Family involvement and treatment for young children with Obsessive-Compulsive Disorder: Randomized control study.

BACKGROUND/OBJECTIVE: The aim of this paper was to evaluate the diferential efficacy of cognitive behavioral family treatment in children under 8 years of age with Obsessive-Compulsive Disorder (OCD) in the reduction of obsessive-compulsive responses and secondary outcomes in three treatment conditions: (a) Treatment of parents and child, (b) Treatment of mother and child, and (c) Treatment of mother. METHOD: Forty-four children with obsessive-compulsive disorder, aged 5.2-7.9 years old and their parents, were randomized to one of three groups in a 1:1:1 ratio. Seventy-five percent was male and 100% Caucasian (White-European). Treatment involved 12 individual sessions of is Cognitive-Behavioral Family-Based Treatment delivered. RESULTS: The three conditions produced clinical improvements in post-test and follow-up in the primary (symptom severity OCD) and secondary outcomes. The results showed no intergroup differences in variables related to OCD symptom severity, although statistically significant differences were found in groups in Internalizing and Externalizing problem, mother and fathers accomodation. CONCLUSIONS: The most efficient condition was that including a greater number of family members even when there was high family accommodation. The direct involvement of the child in the psychological treatment was important in achieving better results.

ANTECEDENTES/OBJETIVO: El objetivo fue analizar la eficacia diferencial de un tratamiento cognitivo-conductual para la reducción de obsesiones y compulsions y otras medidas secundarias en niños menores de 8 años con Trastorno Obsesivo-Compulsivo (TOC). Las tres condiciones de tratamiento fueron: (a) Tratamiento a los padres y al niño, (b) Tratamiento a la madre y al niño, (3) Tratamiento a la madre. MÉTODO: Cuarenta y cuatro niños, con edades comprendidas entre 5,2­7,9 años, y sus padres fueron asignados al azar a uno de los tres grupos, ratio de 1:1:1. El 75% eran varones y el 100% españoles. El tratamiento consistió en 12 sesiones individuales de Terapia familiar cognitivo-conductual. RESULTADOS: Las tres condiciones de tratamiento produjeron mejorías clínicas en el postest y seguimiento en las medidas primarias (severidad TOC) y secundarias. Los resultados mostraron que no existían diferencias entre los grupos en las variables relacionadas con síntomas de severidad, mientras que sí se hallaron en problemas internalizantes y externalizantes, y acomodación de la madre y del padre. CONCLUSIONES: La condición más eficiente fue la que incluía mayor número de miembros familiares, sobre todo cuando había una mayor acomodación familiar. La participación directa del niño en el tratamiento psicológico fue importante para lograr mejores resultados.

Family involvement and treatment for young children with Obsessive-Compulsive Disorder: Randomized control study / Implicacion familiar y tratamiento de niños pequeños con Tastorno Obsesivo-Compulsivo: un estudio aleatorizado

Background/Objective: The aim of this paper was to evaluate the diferential efficacy of cognitive behavioral family treatment in children under 8 years of age with Obsessive-Compulsive Disorder (OCD) in the reduction of obsessive-compulsive responses and secondary outcomes in three treatment conditions: (a) Treatment of parents and child, (b) Treatment of mother and child, and (c) Treatment of mother. Method: Forty-four children with obsessive-compulsive disorder, aged 5.2-7.9 years old and their parents, were randomized to one of three groups in a 1:1:1 ratio. Seventy-five percent was male and 100% Caucasian (White-European). Treatment involved 12 individual sessions of is Cognitive-Behavioral Family-Based Treatment delivered. Results: The three conditions produced clinical improvements in post-test and follow-up in the primary (symptom severity OCD) and secondary outcomes. The results showed no intergroup differences in variables related to OCD symptom severity, although statistically significant differences were found in groups in Internalizing and Externalizing problem, mother and fathers accomodation. Conclusions: The most efficient condition was that including a greater number of family members even when there was high family accommodation. The direct involvement of the child in the psychological treatment was important in achieving better results

Antecedentes/Objetivo: El objetivo fue analizar la eficacia diferencial de un tratamiento cognitivo-conductual para la reducción de obsesiones y compulsions y otras medidas secundarias en niños menores de 8 años con Trastorno Obsesivo-Compulsivo (TOC). Las tres condiciones de tratamiento fueron: (a) Tratamiento a los padres y al niño, (b) Tratamiento a la madre y al niño, (3) Tratamiento a la madre. Método: Cuarenta y cuatro niños, con edades comprendidas entre 5,2-7,9 años, y sus padres fueron asignados al azar a uno de los tres grupos, ratio de 1:1:1. El 75% eran varones y el 100% españoles. El tratamiento consistió en 12 sesiones individuales de Terapia familiar cognitivo-conductual. Resultados: Las tres condiciones de tratamiento produjeron mejorías clínicas en el postest y seguimiento en las medidas primarias (severidad TOC) y secundarias. Los resultados mostraron que no existían diferencias entre los grupos en las variables relacionadas con síntomas de severidad, mientras que sí se hallaron en problemas internalizantes y externalizantes, y acomodación de la madre y del padre. Conclusiones: La condición más eficiente fue la que incluía mayor número de miembros familiares, sobre todo cuando había una mayor acomodación familiar. La participación directa del niño en el tratamiento psicológico fue importante para lograr mejores resultados

Cognitive-behavioral high parental involvement treatments for pediatric obsessive-compulsive disorder: A meta-analysis.

A meta-analysis on the efficacy of cognitive-behavior-family treatment (CBFT) on children and adolescents with obsessive-compulsive disorder (OCD) was accomplished. The purposes of the study were: (a) to estimate the effect magnitude of CBFT in ameliorating obsessive-compulsive symptoms and reducing family accommodation on pediatric OCD and (b) to identify potential moderator variables of the effect sizes. A literature search enabled us to identify 27 studies that fulfilled our selection criteria. The effect size index was the standardized pretest-postest mean change index. For obsessive-compulsive symptoms, the adjusted mean effect size for CBFT was clinically relevant and statistically significant in the posttest (dadj=1.464). For family accommodation the adjusted mean effect size was also positive and statistically significant, but in a lesser extent than for obsessive-compulsive symptoms (dadj=0.511). Publication bias was discarded as a threat against the validity of the meta-analytic results. Large heterogeneity among effect sizes was found. Better results were found when CBFT was individually applied than in group (d+=2.429 and 1.409, respectively). CBFT is effective to reduce obsessive-compulsive symptoms, but offers a limited effect for family accommodation. Additional modules must be included in CBFT to improve its effectiveness on family accommodation.

A preliminary study of cognitive-behavioral family-based treatment versus parent training for young children with obsessive-compulsive disorder.

BACKGROUND: Cognitive-Behavioral Family-Based Treatment (CBFT) is the standard of care in young children with OCD. Developmental considerations, parent desires, and cost-effective advantages motivate research to explore the relative efficacy of parent-only interventions. The main goal in this study was to test the effectiveness and feasibility of a parent only intervention for OCD in young children, comparing, in a preliminary fashion the relative efficacy of reducing obsessive-compulsive symptoms through two treatment conditions: 1) an individual CBFT for early OCD involving both parents and children, and 2) the family component of the intervention involving only individual Parent Training (PT). METHODS: Twenty treatment-seeking families from two private outpatient clinics in Spain were alternately assigned to one of the two treatment conditions. Participants had a primary diagnosis of OCD and a mean age of 6.62 years (65% males). Interventions were conducted by the same therapist and the assessments were administered by independent clinicians who were blind to the experimental conditions of the participants. Assessment time-points were pretreatment, posttreatment, and 3-month follow-up (including diagnosis, symptom severity, global functioning, family accommodation, externalizing and internalizing symptoms, and satisfaction measures). RESULTS: The two ways of implementation, involving child and parents (CBFT) or involving only parents (PT), produced clinical improvements and were well-accepted by parents and children. The CBFT condition was superior to the PT condition in reducing externalizing problems. LIMITATIONS: reduced sample size and absence of randomization were the main limitations of this study. CONCLUSIONS: these results suggest, in a preliminary manner, that the need to have the child present at session with the clinician could be decreased for some children, as well as the overall feasibility of working only with parents for the implementation of CBT for OCD in very young children.

Psychological treatment of obsessive-compulsive disorder in children and adolescents: a meta-analysis.

Although several meta-analyses have investigated the efficacy of psychological treatments for pediatric obsessive-compulsive disorder (OCD), there is not yet a consensus on the most efficacious treatment components. A meta-analysis was carried out to examine the efficacy of the different treatment techniques used in the psychological interventions of pediatric OCD. An exhaustive literature search from 1983 to February 2014 enabled us to locate 46 published articles that applied some kind of cognitive-behavioral therapy (CBT). For each group the effect size was the standardized pretest-posttest mean change, and it was calculated for obsessive-compulsive symptoms and for other outcome measures. The results clearly showed large effect sizes for CBT in reducing obsessive-compulsive symptoms and, to a lesser extent, other outcome measures (d + = 1.860; 95% CI: 1.639; 2.081). The most promising treatments are those based on multicomponent programs comprising ERP, cognitive strategies, and relapse prevention. The analysis of other potential moderator variables and the implications for clinical practice are discussed.

Psychological treatment of obsessive-compulsive disorder in children and adolescents: a meta-analysis

Although several meta-analyses have investigated the efficacy of psychological treatments for pediatric obsessive-compulsive disorder (OCD), there is not yet a consensus on the most efficacious treatment components. A meta-analysis was carried out to examine the efficacy of the different treatment techniques used in the psychological interventions of pediatric OCD. An exhaustive literature search from 1983 to February 2014 enabled us to locate 46 published articles that applied some kind of cognitive-behavioral therapy (CBT). For each group the effect size was the standardized pretest-posttest mean change, and it was calculated for obsessive-compulsive symptoms and for other outcome measures. The results clearly showed large effect sizes for CBT in reducing obsessive-compulsive symptoms and, to a lesser extent, other outcome measures (d+ = 1.860; 95% CI: 1.639; 2.081). The most promising treatments are those based on multicomponent programs comprising ERP, cognitive strategies, and relapse prevention. The analysis of other potential moderator variables and the implications for clinical practice are discussed (AU)

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Obsessive compulsive inventory-child version (OCI-CV) in a Spanish community sample of children and adolescents / El Inventario Obsesivo Compulsivo-Versión niños (OCI-CV) en una muestra comunitaria de niños y adolescentes españoles

BACKGROUND: There is a growing interest in designing instruments to assess obsessive-compulsive symptoms in children. The Obsessive-Compulsive Inventory-Child Version (OCI-CV) has showed to be a valid in the evaluation of OCD in clinical and nonclinical populations. The main goal in this study was to analyze factor structure and psychometric properties of the OCI-CV in a community Spanish sample. METHOD: Data were collected from 914 children/adolescents with a mean age of 13.01 (SD = 1.96; Males = 51.3%). Exploratory factor analysis was carried out in order to study the internal structure of the OCI-CV Spanish version. Further, internal consistency, test-retest reliability, and convergent and discriminant validity of the total score and the factors obtained were examined. Finally, age and gender differences were also explored. RESULTS: Exploratory factor analysis yielded a similar structure to the original OCI-CV with the following six factors: Washing/Checking, Obsession, Ordering, Doubting, Neutralizing, and Hoarding. The internal consistency was strong for the total score, but moderate for the subscales. The Spanish version of the OCI-CV showed evidences of test-retest reliability and convergent and discriminant validity. CONCLUSION: The Spanish version of the OCI-CV is an instrument with adequate psychometric properties to assess obsessions and compulsions in Spanish children/adolescents

ANTECEDENTES: existe un creciente interés en el diseño de instrumentos que evalúen los síntomas obsesivo-compulsivos en niños. El Inventario Obsesivo Compulsivo-Versión para Niños (OCI-CV) ha demostrado ser válido para evaluar estos síntomas en población clínica y no clínica. El objetivo de este estudio fue analizar la estructura factorial y las propiedades psicométricas del OCI-CV en población española comunitaria. MÉTODO: se recogieron datos de 914 niños/adolescentes con una edad media de 13,01 años (DT = 1.96; 51.3% varones). Se realizó un análisis factorial exploratorio. Posteriormente se examinó la consistencia interna, la fiabilidad test-retest y la validez convergente y divergente de la puntuación total del instrumento y de los factores obtenidos. Finalmente, se comprobó la existencia de diferencias en función del sexo y la edad de los participantes. RESULTADOS: los resultados mostraron una estructura similar a la del OCI-CV original, compuesta por los siguientes factores: Lavado/Comprobación, Obsesión, Orden, Duda, Neutralización y Acumulación. La consistencia interna fue buena para la puntuación total, aunque moderada para las diferentes subescalas. La versión en castellano del OCI-CV mostró evidencias de fiabilidad test-retest y validez convergente y discriminante. CONCLUSIONES: OCI-CV es una herramienta con adecuadas propiedades psicométricas para la valoración de obsesiones y compulsiones en niños/adolescentes españoles

Obsessive Compulsive Inventory-Child Version (OCI-CV) in a Spanish community sample of children and adolescents.

BACKGROUND: There is a growing interest in designing instruments to assess obsessive-compulsive symptoms in children. The Obsessive-Compulsive Inventory-Child Version (OCI-CV) has showed to be a valid in the evaluation of OCD in clinical and nonclinical populations. The main goal in this study was to analyze factor structure and psychometric properties of the OCI-CV in a community Spanish sample. METHOD: Data were collected from 914 children/adolescents with a mean age of 13.01 (SD = 1.96; Males = 51.3%). Exploratory factor analysis was carried out in order to study the internal structure of the OCI-CV Spanish version. Further, internal consistency, test-retest reliability, and convergent and discriminant validity of the total score and the factors obtained were examined. Finally, age and gender differences were also explored. RESULTS: Exploratory factor analysis yielded a similar structure to the original OCI-CV with the following six factors: Washing/Checking, Obsession, Ordering, Doubting, Neutralizing, and Hoarding. The internal consistency was strong for the total score, but moderate for the subscales. The Spanish version of the OCI-CV showed evidences of test-retest reliability and convergent and discriminant validity. CONCLUSION: The Spanish version of the OCI-CV is an instrument with adequate psychometric properties to assess obsessions and compulsions in Spanish children/adolescents.

Síntomas psicopatológicos en adolescentes españoles: relación con los estilos parentales percibidos y la autoestima / Psychopatologic symptoms in Spanish adolescents: relationship with perceived parental styles and self-esteem

El objetivo de esta investigación fue analizar la sintomatología psicopatológica evaluada con el SCL-90-R en una muestra comunitaria de 935 adolescentes españoles y su interacción con el estilo parental percibido y la autoestima. La muestra estuvo compuesta por 489 chicos y 446 chicas de edades comprendidas entre los 12 y 18 años (M = 14.84, DT = 1.83) que cursaban estudios de Educación Secundaria y Bachillerato. Catorce centros de la Región de Murcia y Castilla-La Mancha aceptaron participar en el estudio. De éstos, fueron seleccionados al azar siete teniendo en cuenta la titularidad de los centros (pública y concertada). Los resultados indicaron la existencia de diferencias debidas a la edad en todas las variables medidas (síntomas psicopatológicos, autoestima y percepción de los estilos educativos parentales). Las mujeres presentaron menos niveles de sintomatología y mejor percepción de los estilos educativos. Los resultados de los análisis correlacionales confirmaron relaciones significativas y negativas entre auto-estima y síntomas psicopatológicos y entre algunas dimensiones positivas de los estilos educativos. Los predictores más relevantes y de mayor peso en la salud psicológica fueron: autoestima, edad, sexo, revelación y afecto del padre y control psicológico de la madre

The purpose of this research was to study the presence of psychopathologic symptoms in a community sample of 935 Spanish adolescents, and its relationship with perceived parental styles and the self-esteem. Numbers of males and females were 489 and 446, respectively. Age ranged from 12 to 18 years (M = 14.84, SD = 1.83). Fourteen High School centers in Murcia and Castilla-La Mancha agreed to participate in the current study. Five of them were randomly selected to collected data. The results showed age-related differences in all variables (the psychopathologic symptoms, self-esteem and perceived parental styles). On the other hand, females showed less psychopathologic symptoms and better perception of parental styles than males. Significant negative correlations were found between self-esteem, psychopathology and some positive dimensions of parental style. The main predictors of adolescent’s mental health were: self-esteem, age, gender, revelation and affect from father and psychological control of mother