Clinical presentation of not-just right experiences (NJREs) in individuals with OCD: Characteristics and response to treatment

There is increasing recognition that instead of being motivated by a desire to prevent harm and reduce anxiety, some obsessive-compulsive symptoms may be driven by a desire to get things 'just right' or 'complete' and to reduce a sense of discomfort. However, existing data is largely from non-clinical samples. Therefore, in the current paper we examine the clinical presentation of not just right experiences (NJREs) in patients diagnosed with OCD and compare their experiences to both anxious and unselected controls. Then, we provide preliminary data on NJREs before and after cognitive behavioral therapy (exposure and response prevention). First, individuals with OCD were found to report experiencing significantly more NJREs and being more distressed by them compared to anxious controls and unselected controls. Next, there was some support for the specificity of NJREs to feelings of incompleteness. Finally, we found that after completing treatment, patients reported experiencing significantly less NJREs and experienced less distress associated with the NJREs. In conclusion we believe that more work on the role of NJREs is warranted and that characterizing OCD symptoms as either based on harm avoidance or incompleteness/NJREs may be a useful framework for classifying OCD symptoms.