BEHAVIOR THERAPY FOR CHILDHOOD OCD

这是对应用程序的重新提交，以支持受控 标准化多成分认知行为量表的评价 儿童和青少年强迫症的治疗方案 (强迫症)。治疗方案包括个人暴露外加 针对强迫症儿童和兼职家庭的反应预防(ERP) 旨在减少与强迫症相关的家庭冲突的干预措施 家庭脱离受影响儿童的强迫症行为，并重建 正常的家庭互动模式。总共八十(80)种药物- 免费青少年和他们的家人将被随机分配到 ERP/家庭联合治疗方案(n=56)或对照研究 治疗、放松训练(RT)(n=24)。这两种疗法都将是 根据详细信息，提供超过12次90分钟的门诊治疗 治疗手册。选择RT作为对照治疗是因为 它作为焦虑治疗的可信度和对潜在的熟悉度 研究对象。RT已被用作比较条件至少有两个 成人强迫症的随机对照ERP试验 在治疗这种疾病方面无效。强迫症是一种慢性疾病，通常 儿童时期的致残性障碍。初步研究表明，企业资源规划 是一种有效的治疗儿童强迫症的方法，尽管没有控制 关于这一效果的试验已经发表。童年时期的强迫症一直是 与父母精神病变率的增加和 家庭关系和功能严重中断。 此外，家庭背景变量与 较差的治疗反应和较差的长期结果。尽管它 长期以来一直被认为家庭参与治疗可能 值得注意的是，这是第一个纳入了 系统化的手工家庭治疗部分。 青少年和家庭将经历全面、系统、 包括由盲人临床评估者在 基线、治疗期间每月、治疗后和两次随访 六个多月的评估。治疗结果将在#年进行检查 多模式时尚，跨多个功能领域，具有特殊的 强调家庭背景变量。基准线的影响 功能，包括家庭背景，以及随着时间的推移最初的变化 治疗结果也将得到系统的评估。

This is a resubmission of an application to support the controlled evaluation of a standardized multicomponent cognitive behavioral treatment program for child and adolescent Obsessive-Compulsive Disorder (OCD). The treatment program consists of individual exposure plus response prevention (ERP) for the OCD child plus a concurrent family intervention designed to reduce OCD-related family conflict, facilitate family disengagement from the affected child's OCD behavior, and rebuild normal family interaction patterns. A total of eighty (80) medication- free youngsters and their families will be randomly assigned to receive either the combined ERP/Family Treatment Program (n=56) or a comparison treatment, Relaxation Training (RT) (n=24). Both treatments will be delivered over 12 90 minute outpatient sessions according to detailed treatment manuals. RT was selected as the comparison treatment because of its credibility as an anxiety treatment and familiarity to potential subjects. RT has been used as a comparison condition for at least two randomized controlled ERP trials for adult OCD and shown to be ineffective in treating this disorder. OCD is a chronic, often disabling disorder in childhood. Preliminary studies suggest that ERP is an effective treatment for children with OCD although no controlled trials to this effect have been published. OCD in childhood has been associated with increased rates of parental psychopathology and significant disruptions in family relationships and functioning. Moreover, family contextual variables have been associated with both a worse treatment response and a poorer long-term outcome. Although it has long been hypothesized that family participation in treatment may be helpful, this is the first controlled study incorporating a systematic manualized family treatment component. Youngsters and families will undergo comprehensive, systematic, including behavioral, assessments by blind clinical evaluators at baseline, monthly during treatment, posttreatment, and two follow-up evaluations over six months. Treatment outcome will be examined in multimodal fashion and across multiple functional domains with a special emphasis on family contextual variables. The impact of baseline functioning, including family context, and initial change over time on treatment outcome will also be systematically evaluated.