• Type:#article
  • Year read:#read2022
  • Subject: _thesis defense MOC OCD ASD CBT
  • Bibtex: @flygare2020
  • Bibliography: Flygare, O., Andersson, E., Ringberg, H., Hellstadius, A.-C., Edbacken, J., Enander, J., Dahl, M., Aspvall, K., Windh, I., Russell, A., Mataix-Cols, D., & Rück, C. (2020). Adapted cognitive behavior therapy for obsessive–compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study. Autism, 24(1), 190–199. https://doi.org/10.1177/1362361319856974

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Reviewer comments

Adapted CBT for OCD and ASD - response to reviewer comments

  • Low engagement with trt
    • Yes, this was a challenge. There is more work to do for these patients, and a couple of ideas are to provide more in-home support in between sessions and try a concentrated mode of delivery. You could also aim at other outcomes than symptom reduction.
  • Adequate dose of CBT?
    • Treatment was spread out and they didn’t do that many ERP exercises compared to what we expected, so its likely they got a lower dose of ERP than what would have been optimal.
  • Therapist change
    • Yes, likely a side-effect of the spread out sessions. I think this would have been much lower if treatment was delivered more consistently.
  • No control group
    • Yeah we cannot rule out trt effects due to the passage of time or other circumstances beyond the treatment itself. However, spontaneous remission is unlikely for these patients.
  • Sample size
    • It was enough to detect large treatment effects at least, but it would have been an insufficient sample size had we compared to another treatment.
  • OCD/ASD symptom overlap
    • Phenomenological overlap (repetitive behaviors), but functionally different (anxiety reduction in OCD vs pleasurable repetitive activities in ASD)
  • ASD-related differences and difficulties in sessions (sensory issues, generalizing, slower habituation, identifying/labeling/grading emotional response)
    • There were some adaptations, like additional psychoeducation around emotions and grading them, visual guidance, more involvement of family and others. First 5 sessions were setup, which is longer than usual (~2 sessions)