744","article-title":"An Observational Study of OCD Patients Treated With Cognitive Behavioral Therapy during the COVID-19 Pandemic","volume":"12","author":"Zaccari","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1037\/0003-066X.51.10.1031","article-title":"Studying the effectiveness of psychotherapy: How well can clinical trials do the job?","volume":"51","author":"Jacobson","year":"1996","journal-title":"Am. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1037\/0022-006X.68.4.594","article-title":"Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: Randomized compared with nonrandomized samples","volume":"68","author":"Franklin","year":"2000","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1037\/1082-989X.7.1.105","article-title":"Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs","volume":"7","author":"Morris","year":"2002","journal-title":"Psychol. Methods"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1037\/a0016032","article-title":"Cognitive\u2013behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies","volume":"77","author":"Stewart","year":"2009","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/j.cpr.2013.07.003","article-title":"A meta-analysis of nonrandomized effectiveness studies on outpatient cognitive behavioral therapy for adult anxiety disorders","volume":"33","author":"Hans","year":"2013","journal-title":"Clin. Psychol. Rev."},{"key":"ref_38","unstructured":"First, M., Williams, J., Karg, R., and Spitzer, R. (2017). Structured Clinical Interview for DSM-5 (SCID-5 for DSM-5), American Psychiatric Association."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1001\/archpsyc.1989.01810110048007","article-title":"The Yale-Brown Obsessive Compulsive Scale. I. Development, Use, and Reliability","volume":"46","author":"Goodman","year":"1989","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_40","unstructured":"Sica, C. (2012). Yale\u2013Brown Obsessive\u2013Compulsive Scale, In Disturbo Ossessivo-Compulsivo. Questionari e Interviste per la Valutazione Clinica, Erickson."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.comppsych.2015.03.005","article-title":"Validation of the Italian version of the Yale\u2013Brown Obsessive Compulsive Scale\u2013Second Edition (Y-BOCS-II) in a clinical sample","volume":"60","author":"Melli","year":"2015","journal-title":"Compr. Psychiatry"},{"key":"ref_42","unstructured":"Ellis, A. (1962). Reason and Emotion in Psychotherapy, Lyle Stuart."},{"key":"ref_43","unstructured":"Wells, A. (1997). Cognitive Therapy of Anxiety Disorders: A Practice Manual and Conceptual Guide, John Wiley and Sons."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/0005-7967(94)90086-8","article-title":"Cognitive Therapy for Obsessive-compulsive disorder","volume":"32","author":"Arntz","year":"1994","journal-title":"Behav. Res. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1002\/da.21915","article-title":"Experimental investigation of targeting responsibility versus danger in cognitive therapy of obsessive-compulsive disorder","volume":"29","author":"Vos","year":"2012","journal-title":"Depress. Anxiety"},{"key":"ref_46","unstructured":"Leahy, R.L. (2003). Cognitive Therapy Techniques: A Practitioner\u2019s Guide, Guilford Press."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S0005-7967(02)00026-8","article-title":"Thought control strategies in obsessive-compulsive dis-order: A replication and extension\u2019","volume":"41","author":"Abramowitz","year":"2003","journal-title":"Behav. Res. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/0005-7967(78)90022-0","article-title":"Abnormal and normal obsessions","volume":"16","author":"Rachman","year":"1978","journal-title":"Behav. Res. Ther."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Mancini, F. (2019). Accepting risk: Cognitive Techniques. The Obsessive Mind: Understanding and Treating Obsessive-Compulsive Disorder, Routledge.","DOI":"10.4324\/9780429452956"},{"key":"ref_50","first-page":"116","article-title":"Dall\u2019investimento alla rinuncia: Favorire l\u2019accettazione in psicoterapia","volume":"9","author":"Perdighe","year":"2012","journal-title":"Cogn. Clin."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.3389\/fpsyg.2019.02335","article-title":"Two Reasoning Strategies in Patients With Psychological Illnesses","volume":"10","author":"Gangemi","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/S0005-7967(96)00112-X","article-title":"Effects of neutralizing on intrusive thoughts: An experiment investigating the etiology of obsessive-compulsive disorder","volume":"35","author":"Salkovskis","year":"1997","journal-title":"Behav. Res. Ther."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1192\/S0007125000297900","article-title":"Cognitive\u2013behavioural approach to understanding obsessional thinking","volume":"173","author":"Salkovskis","year":"1998","journal-title":"Br. J. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Mancini, F. (2019). Techniques of cognitive Restructuring. The Obsessive Mind: Understanding and Treating Obsessive-Compulsive Disorder, Routledge.","DOI":"10.4324\/9780429452956"},{"key":"ref_55","first-page":"38","article-title":"L\u2019esposizione con prevenzione della risposta come pratica dell\u2019accettazione","volume":"2","author":"Mancini","year":"2005","journal-title":"Cognitivismo Clinico"},{"key":"ref_56","unstructured":"Baldini, F. (2004). Gli Homework Nel Disturbo Ossessivo-Compulsivo. Homework: Un\u2019antologia di Prescrizioni Terapeutiche, McGraw-Hill."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Pugh, M. (2019). Cognitive Behavioural Chairwork: Distinctive Features, Routledge.","DOI":"10.4324\/9780429023927"},{"key":"ref_58","first-page":"91","article-title":"L\u2019efficacia delle tecniche cognitive nella riattribuzione della stima della probabilit\u00e0","volume":"9","author":"Gragnani","year":"2003","journal-title":"Psicoter. Cogn. Comport."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Foa, E.B., Yadin, E., and Lichner, T.K. (2012). Exposure and Response (Ritual) Prevention for Obsessive Compulsive Disorder, Oxford University Press.","DOI":"10.1093\/med:psych\/9780195335286.001.0001"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Mancini, F. (2019). Exposure with Response Prevention as a Practice of Acceptance. The Obsessive Mind: Understanding and Treating Obsessive-Compulsive Disorder, Routledge.","DOI":"10.4324\/9780429452956"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jbtep.2004.04.003","article-title":"Fear of guilt from behaving irresponsibly in obsessive?","volume":"35","author":"Mancini","year":"2004","journal-title":"compulsive disorder. J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_62","first-page":"63","article-title":"Development and initial validation of the Fear of Guilt Scale for obsessive-compulsive disorder (OCD)","volume":"11","author":"Chiang","year":"2016","journal-title":"J. Obs. Compuls. Relat. Disord."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/0005-7967(85)90105-6","article-title":"Obsessional-compulsive problems: A cognitive-behavioural analysis","volume":"23","author":"Salkovskis","year":"1985","journal-title":"Behav. Res. Ther."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/0005-7967(93)90066-4","article-title":"Obsessions, responsibility and guilt","volume":"31","author":"Rachman","year":"1993","journal-title":"Behav. Res. Ther."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/S0005-7967(01)00028-6","article-title":"A cognitive theory of compulsive checking","volume":"40","author":"Rachman","year":"2002","journal-title":"Behav. Res. Ther."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Rachman, S. (2006). Fear of Contamination: Assessment and Treatment, Oxford University Press Inc.","DOI":"10.1093\/med:psych\/9780199296934.001.0001"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Frost, R.O., and Steketee, G. (2002). Responsibility. Cognitive Approaches to Obsessions and Compulsions, Elsevier Science.","DOI":"10.1016\/B978-008043410-0\/50001-5"},{"key":"ref_68","first-page":"395","article-title":"Fear of deontological guilt and fear of contamination in obsessive compulsive patient","volume":"17","author":"Mancini","year":"2011","journal-title":"Psicoter. Cogn. Comport."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Mancini, F. (2019). Intervention on Historical Vulnerability. The Obsessive Mind: Understanding and Treating Obsessive-Compulsive Disorder, Routledge.","DOI":"10.4324\/9780429452956"},{"key":"ref_70","first-page":"299","article-title":"Early life experiences in ocd and other disorders: A retrospective observational study using imagery with rescripting","volume":"15","author":"Basile","year":"2018","journal-title":"Clin. Neuropsychiatry"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.4236\/psych.2018.99129","article-title":"A Theoretical Integration of Schema Therapy and Cognitive Therapy in OCD Treatment: Goals and Beliefs of the Obsessive Mind (Part I)","volume":"9","author":"Luppino","year":"2018","journal-title":"Psychology"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.4236\/psych.2018.99130","article-title":"A theoretical integration of Schema Therapy and Cognitive Therapy in OCD treatment: Conceptualization and rationale (Part II)","volume":"9","author":"Tenore","year":"2018","journal-title":"Psychology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jbtep.2015.03.003","article-title":"Imagery Rescripting for Obsessive Compulsive Disorder: A single case experimental design in 12 cases","volume":"49","author":"Veale","year":"2015","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"543806","DOI":"10.3389\/fpsyt.2020.543806","article-title":"Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study","volume":"11","author":"Tenore","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Mancini, F. (2019). Preventing relapses and concluding therapy. The Obsessive Mind: Understanding and Treating Obsessive-Compulsive Disorder, Routledge.","DOI":"10.4324\/9780429452956"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"863","DOI":"10.3389\/fpsyg.2013.00863","article-title":"Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs","volume":"4","author":"Lakens","year":"2013","journal-title":"Front. Psychol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1037\/a0024338","article-title":"Effect size estimates: Current use, calculations, and interpretation","volume":"141","author":"Fritz","year":"2012","journal-title":"J. Exp. Psychol. Gen."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1037\/0022-006X.59.1.12","article-title":"Clinical significance: A statistical approach to defining meaningful change in psychotherapy research","volume":"59","author":"Jacobson","year":"1991","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_79","unstructured":"Lemon, J., and Lemon, M.J. (2021, December 29). Package \u2018clinsig\u2019. Available online: https:\/\/CRAN.R-project.org\/package=clinsig."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/S0005-7967(97)00040-5","article-title":"A cognitive theory of obsessions","volume":"31","author":"Rachman","year":"1997","journal-title":"Behav. Res. Ther."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1002\/cpp.292","article-title":"Responsibility attitude, obsession and compulsion: Further support in a non-clinical sample","volume":"8","author":"Mancini","year":"2001","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_82","unstructured":"Mancini, F. (2005). Il Disturbo Ossessivo-Compulsivo. Il Manuale di Terapia Cognitiva, Bollati Boringhieri."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jbtep.2007.02.002","article-title":"Not just right experience: Is it influenced by feelings of guilt?","volume":"39","author":"Mancini","year":"2008","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_84","first-page":"83","article-title":"Examining an obsessive-compulsive core dimensions model: Structural validity of harm avoidance and incompleteness","volume":"3","author":"Summerfeldt","year":"2014","journal-title":"J. Obs. Compuls. Relat. Disord."},{"key":"ref_85","first-page":"39","article-title":"Explaining Interaction of Guilt and Obses-sive-Compulsive Symptoms In Not Just Right Experiences","volume":"19","author":"Zaccari","year":"2022","journal-title":"Clin. Neuropsychiatry"},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Hayes, S.C., Strosahl, K.D., and Wilson, K.G. (2012). Acceptance and commitment therapy. The Process and Practice of Mindful Change, The Guilford Press. [2nd ed.].","DOI":"10.1037\/17335-000"},{"key":"ref_87","unstructured":"Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, Dell Publishing."},{"key":"ref_88","unstructured":"Barcaccia, B. (2007). Accepting Events: Topicality of Seneca\u2019s Stoic Proposal. [Ph.D. Thesis, Roma Tre University]. (In Italian)."},{"key":"ref_89","unstructured":"Barcaccia, B. (2008). Accepting Limitations of Life: Leading Our Patients through a Painful but Healing Path, Invited Lecture Conducted from Ludwig-Maximilians-University, Munich Department Psychologie."},{"key":"ref_90","first-page":"222","article-title":"La mente non accettante","volume":"14","author":"Mancini","year":"2017","journal-title":"Cogn. Clin."},{"key":"ref_91","first-page":"67","article-title":"Accettazione, Amor fati e Ordine naturale: Una prospettiva cognitivista","volume":"18","author":"Carlo","year":"2021","journal-title":"Cogn. Clin."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Mancini, F. (2019). Constructing a Diagrammatic Model for Understanding the Disorder. The Obsessive Mind: Understanding and Treating Obsessive-Compulsive Disorder, Routledge.","DOI":"10.4324\/9780429452956"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/10\/2762\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:10:33Z","timestamp":1760137833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/10\/2762"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,13]]},"references-count":92,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["jcm11102762"],"URL":"https:\/\/doi.org\/10.3390\/jcm11102762","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,5,13]]}}}