BEHAVIOR THERAPY FOR CHILDHOOD OCD

这是一个重新提交的申请，以支持控制 标准化多成分认知行为评估 儿童和青少年强迫症治疗计划 （强迫症）。 治疗方案包括个人暴露加上 强迫症儿童的反应预防（ERP）加上并发家庭 旨在减少与强迫症有关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 共80种药物- 免费的青少年及其家人将被随机分配到 结合ERP/家庭治疗计划（n=56）或比较 放松训练（RT）（n=24）。 两种治疗方法都将 提供了超过12个90分钟的门诊会议，根据详细的 治疗手册 选择RT作为比较治疗，因为 它作为一种焦虑治疗的可信度和对潜在的 科目RT已被用作至少两个的比较条件 成人强迫症的随机对照ERP试验， 对治疗这种疾病无效。 强迫症是一种慢性病， 儿童期的残疾障碍 初步研究表明， 是一种有效的治疗儿童强迫症，虽然没有控制 已经发表了这方面的试验。 童年的强迫症 与父母精神病理学的发病率增加有关， 严重破坏家庭关系和功能。 此外，家庭背景变量与这两个因素都有关联。 治疗反应较差，长期结果较差。 虽然 长期以来一直假设，家庭参与治疗可能 这是第一个对照研究， 有系统的家庭治疗组成部分。 青少年和家庭将接受全面，系统， 包括行为评估，由盲态临床评价者进行， 基线、治疗期间每月、治疗后和两次随访 六个月以上的评估。 治疗结果将在 多模式的时尚和跨多个功能领域的特殊 强调家庭背景变量。基线的影响 包括家庭环境，以及 治疗结果也将进行系统评估。

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.