Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders - a randomized controlled trial
- Type:#article
- Year read:#read2017
- Subject: OCD ASD CBT
- Bibtex: @russell2013
- Bibliography: Russell, A. J. et al. Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: a randomized controlled trial. Depress. Anxiety 30, 697–708 (2013).
Notes & Comments
n = 46 randomized to CBT for OCD or anxiety management.
YBOCS results
- CBT: d = 1, 45% had at least 25% improvement pre-post
- AM: d = 0.6, 20% had at least 25% improvemenet pre-post
Adaptations of standard CBT
- Ensuring the building blocks for treatment (i.e., understanding and differentiating emotions, particularly anxiety, and making links between thoughts, feelings, and behaviors) were in place
- If required, educational sessions about understanding and rating anxiety
- Visual tools and concrete/special interest related analogies were used to convey psychological concepts
- A structured and therapist-directed approach to sessional and homework content
There were on average 10 ERP homework tasks, 79% compliance.
- Annotations
Page 1: Highlight annotation by Oskar Flygare on December 8th 2017, 8:23:08 am:
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.
Page 1: Highlight annotation by Oskar Flygare on December 8th 2017, 8:23:27 am:
evaluations blind to treatment group. Treatment response was defined as > 25% reduction in YBOCS total severity scores.
Page 1: Highlight annotation by Oskar Flygare on December 8th 2017, 8:23:45 am:
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.
Page 1: Highlight annotation by Oskar Flygare on December 8th 2017, 8:23:54 am:
Evidence-based psychological interventions, both AM and CBT, were effective in treating comorbid OCD in young people and adults with ASD.
Page 3: Highlight annotation by Oskar Flygare on December 8th 2017, 8:41:04 am:
the compliance rate for ERP homework tasks was 79%
Page 3: Highlight annotation by Oskar Flygare on December 8th 2017, 8:44:46 am:
A reduction of at least 25% on the YBOCS severity rating scale is considered to be a sensitive but not specific measure of treatment response.[28] A YBOCS total score of ≤ 12 for 1 week or more was used to define remission[28] with remission lasting for longer than 1 month being defined as recovery.
Page 4: Highlight annotation by Oskar Flygare on December 8th 2017, 8:45:44 am:
In terms of missing data, Y- BOCS and D-YBOCS ratings were available for all par- ticipants in both groups at the start of treatment, 20 in the CBT group, and 20 in the AM group at the end of treatment, and 18 in the CBT and 17 in the AM group at 1-month follow-up.
Page 5: Highlight annotation by Oskar Flygare on December 8th 2017, 8:46:43 am:
When a more stringent rating of treatment response, that is, a CGI “much or very much improved” combined with a > 35% reduction in YBOCS total severity ratings was considered, 6/20 (30%) of the CBT group achieved treatment response compared with 2/20 (10%) of the AM group.