Irritability in Children and Adolescents With OCD.
Irritability in Children and Adolescents With OCD.
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DOI：
10.1016/j.beth.2020.11.001
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发表时间：
2021-07
期刊：
影响因子：
3.7
通讯作者：
Storch EA
中科院分区：
文献类型：
--
作者：
Guzick AG;Geller DA;Small BJ;Murphy TK;Wilhelm S;Storch EA
易激惹是儿童期精神病理学中一种常见的损害性转诊症状，但在儿童期强迫症（OCD）中尚未得到全面研究。此外，强迫症的中央认知行为治疗成分，暴露和反应预防疗法（ERP），最近已被提出作为易怒的治疗。本研究旨在评估某些临床特征是否与儿童强迫症的易激惹相关，以及ERP后易激惹是否减少。参与者是161名患有强迫症的青少年（7-17岁）和一名参加D-环丝氨酸或药丸安慰剂增强ERP的随机对照试验的护理人员。参与者在治疗期间完成了经验证的评估。易怒与抑郁症状、蔑视、功能障碍和家庭住宿显著正相关，与伤害责任/夸大威胁估计信念负相关，但与治疗前强迫症严重程度、症状维度、完美主义/确定性需求或焦虑无关。治疗后易怒显著下降，超过一半的青少年与任何治疗前易怒经历临床显著变化，虽然这种变化与强迫症的改善无关。结果表明，易激惹可能是一个标记的精神comorbability，父母的住宿，并在青年与强迫症的损害。对以焦虑为基础的易怒治疗的影响进行了讨论。
Irritability is a common, impairing transdiagnostic symptom in childhood psychopathology, though it has not been comprehensively studied in pediatric obsessive-compulsive disorder (OCD). Further, the central cognitive behavioral treatment component for OCD, exposure and response prevention therapy (ERP), has been recently proposed as a treatment for irritability. This study aimed to evaluate whether certain clinical characteristics are associated with irritability in pediatric OCD and whether irritability reduces following ERP. Participants were 161 youth (ages 7–17) with OCD and a caregiver participating in a randomized controlled trial of D-cycloserine or pill placebo augmented ERP. Participants completed validated assessments during treatment. Irritability was significantly and positively associated with depressive symptoms, defiance, functional impairment, and family accommodation, was negatively related to responsibility for harm/inflated threat estimation beliefs, but was not associated with pretreatment OCD severity, symptom dimensions, perfectionism/need for certainty, or anxiety. Irritability significantly declined following treatment, with over half of youth with any pretreatment irritability experiencing clinically significant change, though this change was not related to OCD improvement. Results suggest that irritability may be a marker of psychiatric comorbidity, parental accommodation, and impairment in youth with OCD. Implications for the exposure-based treatment of irritability are discussed.
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