D-Cycloserine Augmentation of Cognitive Behavior Therapy for Pediatric OCD: Predictors and Moderators of Outcome
| Autor: | Daniel A. Geller, Brent J. Small, Eric A. Storch, Rachel Porth, Noah C. Berman, Sabine Wilhelm |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Obsessive-Compulsive Disorder Adolescent Antimetabolites medicine.medical_treatment Psychological intervention behavioral disciplines and activities Outcome (game theory) Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Obsessive compulsive Medicine Humans 0501 psychology and cognitive sciences Family history Child Depression (differential diagnoses) Problem Solving Cognitive Behavioral Therapy business.industry 05 social sciences Cognition Combined Modality Therapy 030227 psychiatry Cognitive behavioral therapy Psychiatry and Mental health Clinical Psychology Treatment Outcome Cycloserine Female business 050104 developmental & child psychology Clinical psychology |
| Popis: | Background Over half of children receiving cognitive behavioral therapy (CBT) for obsessive compulsive disorder (OCD) do not fully remit. To improve response rates and enhance extinction learning, d-cycloserine (DCS) has been examined as an augmenting agent of CBT. To direct children with OCD towards treatments with the highest likelihood of success, the current study evaluated the conditions under which DCS augmentation works best (i.e., moderators) and the baseline characteristics associated with outcome, irrespective of treatment type (i.e., predictors). Methods Data came from a two-site randomized controlled trial (N = 142) in which children received either DCS + CBT (n = 70) or placebo + CBT. Results No baseline variables moderated the effects of DCS augmentation on CBT outcome. However, several predictor variables were associated with a decreased likelihood of achieving remission status, including higher family accommodation scores, higher impairment scores, higher depression scores, and higher externalizing scores. Furthermore, better insight at pre-treatment was associated with more improvement longitudinally on a clinician-rated summary measure of illness severity. Limitations The current study did not examine all variables that had previously been shown to moderate or predict treatment outcome (e.g., family history of OCD or cognitive profile). Conclusions The absence of significant moderators suggests that baseline factors cannot yet be used to determine who benefits most from DCS. To maximize treatment benefits for children presenting with identified predictors of worse treatment outcome, clinicians might need to adapt existing CBT protocols and administer additional interventions that address patients’ specific problem areas. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|