Journal
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
Volume 59, Issue 5, Pages 650-+Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jaac.2019.05.030
Keywords
exposure and response prevention; mega-analysis; predictors; symptom recognition; treatment response
Categories
Funding
- BC Children's Hospital Research Institute
- National Institute of Mental Health (NIMH) [1R01MH093381, 5R01MH093402]
- National Health and Medical Research Council (NHMRC)
- Foundation for Children
- TrygFonden
- Danish Council for Strategic Research
- Center for Child and Adolescent Mental Health
- Stiftelsen Clas Groschinskys Minnesfond, Eastern and Southern Norway
- Norwegian Research Council
- Helse and Rehabilitering, Norge
- Michael Smith Foundation for Health Research (MSFHR)
- British Columbia Provincial Health Services Administration
- Rotary Foundation
- Pulje til styrkelse af psykiatrisk Forskning i Region Midtjylland
Ask authors/readers for more resources
Objective: Insight and avoidance are commonly discussed factors in obsessive-compulsive disorder (OCD) that have demonstrated associations with increased severity as well as reduced treatment response in adults, but these factors have not been sufficiently examined in pediatric OCD. This study examined the impacts of avoidance, insight, and impairment recognition concordance on cognitive-behavioral therapy (CBT) outcomes as well as impacts of CBT on insight and avoidance in a large sample of youths affected by OCD. Method: Data from 573 OCD-affected youths enrolled in CBT trials were aggregated. Children's Yale-Brown Obsessive-Compulsive Scale items measured treatment response, insight, and avoidance. Standardized differences between child and parent ratings of impairment were used to calculate impairment recognition concordance. Binary logistic regression was used to identify variables associated with treatment response. Results: Greater avoidance, limited child recognition of impairment, older age, and lower baseline severity predicted reduced likelihood of treatment response, but insight did not. Both insight and avoidance improved significantly following CBT. Response rates were lower when posttreatment insight and avoidance were worse. Conclusion: Contrasting with prevailing belief, poor insight does not appear to limit CBT response potential in pediatric OCD. Avoidance and impairment recognition are understudied CBT response predictors and warrant further consideration in pediatric OCD. Clinicians should attend to these factors to optimize outcomes for children affected by this common, debilitating illness.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available