Measuring fear change within exposures: Functionally-defined habituation predicts outcome in three randomized controlled trials for pediatric OCD.

Benito, Kristen; Machan, Jason T.; Freeman, Jennifer B.; Garcia, Abbe; Walther, Michael; Frank, Hannah E.; Wellen, Brianna; Stewart, Elyse; Edmunds, Julie; Kemp, Joshua J.; Sapyta, Jeffrey; Franklin, Martin E.

doi:10.1037/ccp0000315

Cited by 57 publications

(46 citation statements)

References 38 publications

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“…There is evidence from two studies that greater variability of distress during exposure is associated with better outcomes (Kircanski and Waters et al 2015). At post-treatment, Waters et al (2015) found a significant association between greater emotional variability and improved mixed anxiety severity immediately post-treatment, with a large effect size, although this association was not found by Benito et al (2018) or Kircanski and Peris (2015). However, at 3-month follow-up, Kircanski and Peris (2015) did find that greater emotional variability in distress was significantly associated with reductions in OCD severity, with a medium effect size.…”

Section: Variability Of Distressmentioning

confidence: 97%

“…Five studies investigated the relationship between child distress during exposure and treatment outcomes (Benito et al 2018;Hedtke et al 2009;Kircanski and Peris 2015;Peterman et al 2016;Waters et al 2015).…”

Section: Distressmentioning

confidence: 99%

“…the highest anxiety rating) during exposure and treatment outcomes (Benito et al 2018;Hedtke et al 2009;Peterman et al 2016). None of the studies found significant associations between fear activation and OCD or mixed anxiety symptom severity post-treatment (Benito et al 2018;Hedtke et al 2009;Peterman et al 2016) and, in the one study where an effect size was available, this did reach a small effect at post-treatment and at 1-year follow-up (Peterman et al 2016). However, secondary analysis of the data in Peterman et al (2016) did find that greater initial fear activation was significantly associated with lower anxiety severity at 1-year follow-up for children with a diagnosis of separation anxiety and/or social anxiety disorder, but not for those with generalised anxiety disorder.…”

Section: Fear Activationmentioning

confidence: 99%

“…Four studies looked at the relationship between withinexposure fear reduction and treatment outcomes (Benito et al 2018;Kircanski and Peris 2015;Peterman et al 2016;Waters et al 2015). There is mixed evidence from two studies with young people with OCD that greater withinexposure fear reduction across treatment is associated with more positive outcomes.…”

Section: Fear Reductionmentioning

confidence: 99%

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Optimising Exposure for Children and Adolescents with Anxiety, OCD and PTSD: A Systematic Review

Plaisted

Waite

Gordon

et al. 2021

Clin Child Fam Psychol Rev

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Cognitive behavioural therapy is an effective treatment for anxiety disorders in children and young people; however, many do not benefit. Behavioural exposure appears to be the critical ingredient in the treatment of anxiety disorders. Research with adults has identified innovative strategies to optimise exposure-based treatments, yet it is not clear how to optimise the effects of exposure for children and young people. This review was a preliminary exploration of the association between potential optimisation strategies and treatment procedures and outcomes for the treatment of child anxiety symptoms/disorders. We searched Psych-Info and Medline databases using a systematic search strategy and identified 29 articles. We found preliminary evidence that some specific strategies may enhance the effects of exposure, such as dropping safety behaviours, parents and therapists discouraging avoidance, and the use of homework. However, not one significant finding was replicated by another study for the same timepoint using the same methodology. To a large degree, this lack of replication reflects a limited number of studies combined with a lack of consistency across studies around conceptualisations, methodological approaches, and outcome measures making it difficult to make meaningful comparisons between studies and draw firm conclusions. Examination is needed of a wide range of theoretically-driven potential optimisation strategies using methodologically robust, preclinical studies with children and young people. Furthermore, the methods used in future research must enable comparisons across studies and explore developmental differences in the effects of particular optimisation strategies.

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Section: Variability Of Distressmentioning

confidence: 97%

Section: Distressmentioning

confidence: 99%

Section: Fear Activationmentioning

confidence: 99%

Section: Fear Reductionmentioning

confidence: 99%

See 2 more Smart Citations

Optimising Exposure for Children and Adolescents with Anxiety, OCD and PTSD: A Systematic Review

Plaisted

Waite

Gordon

et al. 2021

Clin Child Fam Psychol Rev

View full text Add to dashboard Cite

show abstract

“…CBT+NIBS trials should also incorporate established treatment fidelity methods to ensure that the CBT is delivered, received, and enacted as intended (38,39). Quantification of process elements [e.g., patient/therapist behaviors (40)] and measurement of relevant moderators and mediators should also be considered, as these methods may reveal causes of variable outcomes, information that can in turn be used to further refine, personalize, or optimize the intervention.…”

Section: Consideration 4: Cbt Efficacy Varies Across Individuals and Practitionersmentioning

confidence: 99%

Considerations for Pairing Cognitive Behavioral Therapies and Non-invasive Brain Stimulation: Ignore at Your Own Risk

et al. 2021

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Multimodal approaches combining cognitive behavioral therapies (CBT) with non-invasive brain stimulation (NIBS) hold promise for improving the treatment of neuropsychiatric disorders. As this is a relatively new approach, it is a critical time to identify guiding principles and methodological considerations to enhance research rigor. In the current paper, we argue for a principled approach to CBT and NIBS pairings based on synergistic activation of neural circuits and identify key considerations about CBT that may influence pairing with NIBS. Careful consideration of brain-state interactions and CBT-related nuances will increase the potential for these combinations to be positively synergistic.

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A critical review of cognitive behavioural therapy for hoarding disorder: How can we improve outcomes?

David

Crone

Norberg

2021

Clin Psychology and Psychoth

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Psychological treatment for hoarding problems has historically been associated with poor outcomes. When treated as a subgroup of obsessive-compulsive disorder, individuals with hoarding beliefs were less likely to respond to treatment than individuals exhibiting other obsessive-compulsive beliefs and behaviours. When treated as its own disorder using cognitive behavioural therapy, individuals report approximately 25% improvement in symptoms on average. However, less than a third of people experience clinically meaningful change. Further, changes in functioning and quality of life are not routinely assessed. In this paper, we review the current conceptualization and treatment of hoarding problems to shed light on how treatment for hoarding disorder may be improved. Utilizing a harm reduction approach before administering treatment may be important to ensure the safety of individuals. Research should test whether treatment outcomes improve by including strategies that enhance a client's interpersonal functioning and ability to regulate emotions (i.e., based on dialectal behaviour therapy and mentalization-based treatments), especially while discarding and organizing belongings. We should also use modern learning theory to improve the delivery of exposure activities.

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Measuring fear change within exposures: Functionally-defined habituation predicts outcome in three randomized controlled trials for pediatric OCD.

Cited by 57 publications

References 38 publications

Optimising Exposure for Children and Adolescents with Anxiety, OCD and PTSD: A Systematic Review

Optimising Exposure for Children and Adolescents with Anxiety, OCD and PTSD: A Systematic Review

Considerations for Pairing Cognitive Behavioral Therapies and Non-invasive Brain Stimulation: Ignore at Your Own Risk

A critical review of cognitive behavioural therapy for hoarding disorder: How can we improve outcomes?

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