Digital Mindfulness-Based Therapy for Obsessive-Compulsive Disorder

The Yale-Brown Obsessive Compulsive Scale is a clinician-administered scale used to assess the severity of obsessive-compulsive symptoms. It consists of 10 items assessing obsessions and compulsions. Each item is scored from 0 to 4, resulting in a total score ranging from 0 to 40, with higher scores indicating greater symptom severity. The primary outcome is the change in total score from baseline to the end of the 6-week intervention.

The Yale-Brown Obsessive Compulsive Scale is a 10-item clinician-administered measure of obsessive-compulsive symptom severity. Each item is scored from 0 to 4, resulting in a total score ranging from 0 to 40. Higher total scores indicate more severe obsessive-compulsive symptoms and therefore represent a worse outcome. Changes from baseline will be assessed weekly during the 6-week intervention and at follow-up assessments to evaluate symptom trajectories and the maintenance of treatment effects.

The Five Facet Mindfulness Questionnaire is a 39-item self-report measure assessing five dimensions of mindfulness: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. Each item is scored from 1 to 5. The total score ranges from 39 to 195, with higher total scores indicating higher levels of mindfulness and therefore representing a better outcome. Subscale scores range from 8 to 40 for observing, describing, acting with awareness, and nonjudging of inner experience, and from 7 to 35 for nonreactivity to inner experience. Changes from baseline will be assessed during treatment and follow-up.

The State Mindfulness Scale is a 21-item self-report measure assessing mindful awareness of bodily sensations and mental events during a recent period. Each item is scored from 1 to 5, resulting in a total score ranging from 21 to 105. Higher total scores indicate higher levels of state mindfulness and therefore represent a better outcome. Changes from baseline will be assessed during treatment and follow-up.

Heart rate variability will be assessed using time-domain, frequency-domain, and nonlinear indices, including the standard deviation of normal-to-normal intervals, root mean square of successive differences, high-frequency power, low-frequency power, the low-frequency to high-frequency power ratio, SD1, and SD2. Changes from baseline will be evaluated weekly during the 6-week intervention.

Electroencephalographic measures will include the mean amplitude and latency of the N200 and P300 event-related potential components. Changes from baseline will be evaluated at the end of the 6-week intervention and at the 3-month and 6-month follow-up assessments.

The Beck Depression Inventory-II is a 21-item self-report measure of depressive symptom severity. Each item is scored from 0 to 3, resulting in a total score ranging from 0 to 63. Higher total scores indicate greater depressive symptom severity and therefore represent a worse outcome. Changes from baseline will be assessed during treatment and follow-up.

The State subscale of the State-Trait Anxiety Inventory is a 20-item self-report measure assessing the current intensity of anxiety symptoms. Each item is scored from 1 to 4, resulting in a total score ranging from 20 to 80. Higher total scores indicate greater state anxiety and therefore represent a worse outcome. Changes from baseline will be assessed during treatment and follow-up.

The Thought-Action Fusion Scale is a 19-item self-report measure assessing beliefs that having an unacceptable thought increases the likelihood of a related event occurring or is morally equivalent to carrying out the corresponding action. Each item is scored from 0 to 4, resulting in a total score ranging from 0 to 76. Higher total scores indicate stronger thought-action fusion beliefs and therefore represent a worse outcome. Changes from baseline will be assessed during treatment and follow-up.

The Self-Compassion Scale-Short Form is a 12-item self-report measure assessing self-kindness, common humanity, mindfulness, self-judgment, isolation, and over-identification. Each item is scored from 1 to 5. After reverse-scoring the negatively worded items, the mean of the 12 items is calculated, resulting in a mean score ranging from 1 to 5. Higher mean scores indicate higher levels of self-compassion and therefore represent a better outcome. Changes from baseline will be assessed during treatment and follow-up.