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Cognitive-Behaviour Therapy in Pediatric Obsessive-Compulsive Disorder

 
Obsessive-Compulsive Disorder (OCD) is a common neuropsychiatric illness beginning in childhood.

Clinical Outcomes following Group-based Family Cognitive-Behaviour Therapy in Pediatric Obsessive-Compulsive Disorder (OCD)

Effective OCD treatments include cognitive-behaviour therapy (CBT) and medications but access to treatment is difficult and does not systematically include parents.

In this study, researchers evaluate clinical effects of Group-based Family CBT (GF-CBT), a novel and efficient treatment model that has not yet been formally studied in Pediatric OCD. This case-control study examines efficacy correlates of GF-CBT for Pediatric OCD, in addition to utilization rates and correlates of follow-up booster sessions.

Study procedures

Recruitment is conducted from GF-CBT referred patients; these patients will have already received the Anxiety Disorder Interview Schedule (ADIS), conducted by the OCD clinic psychologist. Once consent has been obtained, participants are also supplied with a link to the REDCap questionnaires/measures and asked to complete these. We collect clinical outcome data related to OCD severity, individual and family functioning at six time points which include baseline, midpoint at the completion of 12 sessions, as well as for each of the booster sessions.

This CBT group, which is co-facilitated by the OCD clinic psychologist and doctoral-level psychology trainees, includes psychoeducation, exposure and response prevention (E/RP) tasks, challenging cognitive distortions, and anxiety-management strategies. To increase the ecological validity of the treatment, there are several opportunities per week to complete E/RPs outside of the hospital-based clinic. Parents participate in concurrent one-hour parent support groups during the treatment period. These groups enables parents to (1) obtain social support from other parents of OCD-affected youth; (2) to learn specific treatment strategies; (3) to decrease family accommodation of OCD behaviours; and (4) to coach their child through E/RPs at home.

GF-CBT booster sessions are conducted with participants who have completed GF-CBT. Sessions focus on review of the content from previous GF-CBT sessions and the development and practice of Exposure and Response Prevention (ERP) exercises.

Potential benefits

If GF-CBT is demonstrated to improve OCD-related outcomes, the current study may provide a rationale for the expansion of the use of this treatment method to other clinics. it is anticipated that findings from this study will also help to advance psychiatric research generally and knowledge of OCD in particular. In addition, it is hypothesized that at least some of these individuals will benefit from GF-CBT with respect to improvements in OCD severity, overall functioning, and family functioning. 


The Epigenetic Effects of Cognitive Behavioral Therapy in Obsessive-Compulsive Disorder

The high heritability of OCD – up to 65% of identical twins share the disease, and 10-25% of children and adolescents with OCD have at least one parent with OCD – points to an important role for genetics in controlling the development and expression of OCD. However, two genome-wide association studies (GWAS) and more defined linkage studies have so far failed to identify replicable genetic loci that confer risk for the development of OCD. This suggests that although OCD exhibits strong evidence of heritability, its inheritance may be mediated, at least in part, by mechanisms extraneous to the actual coding sequence of DNA.

 

This study will examine whether differences in DNAm exist between OCD –affected and control youth.  It will also attempt to discern whether dynamic changes in DNAm occur alongside response to CBT treatment in OCD-affected youth.

Study Procedures

Clinical measures and sociodemographic data pertaining to the Study Clinical Outcomes following Group-based Family Cognitive-Behaviour Therapy in Pediatric Obsessive-Compulsive Disorder (OCD) is obtained from OCD-affected participants who have consented to data-sharing within Canada. All samples (OCD-affected youth and healthy controls) will be collected by BC Children's Biobank staff using buccal swabs. All patient genetic material and data needed to complete this study will be in the Biobank repository.

OCD-affected participants have participated in 12 sessions of group CBT therapy. This CBT group, which is co-facilitated by the OCD clinic psychologist and doctoral-level psychology trainees, includes psychoeducation, exposure and response prevention (E/RP) tasks, challenging cognitive distortions, and anxiety-management strategies. Parents participate in concurrent one-hour parent support groups during the treatment period.

Potential benefits

it is anticipated that findings from this study will help to advance psychiatric research generally and knowledge of OCD, its epigenetic underpinnings and its response to CBT in particular.


SOURCE: Cognitive-Behaviour Therapy in Pediatric Obsessive-Compulsive Disorder ( )
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