Predictors And Moderators Of Cognitive-Behavioural Therapy Outcomes In Childhood Obsessive-Compulsive Disorder

Abstract

Obsessive-compulsive disorder (OCD) can be a chronic and impairing condition affecting up to 3% of children and adolescents. While previous research has established cognitivebehavioural therapy (CBT) as the psychological treatment of choice, some children and adolescents do not experience disorder remission following CBT. The aim of this research was to better understand predictors and moderators of CBT treatment for children and adolescents with OCD. Study 1 was a systematic review of this treatment outcome literature. PsycINFO, EMBASE, CENTRAL, and PubMed databases were searched and studies were selected for the review based on pre-determined inclusion criteria. A range of factors were identified as predictors of CBT treatment outcome including OCD symptom severity, functional impairment, family accommodation, comorbidity, and therapeutic process factors. Study 2 used the outcomes of Study 1 to complete predictor and moderation analyses using data obtained from a completed randomised controlled non-inferiority trial comparing telephone delivered CBT to clinic-based CBT in a sample of 72 adolescents with OCD. Results showed no predictors of treatment outcome, however maternal accommodation of OCD symptoms predicted outcome in face-to-face CBT. Maternal accommodation and conduct disorder symptoms moderated the effect of treatment condition on outcome. These findings indicate that predictors and moderators of treatment outcome may differentiate between treatment modalities