The Effectiveness of "Intensive and Short-Term Psychodynamic Therapy" on Fear of Guilt and Latent Aggression in Female Patients with Contamination Obsessive-Compulsive Disorder

Fear of guilt and latent aggression are two important variables in creating and maintaining obsessive-compulsive symptoms that have so far been overlooked in the treatment of contamination obsessive-compulsive disorder. The aim of this study was to determine the effectiveness of "Intensive and Short-term Psychodynamic Therapy" on fear of guilt and latent aggression in female patients with contamination obsessive-compulsive disorder.

The present study was performed with a single case experimental design with asynchronous multiple baseline. The statistical population includes women contamination obsessive-compulsive disorder referred to psychotherapy clinics, psychiatric offices and psychology in Ahvaz in 2019. The research sample consisted of 3 people who met the entry and exit criteria and were purposefully selected and convenience. Patients were clinically interviewed according to DSM-5 criteria to confirm contamination obsessive-compulsive disorder. To collect data from the demographic questionnaire, "Fear of Guilt Scale" and to assess the latent aggression from the latent aggression subscale "Responsibility and Interpersonal Behavior and Attitude Questionnaire" was used. The validity of the instruments was assessed by content validity, construct validity by confirmatory factor analysis, convergent validity and the reliability of an internal consistency method by calculating Cronbach's alpha coefficient.3 patients were admitted to the study according to the instructions of one-case plans and in 20 sessions of 60 minutes (one session per week) underwent “Intensive and Short-term Psychotherapy" and during 3 stages of baseline, treatment and follow-up evaluation. Data were analyzed using descriptive statistical methods such as stable change index, clinically significant improvement, and visual mapping.

Stable change index for the fear of guilt variable in the first to third patient was 4.8, 4.8, 4.6. According to RCI <1.96, the findings are significant and not random. The recovery rates for the first to third patients were 28%, 63% and 53%, respectively, indicating relative success in the first patient and complete success in the second and third patients. The stable change index for the latent aggression variable of the first to third patients was 1.5, 4 and 4.3, respectively. The results are higher than RCI <1.96 and indicate that the changes are significant and non-random. The patients' recovery rates were 15%, 32% and 37%, respectively. The second and third patients were in the range of relative recovery and the first patient was in the range of treatment failure. 

“Intensive and Short-term Psychotherapy" was effective in reducing fear of guilt and latent aggression. Fear of guilt was influenced by treatment rather than latent aggression. Therefore, the use of the above treatment method is recommended for female patients with contamination obsessive-compulsive disorder.