title: Evidence for successful implementation of exposure and response prevention in a naturalistic group format for pediatric OCD.
abstract: BACKGROUND
  Although exposure and response prevention (ERP) is an effective treatment for youth with obsessive-compulsive disorder (OCD), the majority of studies, randomized clinical trials of individual therapy, find variability in treatment response. We evaluated the potential role of individual differences in OCD presentation, comorbid disorders, age, and gender on treatment effects. Moreover, we examined these potential effects in a group format in a naturalistic, clinic-based sample of patients.
  
  
  METHODS
  Pediatric patients with a DSM-IV diagnosis of OCD (n=41) were treated with ERP in an intensive outpatient community-based program. OCD, mood, and anxiety symptom severity was measured at baseline, during treatment, and at discharge. Trajectories and predictors of treatment outcome were measured using linear growth models.
  
  
  RESULTS
  We found that group-based ERP was effective in reducing pediatric OCD symptom severity in a naturalistic treatment setting irrespective of age or gender. Furthermore, ERP was found to be effective at reducing depressive symptoms but not other anxiety symptoms. We also found inter-individual variability in the discharge levels of contamination, symmetry, and intrusive sexual thoughts and in the rate of severity reduction of intrusive sexual thoughts.
  
  
  CONCLUSIONS
  Group-based ERP is an effective treatment for children and adolescents with OCD. Several factors, including symptom dimensions and comorbid psychopathology, are associated with treatment response and outcome in this pediatric population.
authors: Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA 15213, USA. olinotm@upmc.edu
authors: Thomas M
authors: TM
authors: Olino
authors: Susan
authors: S
authors: Gillo
authors: David
authors: D
authors: Rowe
authors: Sean
authors: S
authors: Palermo
authors: Elizabeth C
authors: EC
authors: Nuhfer
authors: Boris
authors: B
authors: Birmaher
authors: Andrew R
authors: AR
authors: Gilbert
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D055317:Evidence-Based Practice; D005196:Family Therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D007206:Individuality; D007266:Inhibition, Psychological; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011615:Psychotherapy, Group / Q000379:methods*; D016896:Treatment Outcome