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Gamified Combined Cognitive Bias Modification in Adults Diagnosed With OCD: Randomized Controlled Trial

Sponsor: Dokuz Eylul University • ClinicalTrials.gov ID: NCT06941155

Registry updated: 2026-10-16

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Description

This randomized controlled trial examines the effects of a mobile-based gamified combined cognitive bias modification (CBM-C) intervention on obsessive-compulsive symptoms, obsessive beliefs, attentional and interpretation biases, depressive symptoms, and psychological distress. The gamified CBM-C condition is compared to a standard mobile-based CBM-C and a placebo control condition. All interventions are delivered via a mobile application. Assessments are conducted at baseline, post-intervention (week 4), and 3-month follow-up.

Interventions

Gamified-Combined Cognitive Bias Modification (Behavioral)
A gamified version of the combined cognitive bias modification (CBM-C) intervention, which includes both attention and interpretation bias modification tasks. The attention component is a modified dot-probe task, and the interpretation component consists of OCD-related scenarios with word-completion exercises. Gamification elements such as feedback and visual rewards are embedded to enhance motivation and engagement. The presentation order of the two intervention components will be counterbalanced: half of the participants will receive the attention bias task first followed by the interpretation task; the other half will receive the interpretation task first followed by the attention bias task. The intervention is delivered via mobile phone in eight sessions over four weeks (two sessions per week).
Standard Combined Cognitive Bias Modification (Behavioral)
A standard version of the combined cognitive bias modification (CBM-C) intervention, consisting of attention and interpretation bias tasks without gamification features. The attention task is a modified dot-probe paradigm, and the interpretation task involves OCD-related scenarios followed by word-completion exercises. The presentation order of the two intervention components will be counterbalanced: half of the participants will receive the attention bias task first followed by the interpretation task; the other half will receive the interpretation task first followed by the attention bias task. The intervention is delivered via mobile phone in eight sessions over four weeks (two sessions per week).
Placebo (Behavioral)
A placebo version of the standard CBM-C intervention that retains the same structure and timing but omits all active bias modification elements. The attention task (modified dot-probe) presents probes equally behind threat and neutral stimuli, and the interpretation task includes OCD-related scenarios with word-completion items that lead to neutral outcomes. No manipulations are applied to shift cognitive bias. The presentation order of the two intervention components will be counterbalanced: half of the participants will receive the attention bias task first followed by the interpretation task; the other half will receive the interpretation task first followed by the attention bias task. The intervention is delivered via mobile phone in eight sessions over four weeks (two sessions per week).

Eligibility criteria

Inclusion Criteria: * Age 18 years or older * Primary diagnosis of obsessive-compulsive disorder (OCD), confirmed by a licensed clinician using the Structured Clinical Interview for DSM-5 (SCID-5) * No current suicidal ideation or psychotic symptoms * Access to the internet and a mobile phone * Stable psychiatric medication use for at least one month prior to enrollment, with no changes in dosage during the 4-week intervention period * No current neurological or medical condition that would interfere with participation * Ability to perceive colored visual stimuli (e.g., no color blindness) * Not currently enrolled in another intervention-based study * Not receiving any other form of psychological treatment at the time of participation Exclusion Criteria: * Presence of active suicidal ideation or psychotic symptoms * Unstable psychiatric medication use (e.g., recent dose change within the past month or expected change during the intervention period) * Significant neurological or medical illness that may interfere with participation * Visual impairments that would prevent accurate perception of colored stimuli (e.g., color blindness) * Current participation in another clinical trial involving psychological intervention * Receiving concurrent psychotherapy or other psychological treatments outside of the study

Conditions

Obsessive Compulsive Disorder (OCD)

Locations

Dokuz Eylul University Hospital — Izmir, Turkey (Türkiye)

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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