Erik Anderssons team study intrusive thoughts, a universal human experience that for some people develops into obsessive-compulsive disorder (OCD). We aim to understand why certain thoughts become sticky and distressing, what distinguishes everyday intrusions from clinical obsessions, and how this knowledge can inform better and more accessible treatment, including digital CBT.
About our research
Almost everyone occasionally has thoughts that pop up against their will and feel unpleasant, alien or frightening, such as a sudden image of harming someone they love. For most people, these thoughts pass. For some, they get stuck and lead to intense anxiety, avoidance and compulsions, and sometimes develop into obsessive-compulsive disorder (OCD). We want to understand what determines whether an intrusive thought becomes a problem. A central question is how people interpret and respond to their thoughts, and how this affects whether the thoughts become more or less distressing. We use this knowledge to develop treatments that reach more people, often digitally. We study both whether the treatments work and why they work.
Digital CBT for OCD
We have developed internet-delivered CBT for OCD and evaluated it in several randomised trials. Among other things, it has been compared with face-to-face CBT, and we have examined its cost-effectiveness. The treatment has been adapted for children and adolescents and for related conditions such as body dysmorphic disorder and tic disorders. Since 2018 it has been part of routine psychiatric care.
Taboo obsessions
Obsessions about sexuality, religion or violence, for example, are among the most difficult to treat. We have developed an internet-delivered treatment that targets how people interpret such thoughts. In a randomised trial, the first of its kind, symptoms decreased, and the effect was explained by a reduction in negative interpretations of the thoughts.
Intrusive thoughts in new parents
About one in five new parents are troubled by intrusive thoughts about their baby coming to harm. We have developed an online self-help programme that, in a pilot study, reduced worry and functional impairment and improved parental functioning. We are now preparing a larger randomised trial. It will also examine how hormone sensitivity affects these thoughts and include training for midwives and nurses. The project is a collaboration with Nichole Fairbrother, University of British Columbia, and Bronwyn Graham, University of New South Wales.
Work and recovery in severe OCD
Almost half of all people with OCD are outside the labour market. We have introduced the vocational rehabilitation model IPS (Individual Placement and Support) at specialised OCD clinics in Region Stockholm, and we are now evaluating it in an effectiveness trial.
Worry and intrusive memories
We also develop and evaluate internet-delivered treatments for excessive worry and for intrusive memories after trauma. One of our worry treatments is currently offered through 1177, Sweden's national healthcare service guide.