Self-Regulation and Other Executive Functions Relationship to Pediatric OCD Severity and Treatment Outcome

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• 作者：Joseph P. H. McNamara (1)
  Adam M. Reid (1) (2)
  Amanda M. Balkhi (1) (2)
  Regina Bussing (1) (2) (5)
  Eric A. Storch (4) (6)
  Tanya K. Murphy (4) (6)
  Paulo A. Graziano (3)
  Andrew G. Guzick (1)
  Gary R. Geffken (1) (2)
  
• 关键词：Obsessive ; compulsive disorder ; Children ; BRIEF ; Cognitive behavioral therapy ; Serotonin reuptake inhibitors ; Treatment outcome
• 刊名：Journal of Psychopathology and Behavioral Assessment
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：36
• 期：3
• 页码：432-442
• 全文大小：278 KB
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• 作者单位：Joseph P. H. McNamara (1)
  Adam M. Reid (1) (2)
  Amanda M. Balkhi (1) (2)
  Regina Bussing (1) (2) (5)
  Eric A. Storch (4) (6)
  Tanya K. Murphy (4) (6)
  Paulo A. Graziano (3)
  Andrew G. Guzick (1)
  Gary R. Geffken (1) (2)
  
  1. Division of Medical Psychology, Department of Psychiatry, University of Florida, P.O. Box 100234, 1600 S Archer Rd, Gainesville, FL, 32611, USA
  2. Department of Clinical and Health Psychology, University of Florida, P.O. Box 100165, 1600 S Archer Rd, Gainesville, FL, 32611, USA
  5. Department of Pediatrics, University of Florida, PO Box 100296, Gainesville, FL, 32610, USA
  4. Department of Pediatrics, University of South Florida, 880 6th Street South 4th Floor, Box 7523 St., Petersburg, FL, 33701, USA
  6. Department of Psychiatry & Behavioral Neurosciences, University of South Florida, 3515 E. Fletcher Ave., Tampa, FL, 33613, USA
  3. Center for Children and Families & Department of Psychology, Florida International University, 11200 SW 8th Street, HLS 1 Rm. 235A, Miami, FL, 33199, USA
  
• ISSN：1573-3505

文摘

The intersection of obsessive-compulsive disorder (OCD) and executive functioning (EF) in children and adolescents is an emerging topic in the current literature. Spurred by the consistent association between increased EF deficits and higher adult obsessive-compulsive severity, a few initial studies have replicated this relationship in pediatric OCD samples and also have found preliminary evidence that EF deficits are associated with worse response to first-line psychotherapeutic or psychopharmacological treatments for pediatric OCD. This study aimed to extend the literature by providing the first comprehensive investigation of how multiple EF domains, measured repeatedly over the course of treatment, impact pediatric obsessive-compulsive severity and response to multimodal treatment. Multi-level modeling results found that deficits in shifting, inhibition, emotional control, planning/organizing, monitoring and initiating all predicted higher average obsessive compulsive severity across treatment. Interestingly, out of the eight domains of EF investigated, only emotional control moderated treatment outcome such that those with worse emotional control experienced less of a reduction in obsessive-compulsive severity during treatment. The findings generally align with previous theories for the link between EF and OCD and indicate that emotional control has important implications in the treatment of pediatric OCD. In fact, emotional control may provide one explanation for why factors such as disgust sensitivity, oppositional behavior, and third-wave behavioral treatment techniques have all been linked to pediatric OCD treatment outcome. Future research should investigate augmentation strategies that target emotional control in children and adolescents.