The role of between-session homework in cognitive-behavioral therapy for comorbid obsessive-compulsive disorder and autism: A case vignette.

OBJECTIVE: Cognitive-behavioral therapy (CBT), which includes a decided emphasis on exposure and response/ritual prevention (ERP) and between-session practice of treatment principles, has consistently demonstrated efficacy for the treatment of obsessive-compulsive disorder (OCD) and is a gold standard, recommended first-line treatment. CBT with ERP has been successfully adapted to fit the needs of autistic individuals with OCD. The present article provides a brief overview of CBT for OCD and outlines special considerations and adaptations needed when working with patients with OCD and comorbid autism, with an emphasis on the importance of between-session homework. METHOD: A case vignette is presented. RESULTS: This case study illustrates the role of homework in the exposure-based treatment of an adult autistic individual with comorbid OCD. CONCLUSION: Implications of this case vignette are discussed, and recommendations are offered for clinicians working with autistic individuals with OCD, especially in regard to bolstering completion of between-session ERP homework.

Obsessive-Compulsive Disorder in Children and Adolescents.

Obsessive-compulsive disorder (OCD) in children and adolescents is a neurobehavioral condition that can lead to functional impairment in multiple domains and decreased quality of life. We review the clinical presentation, diagnostic considerations, and common comorbidities of pediatric OCD. An overview of the biological and psychological models of OCD is provided along with a discussion of developmental considerations in youth. We also describe evidence-based treatments for OCD in childhood and adolescence, including cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) and pharmacotherapy. Finally, research evaluating the delivery of CBT in different formats and modalities is discussed, and we conclude with suggestions for future research directions. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

I am Worried: Do the PSWQ and PSWQ-A Display Measurement Invariance Across Four Racial Groups?

The issue of race within the context of psychological assessment is important, but often overlooked. Many self-report measures of psychopathology have been developed and validated using primarily White samples. Research regarding the Penn State Worry Questionnaire (PSWQ) and race has produced mixed results, which in turn may present challenges when comparing scores across racial groups. The current article sought to investigate the measurement invariance of the PSWQ and PSWQ-A (an abbreviated version) across four racial groups (White, Black, Asian, and Hispanic) in a sample of 2,489 undergraduate students. Confirmatory factor analysis of a one-factor structure illustrated poor fit across all racial groups for the full-length PSWQ. Two-factor and one-factor with method effects models of the full-length PSWQ each improved on the previous model fit, although the one-factor method effects model was limited by nonsalient factor loadings. Additionally, a separate confirmatory factor analysis indicated good fit for the PSWQ-A. Further analysis of the PSWQ-A suggested measurement invariance across all racial groups, as well as configural, metric, and scalar invariance. These findings advance the literature on the relationship between worry and race, suggesting that direct comparisons on the PSWQ-A between racial groups is appropriate.

Anxiety sensitivity, disgust sensitivity and aversive reactions to four stimuli.

BACKGROUND: Prior theory and research has implicated disgust as relevant to some, but not all phobias. AIMS: The current study examined whether anxiety sensitivity is more relevant to certain specific phobias and whether disgust sensitivity is more relevant to other specific phobias. METHOD: Participants (n = 201) completed measures of anxiety sensitivity, disgust sensitivity and measures of aversive reactions in the presence of two fear-relevant stimuli (i.e. heights and small, enclosed spaces) and two disgust-relevant stimuli (i.e. spiders and blood/injury). RESULTS: Results of multiple linear regression analyses revealed that disgust sensitivity showed significant associations with aversive reactions in all four stimulus domains after controlling for anxiety sensitivity. After controlling for disgust sensitivity, anxiety sensitivity showed associations with the two fear-relevant phobias but not with the two disgust-relevant phobias included in this study. Anxiety sensitivity also showed an association with variance specific to one of the two fear-relevant specific phobias included in the study. Disgust sensitivity also showed associations with variance specific to both of the disgust-relevant phobias included in the study but not with variance specific to either of the fear-relevant specific phobias. CONCLUSIONS: These results provide evidence that the distinction between fear-relevant and disgust-relevant specific phobias is meaningful and also implicate disgust sensitivity as relevant to aversive reactions to all stimuli included in this study.