Development of an Intervention Program Based on the Lived Experiences of Individuals with Relationship Obsessive-Compulsive Disorder in Isfahan and Its Effectiveness on Obsessive Beliefs and Symptoms
Keywords:
Relationship obsessive-compulsive disorder, obsessive beliefs, relationship beliefs, lived experience, integrative interventionAbstract
ABSTRACT
This study aimed to identify the lived experiences of individuals with relationship obsessive-compulsive disorder (ROCD), develop a culturally informed integrative intervention, and evaluate its effectiveness in reducing obsessive symptoms, obsessive beliefs, and relationship beliefs. An exploratory sequential mixed-methods design was employed. In the qualitative phase, 40 individuals diagnosed with ROCD participated in in-depth semi-structured interviews analyzed phenomenologically. The findings informed the development of an eight-session integrative intervention drawing on cognitive-behavioral, acceptance and commitment, compassion-focused, emotion-focused, and attachment-based approaches. In the quantitative phase, 30 eligible participants were randomly assigned to experimental and control groups (15 each) in a quasi-experimental pretest–posttest design. Data were collected using the Yale–Brown Obsessive-Compulsive Scale, Relationship Obsessive-Compulsive Inventory, Partner-Related Obsessive-Compulsive Symptoms Inventory, Obsessive Beliefs Questionnaire, and Relationship Beliefs Inventory. Multivariate and univariate analyses of covariance were conducted. MANCOVA indicated a significant overall intervention effect on the combined dependent variables after controlling for pretest scores (Pillai’s trace = 0.182, F = 5.21, p = 0.001, partial η² = 0.274). ANCOVA results showed significant reductions in obsessive beliefs (F = 8.10, p = 0.006, partial η² = 0.128), relationship-centered obsessive symptoms (F = 7.25, p = 0.009, partial η² = 0.116), partner-focused obsessive symptoms (F = 6.70, p = 0.012, partial η² = 0.109), and relationship beliefs (F = 5.95, p = 0.018, partial η² = 0.098). The strongest effect was observed for obsessive beliefs, whereas relationship beliefs showed the smallest effect. The lived-experience-based integrative intervention effectively reduced major cognitive and symptomatic dimensions of ROCD and supports the value of culturally adapted, multidimensional treatment programs.
Downloads
References
1. Doron G, Derby DS, Szepsenwol O. Relationship obsessive compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders. 2014;3(2):169-80. doi: 10.1016/j.jocrd.2013.12.005.
2. Doron G, Derby D, Szepsenwol O, Nahaloni E, Moulding R. Relationship Obsessive–Compulsive Disorder: Interference, Symptoms, and Maladaptive Beliefs. Frontiers in Psychiatry. 2016;7. doi: 10.3389/fpsyt.2016.00058.
3. Karadayı Kaynak G, Mısırlı M. Relationship Obsessive Compulsive Disorder: A Systematic Review. Psikiyatride Güncel Yaklaşımlar. 2023;15(4):549-61. doi: 10.18863/pgy.1204303.
4. Misirli M, Kaynak GK. Relationship Obsessive Compulsive Disorder: A Systematic Review. Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry. 2023;15(4):549-61. doi: 10.18863/pgy.1204303.
5. Tinella L, Lunardi L, Rigobello L, Bosco A, Mancini F. Relationship obsessive-compulsive disorder (R-OCD): The role of relationship duration, fear of guilt, and personality traits. Journal of Obsessive-Compulsive and Related Disorders. 2023;37:100801. doi: 10.1016/j.jocrd.2023.100801.
6. Angelo NL, Brullo G, Marsiglia A, Tirelli A, Piroddi E, Viti C, et al. Romantic Relationship Obsessive-Compulsive Doubts, Perfectionism, and DSM-5 Personality Traits in LGB People: A Comparison with Heterosexual Individuals. Frontiers in Psychology. 2024;15:1187179. doi: 10.3389/fpsyg.2024.1187179.
7. Fernandez S, Sevil C, Moulding R. Feared self and dimensions of obsessive compulsive symptoms: Sexual orientation-obsessions, relationship obsessions, and general OCD symptoms. Journal of Obsessive-Compulsive and Related Disorders. 2021;28:100608. doi: 10.1016/j.jocrd.2020.100608.
8. Meydani FN, Vand HDA, Abasi I, Noori M. Mediating Role of Difficulties in Emotion Regulation and Experiential Avoidance in the Relationship Between Attachment Styles and Severity of Relationship Obsessive -Compulsive Disorder Symptoms. Iranian Journal of Psychiatry and Clinical Psychology. 2022;28(03):328-45. doi: 10.32598/ijpcp.28.3.4175.1.
9. Naji Meydani F, Doos Ali Vand H, Abasi I, Noori M. Mediating Role of Difficulties in Emotion Regulation and Experiential Avoidance in the Relationship between Attachment Styles and Severity of Relationship Obsessive-compulsive Disorder Symptoms. IJPCP. 2022;28(3):304-21. doi: 10.32598/ijpcp.28.3.4175.1.
10. Okati GN, Bahrainian SA, Shahabizadeh F. The Effectiveness of Metacognitive Therapy on Relationship Obsessive-Compulsive Disorder (ROCD) and Experiential Avoidance. Psychological Dynamics in Mood Disorders. 2022;4(11).
11. Okati GN, Shahabizadeh F, Bahreinian SAM. The Effectiveness of Metacognitive Therapy on Relationship Obsessive-Compulsive Disorder (ROCD) and Experiential Avoidance. Journal of Psychological Dynamics in Mood Disorders (PDMD). 2023;1(4):18-29.
12. Shaeiri M, Ghomian S, Farahani H. Psychometric Features of Relationship Obsessive-Compulsive Inventory: A scale in the Field of Relationship Obsessive-Compulsive Disorder. International Journal Of Behavioral Sciences-علوم رفتاري سابق. 2019;12(4).
13. Ghomian S, Shaeiri MR, Farahani H. Designing the Relationship Obsessive-Compulsive Inventory (ROCI) based on Iranian culture and evaluation of its psychometric properties. Iranian Journal of Psychiatry. 2021;16(4):418-29. doi: 10.18502/ijps.v16i4.7229.
14. Zarifi M. Identifying the Harms Experienced by Married Women With Relationship Obsessive– Compulsive Disorder. 2026. doi: 10.21203/rs.3.rs-8407007/v1.
15. Levy A, Tibi L, Szepsenwol O, Doron G. “Why Do I Obsess About My Child's Flaws?”: Assessing the Role of Parental Self‐vulnerabilities in Parent–child Relationship Obsessive Compulsive Disorder (ROCD) Symptoms. Clinical Psychologist. 2020;24(3):285-93. doi: 10.1111/cp.12217.
16. Gorelik M, Szepsenwol O, Doron G. Promoting couples' resilience to relationship obsessive-compulsive disorder symptoms using a CBT-based mobile application: A randomized controlled trial. Heliyon. 2023;9(11):e21673. doi: 10.1016/j.heliyon.2023.e21673.
17. Pakrooh Z. The Effectiveness of Building a Lasting Connection (BLC) Program Training on Family Developmental Functioning and Flexibility from the Spouse's Perspective in Couples with Symptoms of Relationship Obsessive-Compulsive Disorder [Master's Thesis]: Ferdowsi University of Mashhad; 2023.
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2026 Hajar Mazaheri (Author); Hassan Zareei Mahmoodabadi; Mohamaad Hosein Fallah , Fahimeh Dehghani (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
