Cognitive-behavioral treatment of childhood obsessive-compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy

Objective

To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive-behavioral treatment (CBT) for childhood obsessive-compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic.

Method

This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement.

Results

Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment.

Conclusions

This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes.     

Response Speed and Accuracy During Anticipatory Stress

Response speed and accuracy of 48 general aviation pilots were determined under condition of anticipatory physical threat stress (APTS). Variables included unpleasantness of the event (electrical shock), proximity of the event, and relationship of Ss’ performance to the occurrence of the event. The data support inclusion of these variables in Wherry’s model of APTS. Ss who believed they could avoid the shock by an adequate performance were able to maintain or improve that performance while the performance of Ss who perceived the shock as inevitable was deteriorating. Two possible modifications of the APTS model were discussed: (1) weighting APTS determiners according to their effectiveness in generating anticipatory stress, (2) recognizing the interaction of the APTS variables with S’s personality structure.     

Transfer of Motor Learning Engages Specific Neural Substrates During Motor Memory Consolidation Dependent on the Practice Structure

The authors investigated how brain activity during motor-memory consolidation contributes to transfer of learning to novel versions of a motor skill following distinct practice structures. They used 1 Hz repetitive Transcranial Magnetic Stimulation (rTMS) immediately after constant or variable practice of an arm movement skill to interfere with primary motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC). The effect of interference was assessed through skill performance on two transfer targets: one within and one outside the range of practiced movement parameters for the variable practice group. For the control (no rTMS) group, variable practice benefited delayed transfer performance more than constant practice. The rTMS effect on delayed transfer performance differed for the two transfer targets. For the within-range target, rTMS interference had no significant affect on the delayed transfer after either practice structure. However, for the outside-range target, rTMS interference to DLPFC but not M1 attenuated delayed transfer benefit following variable practice. Additionally, for the outside-range target, rTMS interference to M1 but not DLPFC attenuated delayed transfer following constant practice. This suggests that variable practice may promote reliance on DLPFC for memory consolidation associated with outside-range transfer of learning, whereas constant practice may promote reliance on M1 for consolidation and long-term transfer.     

An Approach to Use of Color on the Rorschach through Individual Color Preferences

More must be learned of color and its possible relationships with the Rorschach before its interpretation may be taken with assurance. Twenty Ss were administered the Rorschach and a Color Battery of four tasks chosen to tap color preference. Preferences were analyzed for use of the color on the Rorschach plates; color response scores and form-level scores; relationship with color meaning for the subject. Significances were found between: (1) preference and use of color; (2) preference and CF and C scores; (3) plus form-level and preferences. Color meanings varied with each subject. Color preference may influence the subject's use of color on the Rorschach, as well as scores, regardless of what the preferred color may be or the amount available. Generalizations are not warranted on the basis of color or color use, especially as regards differential diagnosis.     

Factor Structure of the Center for Epidemiological Studies Depression Scale in Hong Kong Adolescents

E. A. Southwell &; M. Merbaum (Eds.). Personality: Readings in Theory and Research. (2nd ed.) Belmont, Calif.: Brooks/Cole, 1971, 422 pages. Reviewed by Benjamin Beit-Hallahmi     

Effects of Event Probability and Animateness on Children's Comprehension of Active and Passive Sentences

Thirty-six three-, four-, and five-year-old boys and girls were asked to act out, with appropriate toys, 48 sentences presented with instructions to make the toys do what E said. Sentences were designed to test the effects on comprehension of (a) event probability, (b) sentence voice, and (c) subject/object animateness. Sentences with either an animate subject and object, or an inanimate subject and object, were considered to be reversible; however, not all reversible sentences were symmetrical with respect to event probability. All main effects were significant, and performance improved with age. The significant interactions indicated that there is a difference between animateness and inanimateness in reversible sentences. The data also suggested that (a) animateness may be an important variable in children's early comprehension of speech, and (b) the traditional definition of reversibility should be modified to unconfound the effects of event probability and animateness.     

Biomechanical and energetic determinants of technique selection in classical cross-country skiing

Classical cross-country skiing can be performed using three main techniques: diagonal stride (DS), double poling (DP), and double poling with kick (DK). Similar to other forms of human and animal gait, it is currently unclear whether technique selection occurs to minimize metabolic cost or to keep some mechanical factors below a given threshold. The aim of this study was to find the determinants of technique selection. Ten male athletes roller skied on a treadmill at different slopes (from 0° to 7° at 10 km/h) and speeds (from 6 to 18 km/h at 2°). The technique preferred by skiers was gathered for every proposed condition. Biomechanical parameters and metabolic cost were then measured for each condition and technique. Skiers preferred DP for skiing on the flat and they transitioned to DK and then to DS with increasing slope steepness, when increasing speed all skiers preferred DP. Data suggested that selections mainly occur to remain below a threshold of poling force. Second, critically low values of leg thrust time may limit the use of leg-based techniques at high speeds. A small role has been identified for the metabolic cost of locomotion, which determined the selection of DP for flat skiing.     

Therapists' perceptions of healthy family functioning

Abstract

For several decades family theorists, researchers, and clinicians have attempted to describe healthy and dysfunctional family functioning. The numerous articles and studies with this focus have been reviewed elsewhere (Riskin & Faunce, 1972; Jacob, 1975). Until recently a disproportionate amount of attention has been given to pathology. Several volumes in the past few years have tried to redress this bias by focusing primarily on healthy family functioning (Kantor & Lehr, 1976; Lewis, Beavers, Gossett & Phillips, 1976).     

Cognitive restructuring and a collaborative set in couples' work

Abstract

The present study investigated the effects of cognitive restructuring efforts aimed at modifying unrealistic beliefs marital partners might hold. Seventeen couples participated in the study, nine in the treatment group and eight in a waiting-list control group. The treatment program sought to impact proactively upon variables commonly agreed to as contributing to the creation of an optimistic, positive collaborative set as a prelude to behavioral change strategies: positive therapeutic expectations and relationship goals, and an enhanced base level of marital satisfaction. On all outcome measures, the treatment group showed significant gain scores as compared to the control group. Discussion of the results highlights the importance of marital therapists being particularly attuned to specific beliefs partners may hold pertaining to relationship issues.     

The Relationship Between Arousal and the Remembered Duration of Positive Events

The relation between affect and retrospective duration estimation has hardly been examined. In this paper, we contribute to filling this gap by studying the influence of arousal on the remembered duration of positive events. On the basis of the contextual change model, we expected that high‐arousal positive events would be remembered as longer compared with low‐arousal positive events. To test this hypothesis, we set up a naturalistic study in which participants were asked at the end of a pleasant amusement park ride at the local fair to rate how pleasant and aroused they felt during the ride as well as to estimate the ride's duration. Feeling more aroused during a ride was associated with longer estimates of the ride's duration. Results are discussed within the framework of retrospective time estimation models. Copyright © 2013 John Wiley & Sons, Ltd.