| 1. |
|
|
| 2. |
- Pinciotti, Caitlin M., et al.
(författare)
-
Co-occurring PTSD in intensive OCD treatment : Impact on treatment trajectory vs. response
- 2024
-
Ingår i: Journal of Affective Disorders. - 0165-0327. ; 353, s. 109-116
-
Tidskriftsartikel (refereegranskat)abstract
- 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. Methods: The current study used linear regression and latent growth curve analysis comparing treatment response and trajectory from patients with OCD (n = 3083, 94.2 %) and OCD + PTSD (n = 191, 5.2 %) who received CBT with ERP in two major intensive OCD treatment programs. Results: Although patients with OCD + PTSD evidenced similar trajectories of overall severity change, patients at one site required nearly 11 additional treatment days to achieve comparable reduction in OCD severity. Further, at the dimensional level, those with OCD + PTSD had poorer treatment response for unacceptable thoughts and symmetry symptoms. The moderate effect for unacceptable thoughts, indicating the widest gap in treatment response, suggests these symptoms may be particularly relevant to PTSD. Limitations: Findings are limited by a naturalistic treatment sample with variation in treatment provision. Conclusions: Findings emphasize caution in using a one-size-fits-all approach for patients with co-occurring OCD + PTSD within intensive OCD treatment programs, as broadly defined outcomes (e.g., reduction in overall severity) may not translate to reduction in the nuanced symptom dimensions likely to intersect with trauma. Unacceptable thoughts and symmetry symptoms, when co-occurring with PTSD, may require a trauma-focused treatment approach within intensive OCD treatment.
|
|
| 3. |
- Storch, Eric A., et al.
(författare)
-
Little Doubt That CBT Works for Pediatric OCD
- 2020
-
Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567. ; 59:7, s. 785-787
-
Tidskriftsartikel (refereegranskat)abstract
- 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.1 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.
|
|
| 4. |
- Truong, Quoc Cuong, et al.
(författare)
-
Establishing conversion of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly scores into interval-level data across multiple samples using Rasch methodology
- 2023
-
Ingår i: Psychogeriatrics. - : Wiley. - 1346-3500 .- 1479-8301. ; 23:3, s. 411-421
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) is a well-validated and widely-used measure of cognitive changes (CCs) among older adults. This study aimed to use Rasch methodology to establish psychometric properties of the IQCODE-16 and validate the existing ordinal-to-interval transformation algorithms across multiple large samples. Methods: A Partial Credit Rasch model was employed to examine psychometric properties of the IQCODE-16 using data (n = 918) from two longitudinal studies of participants aged 57–99 years: the Older Australian Twins Study (n = 450) and the Canberra Longitudinal Study (n = 468), and reusing the Sydney Memory and Ageing Study (MAS) sample (n = 400). Results: Initial analyses indicated good reliability for the IQCODE-16 (Person Separation Index range: 0.82–0.90). However, local dependency was identified between items, with several items showing misfit to the model. Replicating the existing Rasch solution could not reproduce the best Rasch model fit for all samples. Combining locally dependent items into three testlets resolved all misfit and local dependency issues and resulted in the best Rasch model fit for all samples with evidence of unidimensionality, strong reliability, and invariance across person factors. Accordingly, new ordinal-to-interval transformation algorithms were produced to convert the IQCODE-16 ordinal scores into interval data to improve the accuracy of its scores. Conclusions: The findings of this study support the reliability and validity of the IQCODE-16 in measuring CCs among older adults. New ordinal-to-interval conversion tables generated using samples from multiple independent datasets are more generalizable and can be used to enhance the precision of the IQCODE-16 without changing its original format. An easy-to-use converter has been made available for clinical and research use.
|
|
| 5. |
- Armstrong, Gabrielle, et al.
(författare)
-
Factors associated with internalizing and externalizing symptoms in a clinical sample of youth with misophonia
- 2023
-
Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - 2211-3649. ; 39
-
Tidskriftsartikel (refereegranskat)abstract
- Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia aged 8–17 years (Nfemales = 69). Participants completed self-report assessments of misophonia severity, sensory sensitivity, cognitive emotion regulation, and emotional-behavioral functioning. In the final model, controlling for all variables, multiple linear regression analyses revealed that sensory sensitivity and age were significant predictors of internalizing symptoms, while sensory sensitivity and the other-blame cognitive emotion regulation facet were significant predictors of externalizing symptoms. Further, findings demonstrated that the positive reappraisal cognitive emotion regulation facet moderated the effect of misophonia severity on internalizing symptoms. Results highlight a strong, consistent relation between sensory sensitivities (beyond sound sensitivity) and psychiatric symptoms in misophonic youth. Further research is necessary to determine mechanisms and clinical variables impacting internalizing and externalizing symptoms within youth with misophonia.
|
|
| 6. |
- Cervin, Linnea, et al.
(författare)
-
Multiple stressors and data deficient populations; a comparative life-history approach sheds new light on the extinction risk of the highly vulnerable Baltic harbour porpoises (Phocoena phocoena).
- 2020
-
Ingår i: Environment international. - : Elsevier BV. - 1873-6750 .- 0160-4120. ; 144
-
Tidskriftsartikel (refereegranskat)abstract
- Many endangered marine mammal populations are difficult to study, spread out over large areas, and capturing them for branding and research purposes would be unethical. Yet, they are in urgent need for assessment and conservation actions. We suggest collecting data from other more abundant populations of the same species, with careful consideration of body size, age at sexual maturity, and ecological conditions to produce scientifically sound best approximations of vital rates of data deficient endangered populations. The genetically distinct Baltic Sea harbour porpoise population amounts to about 500 animals and is classified as 'Critically Endangered' according to the IUCN red list. Data deficiency on nearly all demographic parameters have precluded systematic investigations of the relative importance of stressors affecting population viability. We took a comparative life history approach and investigated the phenotypic plasticity in somatic and demographic vital rates of seven larger, well studied North Atlantic harbour porpoise populations, enabling us to approximate the missing pieces of the life history of the Baltic population. We parameterized a stochastic, individual-based population model, and performed a population viability analysis for a range of biologically realistic parameter values and scenarios of environmental stressors. The baseline scenario was based on the most representative samples of healthy harbour porpoise populations and challenged with three different levels of bycatches. Due to high levels of endocrine disruptive contaminants observed in Baltic harbour porpoises, we also investigated the effect of a possible reduction in fecundity. Subsequently, the combined effects of bycatches and reduced fecundity were investigated in terms of population growth rate and quasi-extinction risk. The Baltic harbour porpoise population is viable in the baseline scenario without anthropogenic stressors. However, even the lowest estimated bycatch level of 7 individuals per year will lead to a population collapse to ≤50 animals with high probability (0.4-1.0) over the next century, assuming an intermediate or low (<73%) fecundity. Adult survival is of critical importance and mitigation of fishery impacts and reduction of anthropogenic disturbances in the identified main breeding areas are recommended.
|
|
| 7. |
- Cervin, Matti, et al.
(författare)
-
Effects of cognitive-behavioral therapy on core aspects of anxiety in anxious youth with autism
- 2023
-
Ingår i: Research in Autism Spectrum Disorders. - 1750-9467. ; 107, s. 1-10
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundAnxiety disorders (ADs) are common in youth with autism and cognitive-behavioral therapy (CBT) may be less efficacious than among anxious youth without autism. Yet, little is known about which aspects of anxiety are targeted less effectively by CBT in youth with autism.MethodWe pooled youth with autism and ADs randomized to CBT or a control condition from five randomized controlled trials (RCTs; CBT, n = 197, Mage = 10.30 [2.05], age range: 7–16; control conditions, n = 83; Mage = 10.57 [2.30], age range: 7–16) and examined whether CBT outperformed control conditions across core aspects of anxiety and whether more pronounced autism traits predicted outcomes. CBT response in youth with autism was also compared to CBT response among anxious youth without autism (n = 129; Mage = 11.16 [2.80], age range: 7–17).ResultsCBT for youth with autism yielded significantly better effects than control conditions for frequency of symptoms, intensity of anxiety, avoidance, family interference, and social interference but not for physical symptoms of anxiety. Youth with more pronounced autism traits had poorer outcomes for frequency of symptoms, family interference, and social interference. Compared to anxious youth without autism, youth with autism had poorer outcomes for physical symptoms and family interference.ConclusionsCBT is efficacious across core aspects of anxiety for youth with autism, but outcomes for anxiety-related interference, particularly for those with more pronounced autism traits, may be poorer than among youth without autism. More work is needed to better understand how anxiety impacts the everyday lives of anxious youth with autism and which interventions and support are needed.
|
|
| 8. |
- Cervin, Matti, et al.
(författare)
-
Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis
- 2024
-
Ingår i: Journal of Child Psychology and Psychiatry. - 0021-9630. ; 65:5, s. 594-609
-
Forskningsöversikt (refereegranskat)abstract
- BackgroundCognitive-behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are recommended treatments for pediatric obsessive-compulsive disorder (OCD), but their relative efficacy and acceptability have not been comprehensively examined. Further, it remains unclear whether the efficacy of in-person CBT is conserved when delivered in other formats, such as over telephone/webcam or as Internet-delivered CBT (ICBT).MethodsPubMed, PsycINFO, trial registries, and previous systematic reviews were searched for randomized controlled trials (RCTs) comparing CBT (in-person, webcam/telephone-delivered, or ICBT) or SRIs with control conditions or each other. Network meta-analyses were conducted to examine efficacy (post-treatment Children's Yale-Brown Obsessive Compulsive Scale) and acceptability (treatment discontinuation). Confidence in effect estimates was evaluated with CINeMA (Confidence in Network Meta-Analysis).ResultsThirty eligible RCTs and 35 contrasts comprising 2,057 youth with OCD were identified. In-person CBT was significantly more efficacious than ICBT, waitlist, relaxation training, and pill placebo (MD range: 3.95–11.10; CINeMA estimate of confidence: moderate) but did not differ significantly from CBT delivered via webcam/telephone (MD: 0.85 [−2.51, 4.21]; moderate), SRIs (MD: 3.07 [−0.07, 6.20]; low), or the combination of in-person CBT and SRIs (MD: −1.20 [−5.29, 2.91]; low). SRIs were significantly more efficacious than pill placebo (MD: 4.59 [2.70, 6.48]; low) and waitlist (MD: 8.03 [4.24, 11.82]; moderate). No significant differences for acceptability emerged, but confidence in estimates was low.ConclusionsIn-person CBT and SRIs produce clear benefits compared to waitlist and pill placebo and should be integral parts of the clinical management of pediatric OCD, with in-person CBT overall having a stronger evidence base. The combination of in-person CBT and SRIs may be most efficacious, but few studies hinder firm conclusions. The efficacy of CBT appears conserved when delivered via webcam/telephone, while more trials evaluating ICBT are needed.
|
|
| 9. |
- Cervin, Matti, et al.
(författare)
-
Measuring misophonia in youth: A psychometric evaluation of child and parent measures
- 2023
-
Ingår i: Journal of Affective Disorders. - 0165-0327. ; 338, s. 180-186
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundMisophonia is characterized by intense emotional reactions to specific sounds or visual stimuli and typically onsets during childhood. An obstacle for research and clinical practice is that no comprehensively evaluated measures for pediatric misophonia exist.MethodsIn a sample of 102 youth meeting the proposed diagnostic criteria of misophonia, we evaluated the child and parent-proxy versions of the self-reported Misophonia Assessment Questionnaire (MAQ; assessing broad aspects of misophonia) and the child version of the Amsterdam Misophonia Scale (A-MISO-S; assessing misophonia severity). Confirmatory and exploratory factor analysis were used to examine factor structures of the measures. Further, child-parent agreement on the MAQ and associations between MAQ/A-MISO-S and impairment, quality of life, and misophonia-related school interference were examined to evaluate aspects of convergent validity.ResultsFor both youth- and parent-ratings, four MAQ factors emerged: pessimism, distress, interference, and non-recognition. A-MISO-S showed a unidimensional structure, but the item ‘effort to resist’ did not load significantly onto the unidimensional factor. Good child-parent agreement on the MAQ scales were found and both MAQ and A-MISO-S were moderately to strongly associated with misophonia-related impairment and school interference, and inversely associated with quality of life.LimitationsMAQ and A-MISO-S assess sensitivity to auditory but not visual stimuli, the sample size was modest, and repeated assessments were not conducted.ConclusionsThe combination of MAQ and A-MISO-S shows promise as a multidimensional assessment approach for pediatric misophonia. Future evaluations should include known-groups validity, screening performance, and sensitivity to change in symptom severity.
|
|
| 10. |
- Cervin, Matti, et al.
(författare)
-
Symptom-specific effects of cognitive-behavioral therapy, sertraline, and their combination in a large randomized controlled trial of pediatric anxiety disorders
- 2020
-
Ingår i: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 61:4, s. 492-502
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Pediatric anxiety disorders are highly prevalent and associated with significant functional disabilities and lifelong morbidity. Cognitive-behavioral therapy (CBT), sertraline, and their combination are effective treatments, but little is known about how these treatments exert their effects.Methods: Using network intervention analysis (NIA), we analyzed data from the largest randomized controlled treatment trial of pediatric anxiety disorders (Child/Adolescent Anxiety Multimodal Study, NCT00052078, clinicaltrials.gov/ct2/show/NCT00052078) and outlined the causal symptom domain-specific effects of CBT, sertraline, and their combination over the course of the 12-week treatment while taking into account both specificity and overlap between symptom dimensions. Results: All active treatments produced positive effects with the most pronounced and consistent effects emerging in relation to psychological distress, family interference, and avoidance. Psychological distress was consistently the most and physical symptoms the least influential symptom domain in the disorder network.Conclusions: All active treatments showed beneficial effects when compared to placebo and NIA identified that these effects were exerted similarly across treatments and primarily through a reduction of psychological distress, family interference, and avoidance. CBT and sertraline may have differential mechanisms of action in relation to psychological distress. Given the lack of causal effects on interference outside family and physical symptoms, interventions tailored to target these domains may aid in the building of more effective treatments. Psychological distress and avoidance should remain key treatment focuses because of their central roles in the disorder network. The findings inform and promote developing more effective interventions. Keywords: CBT/cognitive behavior therapy; anxiety/anxiety disorders; pharmacotherapy; clinical trials; child/adolescent.
|
|
