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<p>This extended commentary critically evaluates recent mindfulness-based interventions (MBIs) for obsessive-compulsive disorder (OCD), with particular attention to the synthesis by Reis et al. (<i>Expert Review of Neurotherapeutics, 24</i>(7), 735–741,&#xa0;<CitationRef CitationID="CR36">2024</CitationRef>). Drawing on a meta-analysis by Chien et al. (<i>Journal of Obsessive-Compulsive and Related Disorders, 32</i>, 100712,&#xa0;<CitationRef CitationID="CR9">2022</CitationRef>) and 10 randomized controlled trials, this review highlighted substantial heterogeneity across intervention types, delivery formats, and outcome measures. Key distinctions were identified among mindfulness-based cognitive therapy, acceptance and commitment therapy, and mindfulness-based exposure and response prevention (MB-ERP). Notable discrepancies between self-reported and clinician-rated outcomes, divergent theoretical frameworks, and the need for greater mechanistic precision were underscored. Integration of mindfulness within ERP emerges as a theoretically promising but still preliminary strategy to enhance inhibitory learning, reduce covert compulsions, and strengthen distress tolerance and treatment engagement. A forward-looking research agenda was proposed, emphasizing mechanism-matched trials, optimization of intervention sequencing, culturally adapted protocols, and scalable digital MB-ERP platforms with fidelity monitoring. This approach aimed to support the development of individualized, effective, and durable mindfulness-based treatments for OCD.</p>

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Parsing the Promise of Mindfulness for Obsessive-Compulsive Disorder: From Heterogeneous Evidence to Mechanistic Precision

  • 期刊论文

  • 发表日期：

    2025年10月28日

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  • Mohammad Asif Sheikh

摘要

This extended commentary critically evaluates recent mindfulness-based interventions (MBIs) for obsessive-compulsive disorder (OCD), with particular attention to the synthesis by Reis et al. (Expert Review of Neurotherapeutics, 24(7), 735–741, 2024). Drawing on a meta-analysis by Chien et al. (Journal of Obsessive-Compulsive and Related Disorders, 32, 100712, 2022) and 10 randomized controlled trials, this review highlighted substantial heterogeneity across intervention types, delivery formats, and outcome measures. Key distinctions were identified among mindfulness-based cognitive therapy, acceptance and commitment therapy, and mindfulness-based exposure and response prevention (MB-ERP). Notable discrepancies between self-reported and clinician-rated outcomes, divergent theoretical frameworks, and the need for greater mechanistic precision were underscored. Integration of mindfulness within ERP emerges as a theoretically promising but still preliminary strategy to enhance inhibitory learning, reduce covert compulsions, and strengthen distress tolerance and treatment engagement. A forward-looking research agenda was proposed, emphasizing mechanism-matched trials, optimization of intervention sequencing, culturally adapted protocols, and scalable digital MB-ERP platforms with fidelity monitoring. This approach aimed to support the development of individualized, effective, and durable mindfulness-based treatments for OCD.