A Meta-analytic Study on Executive Function Performancein Children/Adolescents with OCD / Un Estudio Meta-analítico sobre el Rendimiento en Funciones Ejecutivas en Niños/Adolescentes con TOC

Introducción: El objetivo general de este estudio fue llevar a cabo un estudio meta-analítico con el fin de examinar el rendimiento de las funciones ejecutivas en niños/adolescentes con trastorno obsesivo-compulsivo (TOC). Método: Se llevó a cabo una búsqueda exhaustiva de la literatura desde 1984 hasta septiembre de 2021, seleccionando un total de 20 estudios publicados que comparaban los resultados en funciones ejecutivas entre un grupo de niños y/o adolescentes con TOC y un grupo de control sano. Resultados: Los resultados mostraron que la puntuación total en la escala de calidad de los estudios osciló entre los 3 y los 8.5 puntos (en una escala de 0 a 9), con una media de 6.6. Los tamaños del efecto en las distintas funciones ejecutivas fueron: Inhibición (d+= -0.221), Flexibilidad cognitiva (d+= -0.418), toma de decisiones (d+= -0.169) y planificación (d+= -0.319), indicando un menor rendimiento en los grupos con TOC frente a los grupos de control sano. Los resultados fueron clínicamente significativos en todos los dominios excepto en Toma de decisiones. El sesgo de publicación sólo se pudo llevar a cabo en flexibilidad e inhibición de respuesta. Conclusiones: Los pacientes con TOC presentaron peor rendimiento ejecutivo que los controles sanos en todas las funciones ejecutivas, destacando flexibilidad cognitiva y planificación. No obstante, los resultados deben interpretarse con cautela debido al pequeño tamaño muestral.(AU)

Background:The main objective of this work was to carry out a meta-analytical study to examine performance in executive functions in children/adolescents with obsessive-compulsive disorder (OCD). Method:A comprehensive literature search from 1984 to September 2021 was conducted, selecting a total of 20 published studies comparing executive function outcomes among a group of children and/or adolescents with OCD and a healthy control group. Results:Results showed that the total score on the quality scale of studies ranged between 3 and 8.5 points (on a scale of 0 to 9), with a mean of 6.6. The effect sizes in the different executive functions were as follows: Inhibition (d+= -0.221), Cognitive flexibility (d+= -0.418), Decision making (d+= -0.169) and Planning (d+=-0.319), indicating a lower performance in the OCD groups compared to the healthy control groups. Results were clinically significant in all domains except decision making. Publication bias could only be carried out in flexibility and response inhibition.Conclusions: OCD patients presented worse executive performance than healthy controls in all functions, highlighting cognitive flexibility and planning. However, results should be interpreted with caution due to the small sample size.(AU)

Obsessive beliefs and uncertainty in obsessive compulsive and related patients

Background/objective: The aim of the present study was to examine obsessive beliefs and intolerance of uncertainty differences among patients Obsessive compulsive disoreder (OCD), trichotillomania, excoriation, generalized anxiety disorder (GAD) and a control group healthy.Method: 130 participants between the ages of 17 and 62 years (Mean = 29.56, SD = 11.81) diagnosed with OCD (n = 36), trichotillomania (n = 18), excoriation (n = 17), GAD (n = 31) and a healthy control group (n = 28) were evaluated by Obsessive Beliefs Spanish Inventory-Revised and Intolerance of Uncertainty Scale.Results: The trichotillomania group presented one of the highest obsessive beliefs highlighting over-importance of thoughts, thought action fusion-moral, importance of controlling one's thoughts. The OCD group also had higher scores in inflated responsibility and thought action fusion-likelihood. The GAD group excelled in inhibitory and prospective uncertainty. The level of depression influenced obsessive beliefs while anxiety affected inhibitory and prospective uncertainty.Conclusions: Cognitive variables such as obsessive beliefs and Intolerance of Uncertainty should be considered in the prevention and intervention of obsessive and anxiety disorders. (AU)

Cognitive-Behavioral Therapy and Anxiety and Depression Level in Pediatric Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis.

BACKGROUND: Although some meta-analyses have identified potential moderators associated with treatment outcomes for pediatric obsessive-compulsive disorder (OCD), there is as yet no consensus regarding the influence of anxiety and depression symptoms on the recovery from pediatric OCD. A meta-analysis was conducted to investigate the effects of depression and anxiety symptoms and their comorbidities on the efficacy of CBT in pediatric OCD, as well as other potential moderators that may be associated with outcomes. METHOD: An exhaustive literature search from 1983 to March 2021 located 22 published articles that applied cognitive-behavioral therapy (CBT) to pediatric OCD, producing a total of 26 treatment groups. Some of the moderator variables analyzed included age, gender, comorbidity baseline in anxiety, depression and obsession, and methodological quality. RESULTS: Results showed that the psychological treatment of OCD achieves clinically significant effectiveness, both for measures of obsessions and compulsions ( d + = 2.030), and for anxiety ( d + = 0.613) and depression ( d + = 0.451). An explanatory model for the CY-BOCS effect sizes showed that three moderator variables were statistically related: the mean of the CY-BOCS (Children´s Yale Brown Obsessive Compulsive Scale) in pretest, the effect size for anxiety, and the mean age of the sample. CONCLUSIONS: CBT reduced obsessive-compulsive symptoms and, to a lesser extent, anxiety and depression symptoms. Since anxiety symptoms are reduced with the same therapy, resources would be saved compared to other treatments.

Obsessive beliefs and uncertainty in obsessive compulsive and related patients creencias obsesivas e incertidumbre en pacientes con trastorno obsesivo compulsivo y afines.

Background/objective: The aim of the present study was to examine obsessive beliefs and intolerance of uncertainty differences among patients Obsessive compulsive disoreder (OCD), trichotillomania, excoriation, generalized anxiety disorder (GAD) and a control group healthy. Method: 130 participants between the ages of 17 and 62 years (Mean = 29.56, SD = 11.81) diagnosed with OCD (n = 36), trichotillomania (n = 18), excoriation (n = 17), GAD (n = 31) and a healthy control group (n = 28) were evaluated by Obsessive Beliefs Spanish Inventory-Revised and Intolerance of Uncertainty Scale. Results: The trichotillomania group presented one of the highest obsessive beliefs highlighting over-importance of thoughts, thought action fusion-moral, importance of controlling one's thoughts. The OCD group also had higher scores in inflated responsibility and thought action fusion-likelihood. The GAD group excelled in inhibitory and prospective uncertainty. The level of depression influenced obsessive beliefs while anxiety affected inhibitory and prospective uncertainty. Conclusions: Cognitive variables such as obsessive beliefs and Intolerance of Uncertainty should be considered in the prevention and intervention of obsessive and anxiety disorders.

Systematic Review and Meta-analysis: An Empirical Approach to Defining Treatment Response and Remission in Pediatric Obsessive-Compulsive Disorder.

OBJECTIVE: A lack of universal definitions for response and remission in pediatric obsessive-compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) in determining response and remission. We also aimed to generate empirically derived cutoffs on the CY-BOCS for these outcomes. METHOD: A systematic review of PubMed, PsycINFO, Embase and CENTRAL identified 5,401 references; 42 randomized controlled clinical trials were considered eligible, and 21 provided data for inclusion (N = 1,234). Scores of ≤2 in the Clinical Global Impressions Improvement and Severity scales were chosen to define response and remission, respectively. A 2-stage, random-effects meta-analysis model was established. The area under the curve (AUC) and the Youden Index were computed to indicate the discriminative ability of the CY-BOCS and to guide for the optimal cutoff, respectively. RESULTS: The CY-BOCS had sufficient discriminative ability to determine response (AUC = 0.89) and remission (AUC = 0.92). The optimal cutoff for response was a ≥35% reduction from baseline to posttreatment (sensitivity = 83.9, 95% CI = 83.7-84.1; specificity = 81.7, 95% CI = 81.5-81.9). The optimal cutoff for remission was a posttreatment raw score of ≤12 (sensitivity = 82.0, 95% CI = 81.8-82.2; specificity = 84.6, 95% CI = 84.4-84.8). CONCLUSION: Meta-analysis identified empirically optimal cutoffs on the CY-BOCS to determine response and remission in pediatric OCD randomized controlled clinical trials. Systematic adoption of standardized operational definitions for response and remission will improve comparability across trials for pediatric OCD.

Predictors of Parental Accommodation and Response Treatment in Young Children With Obsessive-Compulsive Disorder.

Background: Cognitive-behavioral family-based treatment (CBFT) is the treatment standard in very young children with obsessive-compulsive disorder (OCD), which includes the same core components of cognitive-behavioral therapy (CBT) with significant family involvement. Although the latter reports high rates of remission, some children do not improve with treatments. Therefore, it is necessary to identify possible moderating variables such as comorbidity, severity of disorder, years of onset, parental anxiety, and parental accommodation. This study has two main aims: (1) to propose a predictive model on family accommodation (father and mother), taking into account variables related to the children (severity of obsessive-compulsive responses, internalizing and externalizing symptoms, and comorbidity) and with the parents before intervention (worry, accommodation of one parental member over the other) and (2) to examine the mediating role of externalizing symptoms and mother's accommodation in the relation between initial severity and improvement of severity of obsessive-compulsive responses in children aged 5-8 years. Methods: Participants comprised 56 children with OCD [mean = 6.61 (SD = 0.76)] and their parents; 79% of the sample was men. Treatment was implemented by two clinicians specialized in OCD (>15 years of experience). Clinicians were trained to administer CBT protocol in the same way. They were doctors of clinical psychology and researchers at the OCD. Results: Mother's accommodation was associated with child variables (Child Behavior Checklist-Externalizing and Initial Severity, Children's Yale-Brown Obsessive-Compulsive Scale). Father's accommodation could be explained by parent variables (mother's accommodation and worry). Simple mediation model tested using the SPSS macro PROCESS supported the relation of the initial severity of symptoms with that following intervention, through the simple indirect effect of externalizing symptoms of the child. Conclusions: Comorbidities with externalizing symptoms, father's worry, and mother's accommodation were variables that should be controlled in treatment of pediatric OCD.

Coping Strategies, Anxiety and Depression in OCD and Schizophrenia: Changes during COVID-19.

BACKGROUND: The main aim was to examine changes in coping strategies, anxiety and depression in obsessive-compulsive and schizophrenia patients during COVID-19, in addition to controlling the influence of intolerance to uncertainty and experiential avoidance. METHOD: The first time, the study comprised (15-30 April 2020) 293 patients, 113 of whom were diagnosed with obsessive-compulsive disorder, 61 with schizophrenia and 119 healthy controls, aged 13-77 years (M = 37.89, SD = 12.65). The second time (15-30 November), the study comprised 195 participants (85 obsessive-compulsive patients, 42 schizophrenic patiens and 77 healthy controls participants). The evaluation was carried out through an online survey. RESULTS: The clinical groups worsened over time in cognitive coping, anxiety and depression, while the control group only worsened in depression. Intergroup differences in anxiety, depression and coping strategies were maintained, highlighting the use of some maladaptive strategies (avoidance, spiritual) in clinical groups. Experiential avoidance and tolerance for uncertainty mainly affected coping. CONCLUSIONS: The duration of COVID-19 not only produced changes in anxiety and depression in clinical groups but also in coping strategies to face this pandemic and its consequences.

Coping strategies in obsessive-compulsive patients during Covid-19 lockdown / Estrategias de afrontamiento en pacientes con Trastorno obsesivo-compulsivo durante el confinamiento por COVID-19

Background/Objective: The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels. (AU)

Antecedentes/Objetivo: El objetivo de este estudio fue comparar las estrategias de afrontamiento utilizadas por pacientes con Trastorno obsesivo-compulsivo (TOC) durante el confinamiento debido a la COVID-19 frente a controles sanos y analizar su relación con algunas variables que pueden influir en los resultados (ansiedad, depresión, comorbilidad, tipo de obsesiones-compulsiones). Método: Los participantes fueron 237, 122 diagnosticados de Trastorno obsesivo-compulsivo y 115 controles sanos, con edades comprendidas entre 13 y 58 años (M = 34,60, DT = 10,41). Resultados: Los grupos presentaron diferencias en el uso de algunas estrategias adaptativas (reinterpretación positiva, aceptación, humor) y desadaptativas (negación, autoculpa). Dentro del grupo TOC, la comorbilidad afectó para el mayor uso de estrategias inadecuadas (negación, abuso de sustancias y autoculpa), mientras que el tipo de obsesiones-compulsiones no influyó en el uso de las mismas. Los niveles de ansiedad y depresión estaban relacionadas con el uso de estrategias menos adaptativas. Conclusiones: Estos hallazgos refuerzan la necesidad de entrenar en la utilización de estrategias de afrontamiento eficaces y adaptativas, siendo necesario mejorar el seguimiento clínico de estos pacientes. Es importante estar en contacto con profesionales de la salud, revisar la medicación y observar los niveles de ansiedad y depresión. (AU)

Executive Functioning and Clinical Variables in Patients with Obsessive-Compulsive Disorder.

BACKGROUND: Cognitive flexibility, response inhibition, and working memory are considered the main mechanisms responsible for executive control. This study examined differences in cognitive flexibility, inhibition, and working memory in patients with obsessive-compulsive disorder (OCD) relative to a control group. METHOD: A total of 62 obsessive-compulsive participants (OCD = 32; healthy control = 32) aged between 17 and 56 years old (M = 33.16, SD = 9.23) were administered the computerized Wisconsin Card Sorting Test, Stroop Color-Word Test, Go/No-Go Task, Digit Test, and Corsi Block Test. Clinician-rated and self-reported obsessive-compulsive symptom severity, and anxiety, depression, and obsessive beliefs were evaluated. RESULTS: The control group performed better than the OCD group in tasks involving cognitive flexibility, inhibition, and visuospatial working memory. Anxiety and obsessive beliefs influenced the participants' performance on inhibition and working memory tasks. Similarly, comorbidity also influenced inhibition and working memory. In addition, the use of pharmacotherapy and the degree of OCD symptom severity influenced verbal working memory. CONCLUSIONS: Cognitive flexibility, inhibition, and visuospatial working memory deficits may be endophenotypes of OCD but require further examination for specificity. OCD severity, comorbidity patterns, anxiety, and obsessive beliefs may influence performance.

Coping strategies in obsessive-compulsive patients during Covid-19 lockdown.

The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). METHOD: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). RESULTS: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. CONCLUSIONS: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.

El objetivo de este estudio fue comparar las estrategias de afrontamiento utilizadas por pacientes con Trastorno obsesivo-compulsivo (TOC) durante el confinamiento debido a la COVID-19 frente a controles sanos y analizar su relación con algunas variables que pueden influir en los resultados (ansiedad, depresión, comorbilidad, tipo de obsesiones-compulsiones). Método: Los participantes fueron 237, 122 diagnosticados de Trastorno obsesivo-compulsivo y 115 controles sanos, con edades comprendidas entre 13 y 58 años (M = 34,60, DT = 10,41). Resultados: Los grupos presentaron diferencias en el uso de algunas estrategias adaptativas (reinterpretación positiva, aceptación, humor) y desadaptativas (negación, autoculpa). Dentro del grupo TOC, la comorbilidad afectó para el mayor uso de estrategias inadecuadas (negación, abuso de sustancias y autoculpa), mientras que el tipo de obsesiones-compulsiones no influyó en el uso de las mismas. Los niveles de ansiedad y depresión estaban relacionadas con el uso de estrategias menos adaptativas. Conclusiones: Estos hallazgos refuerzan la necesidad de entrenar en la utilización de estrategias de afrontamiento eficaces y adaptativas, siendo necesario mejorar el seguimiento clínico de estos pacientes. Es importante estar en contacto con profesionales de la salud, revisar la medicación y observar los niveles de ansiedad y depresión.

Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder / Flexibilidad cognitiva e inhibición de respuestas en pacientes con Trastorno obsesivo-compulsivo y Trastorno de ansiedad generalizada

BACKGROUND/OBJECTIVE: The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption). METHOD: The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. RESULTS: Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. CONCLUSIONS: Cognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las diferencias en flexibilidad cognitiva e inhibición de respuestas teniendo en cuenta algunas variables que pueden influir en los resultados (razonamiento no verbal, depresión, ansiedad, intolerancia a la incertidumbre, comorbilidad, consumo de fármacos). MÉTODO: Los participantes fueron 95 adultos de edades comprendidas entre 17-61 años (M = 33,48; DT = 11,13), diagnosticados de Trastorno obsesivo-compulsivo, Trastorno de ansiedad generalizada y un grupo de control sano. Las variables neuropsicológicas fueron evaluadas con el Test de Clasificación de Tarjetas de Wisconsin, Test Stroop de Colores y Palabras y Tareas Go/NoGo. RESULTADOS: Los grupos clínicos presentaron peores resultados en flexibilidad cognitiva frente al grupo control. El grupo obsesivo-compulsivo alcanzó peores puntuaciones en flexibilidad que el grupo con ansiedad generalizada, una vez controlado el razonamiento no verbal y la tolerancia a la incertidumbre. La comorbilidad y el consumo de fármacos no afectaron a los resultados en el grupo obsesivo-compulsivo. Sin embargo, ambas variables influyeron en el grupo con ansiedad generalizada. CONCLUSIONES: La flexibilidad cognitiva podría ser incluida en los paquetes de tratamiento del Trastorno obsesivo-compulsivo y del Trastorno de ansiedad generalizada

Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder.

BACKGROUND/OBJECTIVE: The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption). METHOD: The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. RESULTS: Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. CONCLUSIONS: Cognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder.

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las diferencias en flexibilidad cognitiva e inhibición de respuestas teniendo en cuenta algunas variables que pueden influir en los resultados (razonamiento no verbal, depresión, ansiedad, intolerancia a la incertidumbre, comorbilidad, consumo de fármacos). MÉTODO: Los participantes fueron 95 adultos de edades comprendidas entre 17-61 años (M = 33,48; DT = 11,13), diagnosticados de Trastorno obsesivo-compulsivo, Trastorno de ansiedad generalizada y un grupo de control sano. Las variables neuropsicológicas fueron evaluadas con el Test de Clasificación de Tarjetas de Wisconsin, Test Stroop de Colores y Palabras y Tareas Go/NoGo. RESULTADOS: Los grupos clínicos presentaron peores resultados en flexibilidad cognitiva frente al grupo control. El grupo obsesivo-compulsivo alcanzó peores puntuaciones en flexibilidad que el grupo con ansiedad generalizada, una vez controlado el razonamiento no verbal y la tolerancia a la incertidumbre. La comorbilidad y el consumo de fármacos no afectaron a los resultados en el grupo obsesivo-compulsivo. Sin embargo, ambas variables influyeron en el grupo con ansiedad generalizada. CONCLUSIONES: La flexibilidad cognitiva podría ser incluida en los paquetes de tratamiento del Trastorno obsesivo-compulsivo y del Trastorno de ansiedad generalizada.

The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth.

OBJECTIVE: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well-established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure of these dimensions in unselected schoolchildren and in children with OCD. METHOD: We estimated the network structure of OCD symptom dimensions in 6,991 schoolchildren and 704 children diagnosed with OCD from 18 sites across 6 countries. All participants completed the Obsessive-Compulsive Inventory-Child Version. RESULTS: In both the school-based and clinic-based samples, the OCD dimensions formed an interconnected network with doubting/checking emerging as a highly central node, that is, having strong connections to other symptom dimensions in the network. The centrality of the doubting/checking dimension was consistent across countries, sexes, age groups, clinical status, and tic disorder comorbidity. Network differences were observed for age and sex in the school-based but not the clinic-based samples. CONCLUSION: The centrality of doubting/checking in the network structure of childhood OCD adds to classic and recent conceptualizations of the disorder in which the important role of doubt in disorder severity and maintenance is highlighted. The present results suggest that doubting/checking is a potentially important target for further research into the etiology and treatment of childhood OCD.

Estilos educativos parentales y emociones como predictores de respuestas obsesivo-compulsivas en población adolescente / Parental educational styles and emotions as predictors of obsessive-compulsive responses in adolescent population

Resumen Las variables familiares y emocionales están relacionadas con el desarrollo y mantenimiento de distintos trastornos psicopatológicos. El objetivo de este estudio fue analizar la relación entre variables emocionales (regulación de emociones, optimismo y tolerancia a la frustración) y familiares (estilos parentales percibidos) con respuestas obsesivo-compulsivas. En cuanto al método, los participantes fueron 473 adolescentes (249 chicos y 224 chicas) con edades comprendidas entre los 12 y 18 años (M = 14.84, DT = 1.83) que cursaban estudios de Educación Secundaria y Bachillerato. En resultados, la variable optimismo alcanzó el mayor peso explicativo de obsesión-compulsión, seguida de la atención a los síntomas, revelación del padre y tolerancia a la frustración. Las puntuaciones en ansiedad y depresión presentaron un alto porcentaje de varianza explicada. Se concluye que el optimismo, la atención adecuada a los síntomas, la tolerancia a la frustración y las relaciones de confianza entre padres e hijos podrían ser factores protectores en la aparición de pensamientos obsesivo-compulsivos.

Abstract Family and emotional variables are related to the development and maintenance of different psychopathological disorders. The aim of this study was to analyze differences between emotional variables (emotion regulation, optimism and tolerance to frustration) and family variables (perceived educational styles) with obsessive-compulsive responses. Method: Participants were 473 adolescents (249 boys and 224 girls) aged between 12 and 18 years old (M = 14.84, SD = 1.83) who were studying Secondary Education. Results: The optimism variable reached the highest explanatory weight of obsession-compulsion, followed by attention to symptoms, sharing of feeling with father and tolerance to frustration. The scores in anxiety and depression showed a high percentage of variance explained. Conclusions: Optimism, adequate attention to symptoms, tolerance to frustration and relationships of trust between parents and children could be protective factors of obsessive-compulsive thoughts.

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

Psychological treatment for family members of children with cancer: A systematic review and meta-analysis.

OBJECTIVE: This meta-analytical study examined the effects of psychological treatments applied to family members of children and adolescents with cancer, as well as the characteristics of the studies that can be associated with their effects. METHODS: Four databases were searched between January 1980 and January 2017; the references of the located studies were reviewed, and emails were sent to experts in this topic. Forty articles fulfilled the selection criteria. The standardized mean pretest-posttest (or pretest-follow-up) change was used as the effect-size index for the treatment and control groups. RESULTS: The 40 articles included 40 treatment groups and 21 control groups. When treatment and control pretest-posttest mean effects were compared, psychological interventions revealed positive, statistically significant results for anxiety (dadj  = 0.339) and problem-solving skills (dadj  = 0.385) and, to a lesser extent, for posttraumatic stress (dadj  = 0.224). No statistically significant differences were found for mood (dadj  = 0.147), acute stress (dadj  = -0.010), coping skills (dadj  = 0.123), social support (dadj  = 0.245), or quality of life (dadj  = 0.538). CONCLUSIONS: Positive effects of mild to moderate magnitude were found in the posttests for some outcome measures. Behavioral interventions seem to be the most promising. Interventions achieved the best results when they were long in duration and low in intensity and when they were applied to family members with young children who were undergoing medical treatment. At follow-up, the intervention benefits were diminished. The application of psychological interventions is recommended to mitigate the negative psychological repercussions in this population.

Is there a relationship between problematic Internet use and responses of social anxiety, obsessive-compulsive and psychological well-being among adolescents? / ¿Existe relación entre uso problemático de Internet y las respuestas de ansiedad social, obsesivo-compulsivas y el bienestar psicológico en adolescentes?

Excessive Internet use in adolescents and young people is related to intrapersonal and interpersonal difficulties. The aim of this research was to study the relationship between problematic Internet use, psychological well-being, and responses of social anxiety and obsessive-compulsive. Participants were 132 male and 178 female high school and college students aged between 16 and 23 years. The results indicate that age influences most of the factors of compulsive Internet use. Gender affects the levels of problematic Internet use, with males scoring higher in Compulsive Internet Use and Negative Outcomes. A significant and direct correlation was found between problematic Internet use and responses of social anxiety and obsessive-compulsive. The main predictors of problematic Internet use were: Environmental mastery, Social anxiety and Obsessive-compulsive symptoms. It can be concluded, tentatively, that while young people with social anxiety could find the Internet use a means of pleasant interaction, young people with obsessive-compulsive symptoms could become excessive Internet users as a means to eliminate compulsive anxiety

El uso excesivo de Internet en adolescentes y jóvenes se considera relacionado con problemas intrapersonales e interpersonales. El objetivo de esta investigación fue estudiar la relación entre el uso problemático de Internet, bienestar psicológico y respuestas de ansiedad social y obsesivo-compulsivas. La muestra estuvo formada por 132 varones y 178 mujeres de edades comprendidas entre 16 y 23 años que cursaban Bachillerato y estudios universitarios. Los resultados indicaron que la edad influyó en la mayor parte de factores del Uso compulsivo de Internet. El sexo afectó a los niveles del uso problemático de Internet siendo los chicos los que mayores puntuaciones alcanzaron en uso compulsivo y consecuencias negativas. Se confirmó una correlación significativa y directa entre uso problemático de Internet y respuestas de ansiedad social y obsesivocompulsivas. Los predictores más importante del uso problemático de Internet fueron el dominio del entorno, la ansiedad social y los síntomas obsesivo-compulsivos. Se podría concluir, aunque con cautela, que mientras que los jóvenes con ansiedad social podrían buscar el uso de internet como un medio de interacción placentero, los jóvenes con síntomas obsesivocompulsivos podrían llegar a un uso excesivo como medio de eliminar la ansiedad compulsiva

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.

Psychometric properties of the Short Leyton Obsessional Inventory-Child Version in a community sample of Spanish children and adolescents / Propiedades psicométricas del Inventario Obsesivo de Leyton para Niños Versión Corta en una muestra comunitaria de niños y adolescentes

El objetivo de este estudio fue analizar las propiedades psicométricas del Short LOI-CV en una muestra española comunitaria. Los participantes fueron 914 niños y adolescentes con edad media de 13.01 años (varones = 51.3%). El AFE mostró un modelo de tres factores compuesto por los dominios Obsesiones, Compulsiones y Limpieza. Tanto la puntuación total como las subescalas mostraron una adecuada consistencia interna. La versión española mostró buena fiabilidad test-retest y moderada validez convergente y discriminante. Los participantes más jóvenes (8 a 10 años) obtuvieron medias más altas que la escala Total y distintas subescalas que los mayores (grupo de 11-13 y de 14-18 años). Se encontraron también diferencias significativas respecto al sexo, siendo los varones los que mayores medias mostraron en la escala de compulsiones. Pese a que es necesaria más investigación, estos resultados sugirieron que la versión en español del Short LOI-CV mostró un buen rendimiento psicométricos para evaluar los síntomas obsesivo-compulsivos en niños y adolescentes en población comunitaria

The aim of the current study was to analyze psychometric properties of the Short LOI-CV in Spanish community sample. Participants were 914 children and adolescents with a mean age of 13.01 years (51.3% males). The EFA yielded a three-factor model representing Obsessions, Compulsions, and Cleanliness dimensions. Both, total score and subscales showed an adequate internal consistency. The Spanish version also exhibited good test-retest reliability and moderate convergent and discriminant validity. The younger participants (from 8 to 10 years) obtained higher means for total score and subscales than older participants (groups 11-13 and 14-18 years). Significant differences related to gender were also observed since males obtained higher means in Compulsions subscale. Despite more research is required, this results suggested that Spanish version of the Short LOI-CV showed a good psychometric performance assessing obsessive-compulsive symptoms in community population