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Behav Res Ther. 2014 May;56:30-8. doi: 10.1016/j.brat.2014.02.001. Epub 2014 Mar 2.

Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial.

Author information

1
Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA. Electronic address: alewin@health.usf.edu.
2
Department of Psychology, University of South Florida, USA.
3
Department of Pediatrics, University of South Florida, USA.
4
Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA.
5
Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.
6
Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.

Abstract

AIMS:

To examine the feasibility, acceptability and preliminary efficacy of family-based exposure/response prevention therapy (E/RP) versus treatment as usual (TAU) in a cohort of very young children with early onset obsessive-compulsive disorder (OCD).

METHODS:

Thirty-one children ages 3-8 years (M = 5.8 years) with a primary diagnosis of OCD were randomized to E/RP or TAU. The E/RP condition received 12 sessions of family-based E/RP twice weekly over 6 weeks. Families were assessed at baseline, post-treatment, 1-month and 3-month follow up. The Children's Yale Brown Obsessive Compulsive Scale and Clinical Global Impression served as primary outcome measures.

RESULTS:

A large group effect emerged in favor of the E/RP group (d = 1.69). Sixty-five percent of the E/RP group was considered treatment responders as compared to 7% in the TAU group. Symptom remission was achieved in 35.2% of the E/RP group and 0% of the TAU group. There was no attrition and satisfaction was high; gains were maintained at 3 months.

CONCLUSIONS:

Even amongst children as young as 3 years, developmentally tailored E/RP is efficacious and well-tolerated in reducing OCD symptoms. Key adaptations for younger children include extensive parent involvement, targeting family accommodation, and frequent meetings while delivering a full course of E/RP.

CLINICALTRIALSGOV IDENTIFIER:

NCT01447966 http://clinicaltrials.gov/ct2/show/NCT01447966?term=ocd+and+st+petersburg&rank=1.

KEYWORDS:

Accommodation; Cognitive therapy; Exposure-response prevention; OCD; Preschool; Very young children

PMID:
24657310
DOI:
10.1016/j.brat.2014.02.001
[Indexed for MEDLINE]

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