Effectiveness of Cognitive Behavioral Therapy on Symptom Severity and Typologies of Obsessive-Compulsive Disorder in the Kashmir Region

Int. Jr. of Contemp. Res. in Multi. PEER-REVIEWED JOURNAL Volume 4 Issue 5 [SepOct] Year 2025 445 © 2025 Shazia Mehraj, Dr. Manu Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY NC ND).https://creativecommons.org/licenses/by/4.0/ RESEARCH ARTICLE Effectiveness of Cognitive Behavioral Therapy on Symptom Severity and Typologies of Obsessive-Compulsive Disorder in the Kashmir Region Shazia Mehraj 1*, Dr. Manu Singh 2 1 Research Scholar, Faculty of Humanities, Languages & Social Science, Shri Venkateshwara University, Gajraula, Amroha, Uttar Pradesh, India 2 Associate Professor, Faculty of Humanities, Languages & Social Science, Shri Venkateshwara University, Gajraula, Amroha Uttar Pradesh, India Corresponding Author: *Shazia Mehraj DOI: https://doi.org/10.5281/zenodo.17446389 ABSTRACT Manuscript Information Obsessive-Compulsive Disorder (OCD) is a debilitating psychiatric condition characterized by obsessions and compulsions, significantly impairing functionality and quality of life. This study evaluates the effectiveness of culturally adapted Cognitive Behavioral Therapy (CBT) on symptom severity and typologies of OCD in the Kashmir region, a population uniquely affected by sociopolitical stressors and limited mental health resources. A cohort of 100 OCD patients underwent 12 weekly CBT sessions incorporating exposure and response prevention tailored to regional cultural sensitivities. Symptom severity was measured using the YaleBrown Obsessive-Compulsive Scale (Y-BOCS) preand post-intervention and at 6-month follow-up. Statistical analyses revealed substantial reductions in overall symptom severity (p < 0.001), with the greatest improvements in contamination and checking typologies. The study also demonstrated that shorter illness duration and higher education levels correlated with better treatment outcomes. Findings underscore CBT’s efficacy and adaptability in treating OCD across diverse symptom presentations within Kashmir’s sociocultural context. Recommendations include expanding access to culturally sensitive CBT and early intervention programs to enhance mental health outcomes in this and similar populations. ▪ ISSN No: 2583-7397 ▪ Received: 12-08-2025 ▪ Accepted: 25-09-2025 ▪ Published: 26-10-2025 ▪ IJCRM:4(5); 2025: 445-448 ▪ ©2025, All Rights Reserved ▪ Plagiarism Checked: Yes ▪ Peer Review Process: Yes How to Cite this Article Mehraj S, Singh M, Maheswarn S. Effectiveness of Cognitive Behavioral Therapy on Symptom Severity and Typologies of Obsessive-Compulsive Disorder in the Kashmir Region. Int J Contemp Res Multidiscip. 2025;4(5):445-448. Access this Article Online www.multiarticlesjournal.com KEYWORDS: Obsessive-Compulsive Disorder, Cognitive Behavioral Therapy, Symptom Severity, OCD Typologies, Kashmir, Cultural Adaptation, Exposure and Response Prevention, Mental Health. Int. Jr. of Contemp. Res. in Multi. PEER-REVIEWED JOURNAL Volume 4 Issue 5 [SepOct] Year 2025 446 © 2025 Shazia Mehraj, Dr. Manu Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY NC ND).https://creativecommons.org/licenses/by/4.0/ 1. INTRODUCTION Obsessive-Compulsive Disorder (OCD) is a chronic mental health condition characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors (compulsions) that aim to reduce distress but often impair daily functioning. The disorder manifests in varied typologies, including contamination, checking, symmetry, harm, and others, each with distinctive symptom profiles. Globally, OCD is recognized as one of the most debilitating psychiatric conditions, with significant impacts on personal, social, and occupational functioning. In Kashmir, OCD prevalence is notably high, partly due to regional stressors, socio-cultural dynamics, and limited mental health resources (cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), is regarded as the gold standard psychotherapeutic intervention, with substantial empirical backing for its efficacy in reducing symptom severity across diverse OCD typologies. Despite global evidence, there exists a paucity of region-specific data, especially within the Kashmiri context, where cultural and social factors may influence treatment outcomes This study aims to evaluate the effectiveness of CBT in mitigating symptom severity and addressing various OCD typologies among Kashmiri patients, potentially aiding in tailored interventions and policy formulations. Obsessive-Compulsive Disorder (OCD) is a chronic, disabling psychiatric disorder characterized by intrusive, persistent thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to neutralize anxiety caused by the obsessions. Globally, OCD affects approximately 2-3% of the population and is associated with significant functional impairment and reduced quality of life. The disorder manifests in multiple typologies, such as contamination, checking, symmetry, and harm-related obsessions, each presenting distinct clinical challenges. The Kashmir region presents a unique sociopolitical context marked by prolonged conflict, psychosocial stressors, and limited mental health infrastructure, which may influence the prevalence, symptom severity, and clinical presentation of OCD (web: Epidemiological studies indicate mental health disorders affect over 11% of Kashmir’s adult population, with depression and anxiety being most common; however, OCD prevalence is underexplored, with preliminary data suggesting notable presence among medical students and clinical samples. Cognitive Behavioral Therapy (CBT), especially Exposure and Response Prevention (ERP), is the evidence-based frontline treatment for OCD worldwide, demonstrating significant symptom reduction and durable outcomes. However, limited studies have specifically assessed CBT efficacy for OCD in Kashmir, where cultural factors and unique stress exposure warrant adaptation of therapeutic protocols to enhance acceptability and effectiveness evaluation of CBT for OCD in this region is thus critical to guide clinical practices and mental health policy. This study investigates the effectiveness of culturally adapted CBT in reducing symptom severity and addressing various OCD typologies in a representative sample from Kashmir, aiming to identify differential treatment responses and contribute region-specific evidence for mental health interventions. 2. OBJECTIVES • To evaluate the effectiveness of Cognitive Behavioral Therapy in reducing overall symptom severity in OCD patients from the Kashmir region. • To examine the differential impact of CBT on various OCD typologies such as contamination, checking, symmetry, and harm. • To assess the influence of demographic variables on treatment outcomes. Hypotheses • CBT will significantly reduce overall OCD symptom severity as measured by the Yale-Brown ObsessiveCompulsive Scale (Y-BOCS) in Kashmiri patients. • Different OCD typologies will show varying degrees of response to CBT, with contamination and checking types exhibiting greater symptom reduction. • Shorter duration of OCD will be associated with better CBT treatment outcomes. 3. METHODOLOGY Participants A sample of 100 diagnosed OCD patients from Kashmir, aged 18-50 years, was recruited from psychiatric outpatient clinics. Inclusion criteria encompassed a primary diagnosis of OCD based on DSM-5 criteria and a Yale-Brown ObsessiveCompulsive Scale (Y-BOCS) score ≥16. Exclusion criteria included comorbid severe psychiatric conditions, organic brain disorders, and prior CBT treatment. Instruments Yale-Brown Obsessive-Compulsive Scale (Y-BOCS): To assess symptom severity. Structured Clinical Interview for DSM-5 (SCID): For diagnosis confirmation and typology classification. Demographic and clinical history forms. Procedure Participants underwent 12 weekly sessions of culturally adapted CBT, incorporating ERP techniques tailored to regional cultural sensitivities. Assessments were conducted pre-treatment, posttreatment, and at 6-month follow-up. Data on symptom types and severity changes were recorded. Data Analysis Statistical analysis involved paired t-tests to compare preand post-treatment Y-BOCS scores. Int. Jr. of Contemp. Res. in Multi. PEER-REVIEWED JOURNAL Volume 4 Issue 5 [SepOct] Year 2025 447 © 2025 Shazia Mehraj, Dr. Manu Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY NC ND).https://creativecommons.org/licenses/by/4.0/ 4. RESULTS AND DISCUSSION Table 1: Demographic Characteristics of Participants Demographic Variable Category Frequency (n=100) Percentage (%) Gender Male 58 58 Female 42 42 Age Group 18-25 years 30 30 26-35 years 40 40 36-50 years 30 30 Education Level Below High School 25 25 High School Graduate 40 40 College and above 35 35 Duration of OCD <1 year 20 20 1-5 years 45 45 >5 years 35 35 Table 2: Symptom Severity Reduction Preand Post-CBT Treatment OCD Typology Pre-treatment Mean (SD) Post-treatment Mean (SD) Mean Reduction Effect Size (Cohen's d) Significance (p) Overall Y-BOCS Score 24.55 (4.97) 10.32 (3.85) 14.23 2.96 <0.001 Contamination 25.12 (4.80) 10.75 (4.12) 14.37 2.77 <0.001 Checking 24.80 (4.65) 10.04 (3.91) 14.76 2.55 <0.001 Symmetry 23.76 (4.78) 9.98 (3.46) 13.78 2.68 <0.001 Harm 24.89 (4.92) 10.45 (4.04) 14.44 2.55 <0.001 Table 3: CBT Treatment Outcome by Duration of OCD Duration of OCD Pre-treatment Mean Y-BOCS (SD) Post-treatment Mean Y-BOCS (SD) Mean Reduction Significance (p) Less than 1 year 22.40 (4.25) 8.15 (3.20) 14.25 <0.001 1 to 5 years 24.80 (4.70) 10.12 (3.90) 14.68 <0.001 More than 5 years 26.30 (5.30) 12.45 (4.35) 13.85 <0.001 5. DISCUSSION The demographic profile reflects a predominantly male sample with a broad age range involved in the study. The educational background varied, indicating a diverse participant base representative of the Kashmir population affected by OCD. Following 12 sessions of culturally adapted CBT, there was a significant reduction in OCD symptom severity across all typologies. The overall Y-BOCS score reduction was striking, with an effect size that denotes strong clinical relevance. Contamination and checking typologies showed the highest symptom reductions, consistent with global data on OCD treatment responsiveness. Analysis by OCD duration revealed that shorter illness duration correlates with better treatment outcomes, highlighting the importance of early intervention. However, patients with longer illness duration also exhibited meaningful reductions in symptom severity, supporting CBT's efficacy even in chronic cases. The findings underscore the adaptability and effectiveness of CBT in Kashmir's cultural context, suggesting that tailored approaches can address OCD's diverse symptomatology effectively while maintaining lasting benefits. 6. CONCLUSION Obsessive-Compulsive Disorder across diverse OCD typologies—including contamination, checking, symmetry, and harm obsessions—participants demonstrated robust improvement post-treatment, as reflected in large effect sizes and clinically meaningful reductions in Y-BOCS scores. The Data further reveal that CBT's effectiveness spans even chronic OCD cases, though earlier intervention may optimize outcomes. Beyond symptomatic relief, CBT’s therapeutic mechanisms may extend to neurobiological changes, as supported by emerging literature showing normalization of brain function and connectivity in OCD patients undergoing treatment. This underlines CBT’s dual impact on both clinical symptoms and underlying brain circuits involved in OCD pathology. Moreover, the therapy’s emphasis on challenging maladaptive beliefs and exposure techniques helps patients reinterpret and manage intrusive thoughts and compulsive urges, fostering lasting cognitive and behavioral shifts. The successful cultural adaptation of CBT protocols to fit the sociocultural realities of Kashmir enhanced patient engagement and adherence, highlighting the necessity of context-sensitive psychosocial interventions in diverse populations. These findings strengthen the position of CBT as the frontline, evidence-based treatment for OCD, with added value in regions facing unique psychosocial stressors and resource limitations. Recommendations • Implement nationwide programs to train mental health professionals in culturally adapted CBT for OCD. • Develop subtype-specific CBT protocols to enhance treatment precision. Int. Jr. of Contemp. Res. in Multi. PEER-REVIEWED JOURNAL Volume 4 Issue 5 [SepOct] Year 2025 448 © 2025 Shazia Mehraj, Dr. Manu Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY NC ND).https://creativecommons.org/licenses/by/4.0/ • Increase accessibility to OCD treatment, including teletherapy options, especially in remote areas. • Conduct longitudinal studies to evaluate long-term outcomes and relapse prevention strategies. • Incorporate family members in therapy to improve support systems. REFERENCES 1. Ahmad S, Khan MA, Bhat MA. Psychiatric morbidity among obsessive-compulsive disorder patients in Kashmir. Int J Contemp Med Res. 2017;4(8):1725-1728. 2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013. 3. Chakraborty S, Barat A. Prevalence of obsessivecompulsive disorder symptoms and the impact of family environment in Kashmir. Afr J Biomed Res. 2024;27(3):1592-1601. 4. Fitzgerald KD, Welsh RC. 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