Co-occurring PTSD in intensive OCD treatment: Impact on treatment trajectory vs. response.

Background: Obsessive-compulsive disorder (OCD) and co-occurring posttraumatic stress disorder (PTSD) is associated with more severe and chronic OCD. However, findings regarding treatment effectiveness of cognitive behavioral treatment (CBT) with exposure and response prevention (ERP) with this comorbidity are mixed. Research aimed at understanding the precise barriers to OCD treatment effectiveness for individuals with co-occurring PTSD may help elucidate unique treatment needs.

Intensive Cognitive-Behavioral Therapy Telehealth for Pediatric Obsessive-Compulsive Disorder During the COVID-19 Pandemic: Comparison With a Matched Sample Treated in Person.

Objective: This naturalistic, nonblinded, nonrandomized study examined the efficacy of multimodal treatment including intensive cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) delivered via telehealth (TH) compared with a matched sample of youth treated in person (IP).

Method: Patients included 1,286 youth ages 7 to 17 inclusive (643 TH, 643 IP) who received TH or IP in either partial hospitalization (n = 818) or intensive outpatient (n = 468) programs. Changes in patient-rated OCD symptoms and quality of life from pretreatment to posttreatment were examined.

Common rituals in obsessive-compulsive disorder and implications for treatment: A mixed-methods study.

Obsessive-compulsive disorder (OCD) is characterized by engagement in rituals that serve to obtain certainty and prevent feared outcomes. Exposure and response prevention is most effective when rituals are resisted, yet existing self-report measures of OCD limit identification of the full range of possible rituals, and little is known about how rituals might cluster together and predict worsened severity and poorer treatment outcomes. In a retrospective sample of 641 adult patients who received intensive OCD treatment, the present study used a mixed-methods approach to (a) identify and validate treatment provider-identified rituals using the Yale-Brown Obsessive-Compulsive Scale, (b) identify clustering patterns of rituals, and (c) examine the impact of these clusters on severity and treatment outcomes.

The contribution of guilt sensitivity in the prediction of obsessive-compulsive disorder symptom dimensions: Replication and extension.

Background: Obsessive-compulsive disorder (OCD) is associated with particular cognitive processes, such as beliefs about the importance of intrusive thoughts. The present study examined the explanatory power of guilt sensitivity to OCD symptom dimensions after controlling for well-established cognitive predictors.

Methods: 164 patients with OCD completed self-reported measures of OCD and depressive symptoms, obsessive beliefs, and guilt sensitivity.

Co-occurring depression and obsessive-compulsive disorder: A dimensional network approach.

Background: Depressive and obsessive-compulsive (OCD) symptoms often co-occur and a number of possible explanations for this co-occurrence have been explored, including shared biological and psychosocial risk factors. Network approaches have offered a novel hypothesis for the link between depression and OCD: functional inter-relationships across the symptoms of these conditions. The few network studies in this area have relied largely on item, rather than process-level constructs, and have not examined relationships dimensionally.

Symptom severity and presentation in comorbid OCD and PTSD: A clinical replication.

Individuals with comorbid obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) experience more severe OCD symptoms and poorer treatment response. Despite some evidence linking OCD symptom domains to trauma, only one study to date has examined typical OCD and PTSD presentations in individuals with OCD+PTSD, and findings were based on a nonclinical sample. The current study sought to replicate findings in a clinical sample of 1,014 patients diagnosed with OCD ( = 928), PTSD ( = 40), and OCD+PTSD ( = 46) in specialty OCD and anxiety treatment programs.

Transgender and Gender Diverse Patients in Intensive Mood Disorder Treatment: A Comparative Examination of Clinical Presentation and Treatment Outcomes.

Individuals who are transgender and gender diverse (TGD) are more likely to suffer from and to seek mental health services for mood disorders. Some literature suggests that TGD individuals, because of pervasive and systemic minority stress, may have more complex clinical presentations (i.e.

Co-Occurring Obsessive-Compulsive and Posttraumatic Stress Disorder: A Review of Conceptualization, Assessment, and Cognitive Behavioral Treatment.

Posttraumatic stress disorder (PTSD) co-occurs with obsessive-compulsive disorder (OCD) nearly 25% of the time, and rates of co-occurring OCD within PTSD populations are even higher. Several studies examining the impact of co-occurring OCD and PTSD with suggest attenuated treatment response, yet findings regarding symptom presentation in this population are mixed. Given phenotypic, functional, and sometimes etiological overlap in OCD and PTSD, differential diagnosis and specialized treatment can be a complex yet important undertaking.

Does the network structure of obsessive-compulsive symptoms at treatment admission identify patients at risk for non-response?

Exposure and response prevention is the gold-standard treatment for obsessive compulsive disorder (OCD), yet up to half of patients do not adequately respond. Thus, different approaches to identifying and intervening with non-responders are badly needed. One approach would be to better understand the functional connections among aspects of OCD symptoms and, ultimately, how to target those associations in treatment.

Using the Child Sheehan Disability Scale to Differentiate Severity Level in Youth With Anxiety Disorders and Obsessive Compulsive Disorder.

The current study extends the psychometric support for the Child Sheehan Disability Scale (CSDS) as a measure of impairment associated with childhood anxiety disorders, including obsessive compulsive disorder. The CSDS was completed by 1,481 predominately Caucasian youth (55.4% female) ages 8 to 17 ( = 12.

Clinical Presentation and Treatment Trajectory of Gender Minority Patients With Obsessive-Compulsive Disorder.

Gender minorities experience unique minority stressors that increase risk for psychiatric disorders. Notably, gender minorities are four and six times more likely than their cisgender female and male peers, respectively, to be treated for or diagnosed with obsessive-compulsive disorder (OCD). Despite higher rates of OCD, more psychiatric comorbidities, and minority stressors, little is known about the clinical presentation and treatment outcomes of gender minorities with OCD.

Efficacy of intensive CBT telehealth for obsessive-compulsive disorder during the COVID-19 pandemic.

Despite evidence for the effectiveness of cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD), many individuals with OCD lack access to needed behavioral health treatment. Although some literature suggests that virtual modes of treatment for OCD are effective, it remains unclear whether intensive programs like partial hospitalization and intensive outpatient programs (PHP and IOPs) can be delivered effectively over telehealth (TH) and within the context of a global pandemic. Limited extant research suggests that clinicians perceive attenuated treatment response during the pandemic.

Cost-effectiveness analysis of deep transcranial magnetic stimulation relative to evidence-based strategies for treatment-refractory obsessive-compulsive disorder.

Objective: This study examined the cost-effectiveness of deep transcranial magnetic stimulation (dTMS) for treatment refractory obsessive-compulsive disorder (OCD) relative to other established treatment options, including antidepressant medication (ADM), ADM + antipsychotic augmentation, real-world cognitive-behavioral therapy (ADM + CBT Effectiveness), clinical trial CBT (ADM + CBT), intensive outpatient program (IOP), partial hospitalization program (PHP), and PHP to IOP stepdown.

Methods: A decision analytic model was developed to evaluate the cost-effectiveness of dTMS relative to other established treatment alternatives for adults (18-64 years old) with refractory OCD. Building on Gregory et al.

Does a unique co-occurring OCD and PTSD factor structure exist?: Examination of overlapping OCD and PTSD symptom clusters.

OCD and PTSD share many commonalities, including phenotypic and functional overlap in symptoms. Specifically, both disorders are characterized by unwanted, intrusive, anxiety/distress-eliciting intrusive thoughts and evoking behaviors intended to control, neutralize, suppress, or outright avoid intrusive thoughts and associated anxiety/distress. Extant factor analytic research supports a model of PTSD at odds with current DSM-5 criteria, and no examination of the factor structure of comorbid OCD+PTSD currently exists despite the noted overlap in symptomatology and high rates of comorbidity.

Comparing efficacy of telehealth to in-person mental health care in intensive-treatment-seeking adults.

The heightened acuity in anxiety and depressive symptoms catalyzed by the COVID-19 pandemic presents an urgent need for effective, feasible alternatives to in-person mental health treatment. While tele-mental healthcare has been investigated for practicability and accessibility, its efficacy as a successful mode for delivering high-quality, high-intensity treatment remains unclear. This study compares the clinical outcomes of a matched sample of patients in a private, nation-wide behavioral health treatment system who received in-person, intensive psychological treatment prior to the COVID-19 pandemic (N = 1,192) to the outcomes of a distinctive group of patients who received telehealth treatment during the pandemic (N = 1,192).

OCD in the time of COVID-19: A global pandemic's impact on mental health patients and their treatment providers.

Individuals with obsessive-compulsive disorder (OCD) have evidenced resilience against large-scale crises, although emerging research on the impact of COVID-19 is mixed. Little is known about the impact of COVID-19 on mental health providers. Items from an instrument evaluating the impact of the September 11, 2001, terrorist attack were adapted to measure the impact of COVID-19 on emotions, cognitions, and behaviors.

Intolerance of uncertainty and obsessive-compulsive disorder dimensions.

Intolerance of uncertainty (IU), which can include prospective (i.e., desire for predictability) and inhibitory (i.

The effects of depression on the treatment of OCD in a residential sample.

Studies investigating the impact of depressive symptoms on obsessive-compulsive disorder (OCD) treatment have yielded mixed findings. The purpose of the study is to extend previous research, which primarily used outpatient samples, to determine whether depression affects OCD treatment outcome among patients receiving intensive residential treatment. OCD patients receiving residential treatment based primarily on exposure and response prevention (ERP) provided data regarding symptoms of depression and OCD at admission and discharge.

Little Doubt That CBT Works for Pediatric OCD.

We write with great concern in response to the recent systematic review and meta-analysis of cognitive-behavioral therapy (CBT) in pediatric obsessive-compulsive disorder (OCD) by Uhre et al. Although the authors' results consistently support the clinical efficacy of CBT for pediatric OCD, we expect that, much like ourselves, readers will be confused by the discordant and inappropriate conclusions that they put forward. These conclusions stem from the authors' application and interpretation of their particular qualitative methods, which could lead important stakeholders (eg, parents, patients, clinicians, and payers) to wrongly discount clear evidence for what is known to be the best evidence-based therapy for pediatric OCD.

Cost-Effectiveness of Treatment Alternatives for Treatment-Refractory Pediatric Obsessive-Compulsive Disorder.

Purpose: Current guidelines for first-line treatment of childhood OCD are cognitive-behavioral therapy (CBT) utilizing exposure and response prevention (ERP), and/or antidepressant (ADM) pharmacotherapy, specifically serotonin reuptake inhibitors (SRI). Given that first-line are relatively similar in terms of clinical effectiveness, the role of costs to provide such services may help influence treatment decisions. In the case of treatment refractory pediatric OCD, this cost-effectiveness analysis (CEA) aims to further evaluate two additional, higher intensity combination therapies, namely OCD-specific Intensive Outpatient (IOP) and Partial Hospitalization Programs (PHP), to determine the additional benefits, in terms of effectiveness, that may result, and the corresponding increase in costs for these higher-intensity courses of therapy.

Obsessive-compulsive symptoms in eating disorders: A network investigation.

Objective: Eating disorders (EDs) are complex, heterogeneous, and severe psychiatric syndromes. They are highly comorbid with obsessive-compulsive disorder (OCD) which exacerbates the course of illness and impedes treatment. However, the direct functional relations between EDs and OCD symptoms remain largely unexplored.

Behavioral Activation as a Mechanism of Change in Residential Treatment for Mood Problems: A Growth Curve Model Analysis.

Research on the efficacy, effectiveness, and dissemination potential of behavioral activation (BA)-focused interventions for depression and comorbid disorders has expanded rapidly. However, research that examines how BA interventions work has seen less growth. A primary purported mechanism of BA is activation, which reflects a person's meaningful (re)engagement in life.