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Estudio primario

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Severe pediatric obsessive compulsive disorder and co-morbid autistic symptoms: Effectiveness of cognitive behavioral therapy

Revista Journal of Obsessive-Compulsive and Related Disorders
Año 2016
Enlaces DOI https://www.sciencedirect.com/science/article/pii/S221136491630080X

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Clinical consensus exists on the recommendation to add medication to cognitive behavioral therapy (CBT) for children with moderate to severe obsessive compulsive disorder (OCD). However, it has never been examined if CBT monotherapy indeed is less effective for this subgroup. In addition, CBT is often expected to be less suitable in case of an autism spectrum disorder. The aim of the present study was to examine if CBT monotherapy is an effective treatment for children with severe OCD and for children with co-morbid autistic symptoms. Methods: Participants were 58 children (8-18 years) with OCD. They were randomized over two conditions: a waitlist followed by CBT, and directly starting CBT. After CBT, participants were followed during a one-year period. Linear mixed model analyses were performed to examine if severity and autistic symptoms were predictors of treatment effect. Results: Results showed that neither baseline severity, F(2, 196.52)=29, p=75, nor autistic symptoms, F(1, 182.72)=2.09, p=15, were predictive of treatment effect. Conclusion: Results suggest that the majority of children with OCD, including children with severe OCD and with autistic symptoms, can be treated effectively with CBT. Therefore, the recommendation to combine CBT and medication for children with moderate to severe OCD may need refinement.

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Treatment of Comorbid Obsessive-Compulsive Disorder in Youth with ASD: The Case of Max

Revista
Año 2016
Enlaces DOI https://doi.org/10.1007/978-3-319-17139-5_23

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Ritualized and repetitive behaviours are included in the diagnostic criteria for both autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD). OCD often co-occurs in young people with ASD, yet there is little clinical research on its phenomenology or treatment. The extant research in this area is largely composed of qualitative and single-subject study designs. In this chapter, we synthesize this body of research and provide recommendations for differential and dual diagnostic decision-making and treatment planning. The case of a 16-year-old male with comorbid ASD and OCD is presented, in which we demonstrate how standard cognitive-behavioural therapy (CBT) for OCD may be modified, for instance, to address problems with emotion regulation that hinder progression through an exposure-based therapy.

Estudio primario

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Outcomes of cognitive behaviour therapy for obsessive-compulsive disorder in young people with and without autism spectrum disorders: A case controlled study.

Revista Psychiatry research
Año 2015
Enlaces Pubmed DOI

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Obsessive-compulsive disorder (OCD) and autism spectrum disorders (ASD) are highly co-morbid. It is suggested that youth with ASD will respond less well to cognitive behaviour therapy (CBT), as compared to their typically developing counterparts. To date there is no empirical evidence to support this view. The current study sought to compare CBT for OCD outcomes among youth with and without ASD. 22 young people with ICD-10 diagnoses of OCD and ASD (OCD+ASD) were matched with 22 youth with OCD, but no ASD (OCD+NoASD) according to base line OCD symptom severity, age, and gender. Outcomes were assessed for the two groups following a course of individually tailored, but protocol-driven CBT for OCD. While both groups responded to treatment the OCD+ASD group's outcomes were inferior to the OCD+NoASD group, as indicated by a significantly smaller decrease in symptoms over treatment (38.31% vs. 48.20%) and lower remission rates at post-treatment (9% vs. 46%). Overall, young people experiencing OCD in the context of ASD benefitted from CBT, but to a lesser extent than typically developing children. Recent efforts to modifying standard CBT protocols for OCD in ASD should continue in order to optimise outcomes among youth with this particular dual psychopathology.

Estudio primario

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Preliminary randomized trial of function-based cognitive-behavioral therapy to treat obsessive compulsive behavior in children with autism spectrum disorder.

Revista Focus on Autism and Other Developmental Disabilities
Año 2015
Enlaces DOI https://doi.org/10.1177/1088357615588517

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Individuals with high functioning <i>autism spectrum disorder</i> (ASD) frequently experience obsessions and/or compulsions that are similar to those specified in <i>Diagnostic and Statistical Manual of Mental Disorders</i> (5th ed.; DSM-5) criteria for <i>obsessive-compulsive disorder</i> (OCD). However, little research exists on effective interventions for OCD-like behaviors (referred to as OCBs) in ASD. In a preliminary <i>randomized controlled trial</i> (RCT; <i>N</i> = 14), a manualized <i>function-based cognitive-behavior therapy</i> (Fb-CBT) consisting of traditional CBT components (psychoeducation and mapping, cognitive-behavioral skills training, exposure, and response prevention) as well as function-based behavioral assessment and intervention significantly decreased OCBs in 8- to 12-year-old children with ASD at post-treatment and 5-month follow-up. This multi-component treatment shows considerable promise, and a larger RCT is needed to further validate and expand these findings. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

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Modified CBT for treatment of OCD in a 7-year-old boy with ASD--a case report.

Autores Elliott SJ , Fitzsimons L
Revista Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc
Año 2014
Enlaces Pubmed DOI

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Children and adolescents with autism spectrum disorder (ASD) frequently experience obsessive-compulsive disorder (OCD). Cognitive behavioral therapy (CBT) is recommended for OCD but may need modification in children and adolescents with ASD because of cognitive differences, but guidance for therapists planning CBT for OCD in young people with ASD is sparse. This report discusses syndromes of OCD and ASD and their overlapping clinical features and etiologies, difficulties in applying CBT in the ASD population, and relevant literature. We present a case report on CBT treatment of a 7-year-old boy with ASD and OCD and modifications to CBT that were helpful.

Estudio primario

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Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: A randomized controlled trial.

Revista Depression and anxiety
Año 2013
Enlaces Pubmed DOI

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BACKGROUND: High rates of anxiety disorders, particularly obsessive compulsive disorder (OCD) are reported in people with Autism spectrum disorders (ASD). Group cognitive behavioral treatment (CBT) has been found effective for anxiety in young people with ASD but not been OCD specific. One uncontrolled pilot study of individual CBT for OCD for adults with ASD showed good treatment efficacy. METHODS: Forty-six adolescents and adults (mean age 26.9 years, 35 Males) with ASD and comorbid OCD were randomized to CBT for OCD or anxiety management (AM), a plausible control treatment. Treatments were matched in duration (mean of 17.4 sessions CBT; 14.4 sessions AM), the Yale–Brown Obsessive Compulsive Severity Scale (YBOCS) as primary outcome measure and evaluations blind to treatment group. Treatment response was defined as &gt; 25% reduction in YBOCS total severity scores. RESULTS: Both treatments produced a significant reduction in OCD symptoms, within-group effect sizes of 1.01 CBT group and 0.6 for the AM group.There were no statistically significant differences between the two groups at end of treatment, although more responders in the CBT group (45 versus 20%). Effect sizes for self-rated improvement were small (0.33 CBT group; −0.05 AM group). Mild symptom severity was associated with improvement in the AM but not the CBT group. Family/carer factors were important for both groups, in that increased family accommodation was associated with poorer outcome. CONCLUSIONS: Evidence-based psychological interventions, both AM and CBT, were effective in treating comorbid OCD in young people and adults with ASD. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

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Family Cognitive-Behavioral Treatment for a Child With Autism and Comorbid Obsessive Compulsive Disorder

Revista Clinical Case Studies
Año 2013
Enlaces DOI https://doi.org/10.1177/1534650113504488

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Cognitive-behavioral therapy (CBT) with exposure/response prevention is effective among youth with autism spectrum disorders (ASDs) and comorbid anxiety symptoms. This case illustrates the application of a modularized family-based CBT approach with a school-aged boy with autistic disorder and comorbid obsessive-compulsive disorder (OCD). Following 16 family sessions over 21 weeks, ?Jerry,? a 9-year-old Caucasian male, showed significant reduction in obsessive-compulsive symptoms. Jerry?s parents also reported improvements in emotional regulation, participation in school activities, and in his parent?child relationships. This case study illustrates the use of family-based CBT, which has been modified to account for social and behavioral deficits endemic to ASDs, for school-aged youth with autism and comorbid OCD.

Estudio primario

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Brief Report: Exposure and Response Prevention for Obsessive Compulsive Disorder in a 12-year-old with Autism

Revista Journal of autism and developmental disorders
Año 2008
Enlaces Pubmed DOI PubMed Central

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Cognitive-behavioral treatment of obsessive-compulsive disorder in a child with Asperger syndrome: a case report.

Revista Autism
Año 2003
Enlaces Pubmed DOI https://doi.org/10.1177/1362361303007002003

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This case report outlines the cognitive-behavioral treatment of obsessive-compulsive disorder in a 7-year-old female with Asperger syndrome. Interventions were based upon the work of March and Mulle and were adapted in light of the patient's cognitive, social, and linguistic characteristics. Obsessive-compulsive symptoms improved markedly after approximately 6 months of treatment. Issues regarding symptom presentation, assessment, and treatment of a dually diagnosed patient are discussed.