Grant: Master's Award: Canada Graduate Scholarships

Background: Obsessive-compulsive disorder (OCD) is a debilitating and prevalent anxiety disorder. While the basal ganglia and frontal cortex are the most commonly hypothesized brain regions involved, the exact pathophysiology is unknown. By observing the effects of treatment on brain structure, the etiology of OCD can be better understood. Currently, the gold standard treatment for OCD is cognitive behavioural therapy (CBT) with exposure and ritual prevention (ERP). However, this is often temporally and geographically inaccessible, time-consuming, and costly. Fortunately, the electronic delivery of CBT (e-CBT) has presented a promising solution to these barriers. Objectives and Hypothesis: This study will implement an e-CBT program for OCD and observe its effects on brain activation levels using functional magnetic resonance imaging (fMRI). It is hypothesized that brain activation levels in the basal ganglia and frontal cortex will decrease following treatment. Methods: Individuals with OCD will be offered a 16-week e-CBT program with ERP mirroring in-person CBT content that will be administered through a secure online platform. Efficacy will be evaluated using clinically validated symptomology questionnaires at baseline, week 8, week 16, and at a 6-month follow-up. Using fMRI at baseline and post-treatment, brain activation levels will be assessed at resting state, and while exposed to an anxiety-induced image (i.e., dirty dishes if cleanliness is an obsession). The effects of treatment on brain activation levels and the correlation between symptom changes and activation levels will be analyzed. Significance: The findings from this study can further our understanding of the etiology of OCD, helping to develop more effective treatments for this disorder.