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• W2020979068 abstract "Abstract Family factors such as conflict, blame, and poor cohesion have been found to attenuate response to cognitive behavior therapy (CBT) for pediatric obsessive compulsive disorder (OCD). This study examined the feasibility and acceptability of a brief, personalized intervention for cases of pediatric OCD complicated by these family features. Twenty youth with a primary Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of OCD (M age = 12.50 years; 55% male; 60% Caucasian) and their families participated. To be included in the study, families were required to evidence poor functioning on measures of blame, conflict, and/or cohesion. Eligible families were randomly assigned either to standard treatment (ST) with 12 weeks of individual child CBT that included weekly parent check-ins and psychoeducation or to Positive Family Interaction Therapy (PFIT), which consisted of 12 weeks of individual child CBT plus an additional 6 sessions of family treatment aimed at shifting family dynamics. Clinical outcomes were determined by blind independent evaluators using the Clinician's Global Impressions–Improvement (CGI-I) scale. All families completed the study. High levels of satisfaction were reported among participants in both arms of the study, despite the added burden of attending the PFIT sessions. Both mothers and fathers attended 95% of the PFIT family sessions. Families in the ST condition demonstrated a 40% response rate on the CGI-I; families in the PFIT condition demonstrated a 70% response rate. Treatment gains were maintained in both conditions at 3-month follow-up. Preliminary data suggest that PFIT is acceptable and feasible. Further testing and treatment development are needed to optimize outcomes for complicated cases of pediatric OCD. Acknowledgments This research was supported by grants from the Obsessive Compulsive Foundation (Piacentini, Peris), a NARSAD Young Investigator Award (Peris), and NIMH K23 MH085058 (Peris). We gratefully acknowledge the contributions of Katharina Kircanski, Shannon Bennett, Joyce Lee, Lynn Lim, and the families who participated in this project. Notes Note: For FES Conflict, higher scores indicate lower levels of conflict. For FES Cohesion, higher scores indicate better family functioning. For the PABS, higher scores reflect higher levels of blame. PFIT = Positive Family Interaction Therapy; ST = standard treatment; CY-BOCS = Children's Yale–Brown Obsessive Compulsive Scale (Scahill et al., Citation1997); CGI-S = Clinician's Global Impressions-Severity Scale (Guy, Citation1976); CGAS = Clinician's Global Assessment Scale (Shaffer et al., Citation1983); FES = Family Environment Scale (Moos & Moos, Citation1994); PABS = Parental Attitudes and Behaviors Scale (Peris, Roblek, et al., 2008). a n = 10. b n = 10. c N = 10. *p < .05. Note: With one outlier removed, the average PFIT satisfaction score for mothers = 26.22, p = .06. PFIT = Positive Family Interaction Therapy; ST = standard treatment. a n = 20. b n = 20. Note: n = 20 at Weeks 0 and 14; n = 16 at Week 24. PFIT = Positive Family Interaction Therapy; ST = standard treatment with individual child CBT plus a weekly family check-in; CY-BOCS = Children's Yale–Brown Obsessive Compulsive Scale; CGAS = Clinician's Global Assessment Scale. Note: Conflict and Cohesion were measured using the respective scales of the Family Environment Scale with higher scores on both measures reflecting better family functioning (i.e., high-conflict score = low levels of family discord). Sample size for each group at each time-point is listed in parentheses. All families (n = 20) completed the Family Accommodation Scale (FAS) at baseline and post-treatment (Week 14) via clinical interview with the independent evaluator and all mothers (n = 20) and available fathers (n = 18 as two participants had no contact with their fathers) had complete data at baseline. Four families were lost to follow-up at Week 24 (two in each condition) with remaining missing data due to (a) only one parent completing measures at the assessment visit, (b) incomplete completion of study measures, or (c) telephone assessment with families who did not mail in their self-report forms. PFIT = Positive Family Interaction Therapy; ST = standard treatment. *Significant group difference, p = .01." @default.
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• W2020979068 date "2013-01-01" @default.
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• W2020979068 title "Optimizing Treatment for Complex Cases of Childhood Obsessive Compulsive Disorder: A Preliminary Trial" @default.
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