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Coercive and disruptive behaviors mediate group cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder
- Source :
- Comprehensive Psychiatry, Vol 86, Iss, Pp 74-81 (2018)
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Purpose Coercive and disruptive behaviors (CDBs) are commonplace in pediatric obsessive-compulsive disorder (OCD) and are associated with increased disorder impact and reduced treatment response. Prior research suggests that CDBs mediate the cross-sectional relationship between family accommodation and OCD symptom severity; however, the impact of reducing CDBs on other treatment outcomes has yet to be studied. Methods Participants comprised 49 OCD-affected youth (42.9% male, Mage at baseline = 13.7) and their parent(s) who completed a 12-week, group family-based cognitive-behavioral treatment at an OCD specialty clinic. Outcomes included parent-report measures of CDBs, family accommodation, symptom severity, and both child- and family-level impairment. Descriptive, correlation, and regression analyses were followed by tests of indirect effects (mediation). Results Changes in all outcome variables had moderate to strong correlations with each other. As hypothesized, CDB decreases predicted positive changes in OCD severity as well as in child and family impairment. Further, whereas improvement in OCD severity predicted changes in child and family impairment, improvements in family accommodation were not directly predictive of any outcomes. Consistent with hypotheses, changes in CDBs mediated relationships between changes in accommodation and child- and family-level impairment, as well as relationships between changes in OCD severity and both levels of impairment. Additional exploratory analyses found that changes in symptom severity significantly mediated relationships between changes in CDBs and both levels of impairments. Conclusions Findings suggest that attention to reducing CDBs is warranted in the treatment of pediatric OCD, and that accommodation reductions lead to meaningful improvements in child and family functioning only when CDBs and/or symptoms are also reduced. Future family-based treatments may benefit from inclusion of components specifically targeting CDBs that occur within the context of accommodating OCD symptoms.
- Subjects :
- Male
Parents
Obsessive-Compulsive Disorder
050103 clinical psychology
Mediation (statistics)
Adolescent
lcsh:RC435-571
Cross-sectional study
medicine.medical_treatment
Treatment outcome
Context (language use)
Correlation
Obsessive compulsive
lcsh:Psychiatry
mental disorders
Humans
Medicine
0501 psychology and cognitive sciences
Child
Problem Behavior
Cognitive Behavioral Therapy
business.industry
05 social sciences
Cognitive behavioral therapy
Psychiatry and Mental health
Clinical Psychology
Cross-Sectional Studies
Treatment Outcome
Psychotherapy, Group
Female
business
Accommodation
050104 developmental & child psychology
Clinical psychology
Subjects
Details
- ISSN :
- 0010440X
- Volume :
- 86
- Database :
- OpenAIRE
- Journal :
- Comprehensive Psychiatry
- Accession number :
- edsair.doi.dedup.....74e22bc883b7ff0e0b1a053fb902de94