title: Reduction of subjective distress in CBT for childhood OCD: nature of change, predictors, and relation to treatment outcome.
abstract: Little research has investigated changes in subjective distress during cognitive-behavioral therapy (CBT) for anxiety disorders in youth. In the current study, 40 youth diagnosed with primary obsessive-compulsive disorder (OCD; M age = 11.9 years, 60% male, 80% Caucasian) and 36 parent informants completed separate weekly ratings of child distress for each OC symptom during a 12-session course of CBT. Between-session changes in distress were calculated at the start of, on average throughout, and at the end of treatment. On average throughout treatment, child- and parent-reported decreases in child distress were significant. Baseline OCD severity, functional impairment, and internalizing symptoms predicted degree of change in child distress. Additionally, greater decreases in child distress were predictive of more improved clinical outcomes. Findings advance our understanding of the strengths and limitations of this clinical tool. Future studies should examine youth distress change between and within CBT sessions across both subjective and psychophysiological levels of analysis.
authors.affiliation: Department of Psychology, Stanford University, Jordan Hall, Building 420, Stanford, CA 94305-2130, United States. Electronic address: katharina.kircanski@gmail.com.
authors.forename: Katharina
authors.initials: K
authors.lastname: Kircanski
authors.affiliation: Department of Psychology, University of South Florida, 4202 East Fowler Avenue, Tampa, FL 33620, United States.
authors.forename: Monica
authors.initials: M
authors.lastname: Wu
authors.affiliation: Division of Child and Adolescent Psychiatry, UCLA-Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA 90024, United States.
authors.forename: John
authors.initials: J
authors.lastname: Piacentini
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D013315:Stress, Psychological / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: Childhood; Cognitive-behavioral therapy (CBT); Fear thermometer; Obsessive-compulsive disorder (OCD); Subjective units of distress (SUDS)