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.

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

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