Avoidance, Insight, Impairment Recognition Concordance, and Cognitive-Behavioral Therapy Outcomes in Pediatric Obsessive-Compulsive Disorder

No Thumbnail Available
File version
Author(s)
Selles, RR
Højgaard, DRMA
Ivarsson, T
Thomsen, PH
McBride, NM
Storch, EA
Geller, D
Wilhelm, S
Farrell, LJ
Waters, AM
Mathieu, S
Stewart, SE
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2019
Size
File type(s)
Location
License
Abstract

Objective: Insight and avoidance are commonly discussed factors in obsessive-compulsive disorder (OCD) that have demonstrated associations with increased severity as well as reduced treatment response in adults, but these factors have not been sufficiently examined in pediatric OCD. This study examined the impacts of avoidance, insight, and impairment recognition concordance on cognitive-behavioral therapy (CBT) outcomes as well as impacts of CBT on insight and avoidance in a large sample of youths affected by OCD. Method: Data from 573 OCD-affected youths enrolled in CBT trials were aggregated. Children’s Yale-Brown Obsessive-Compulsive Scale items measured treatment response, insight, and avoidance. Standardized differences between child and parent ratings of impairment were used to calculate impairment recognition concordance. Binary logistic regression was used to identify variables associated with treatment response. Results: Greater avoidance, limited child recognition of impairment, older age, and lower baseline severity predicted reduced likelihood of treatment response, but insight did not. Both insight and avoidance improved significantly following CBT. Response rates were lower when posttreatment insight and avoidance were worse. Conclusion: Contrasting with prevailing belief, poor insight does not appear to limit CBT response potential in pediatric OCD. Avoidance and impairment recognition are understudied CBT response predictors and warrant further consideration in pediatric OCD. Clinicians should attend to these factors to optimize outcomes for children affected by this common, debilitating illness.

Journal Title

Journal of the American Academy of Child and Adolescent Psychiatry

Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note

This publication has been entered into Griffith Research Online as an Advanced Online Version.

Access the data
Related item(s)
Subject

Biomedical and clinical sciences

Psychology

Cognitive and computational psychology

Clinical sciences

Paediatrics

Applied and developmental psychology

exposure and response prevention

mega-analysis

predictors

symptom recognition

treatment response

Persistent link to this record
Citation

Selles, RR; Højgaard, DRMA; Ivarsson, T; Thomsen, PH; McBride, NM; Storch, EA; Geller, D; Wilhelm, S; Farrell, LJ; Waters, AM; Mathieu, S; Stewart, SE, Avoidance, Insight, Impairment Recognition Concordance, and Cognitive-Behavioral Therapy Outcomes in Pediatric Obsessive-Compulsive Disorder, Journal of the American Academy of Child and Adolescent Psychiatry, 2019

Collections