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ID
Source
Brief title
Health condition
- Cognitive Behavioral Therapy (CBT) (16 weekly sessions)
- Waitlist (8 weeks), followed by CBT (16 weekly sessions)
- For neurobiological measures there is a healthy control group.
Sponsors and support
Intervention
Outcome measures
Primary outcome
1. Severity of OCD (CY-BOCS; measured at the start of the waitlist condition, directly before start of the CBT, session 4, 8, 12 and 16 and follow up after 16 weeks);
2. Anxiety / Depression (RCADS) measured at the start of the waitlist, directly before start of the CBT, at the end of the therapy (session 16) and follow up after 16 weeks).
Secondary outcome
1. Information-processing (explicit: OBQ-44 R, MCQ-A; Implicit: EAST) (measured at the start of the waitlist, directly before start of the CBT, session 8 and 16 and follow up after 16 weeks);
2. Inhibition / selective attention (Dot Probe; measured at the start of the waitlist, directly before start of the CBT, session 8 and 16 and follow up after 16 weeks);
3. Neuroimaging data: volumes grey and white matter, activity on planning (tower of London), selective attention (Flanker) and inhibition (DOT-probe)task in fMRI.
Background summary
For Pediatric Obsessive-Compulsive Disorder (OCD) cognitive behavioral therapy (CBT) (with or without SSRI) is the initial treatment of choice. This treatment is found to be moderately effective. However, working mechanisms of CBT are unclear. Models on which CBT is based are hardly studied in children and adolescents. Knowledge about these issues is needed to improve treatment of OCD.
Cognitive theories propose that dysfunctional cognitions play a maintaining or even etiological role in OCD. Other theorists assume that a domain-specific deficit in the ability to inhibit impulses is the core problem of OCD. Furthermore, from a neurobiologically perspective, deviations in the prefrontal-striatal-thalamic circuit are considered to play a centrol role in the development and maintenance of OCD.
The purpose of this study is to determine some information-processing, neuropsychological and neurobiological mechanisms that contribute to the development and maintenance of OCD and/or mediate cognitive-behavioral treatment of OCD.
Study objective
Information-processing:
1. Changes in measures of severity of OCD are explained (partially) by changes in measures of meta-cognitions (explicit and/or implicit);
2. Changes in measures of meta-cognitions (explicit and implicit) precede changes in measures of severity of OCD.
Neuropsychological processes:
1. Changes in measures of severity of OCD are explained (partially) by changes in measures of inhibition of attentional processes;
2. Changes in measures of inhibition precede changes in measures of severity of OCD.
Neurobiological processes:
1. Volumes of prefrontal cortex and striatum, activity of anterior cingulate, orbitofrontal region and striatum differ from healthy controls and change during treatment.
Intervention
1. 16 weekly sessions Cognitive Behavioral Therapy (CBT);
2. Waitlist (8 weeks) followed by 16 weekly sessions CBT.
Meibergdreef 9
L.H. Wolters
Amsterdam 1105 AZ
The Netherlands
+31 (0)20 5662242
L.h.wolters@amc.uva.nl
Meibergdreef 9
L.H. Wolters
Amsterdam 1105 AZ
The Netherlands
+31 (0)20 5662242
L.h.wolters@amc.uva.nl
Inclusion criteria
1. Children and adolescents 8 - 18 years;
2. Primary diagnosis: Obsessive Compulsive Disorder (OCD);
3. OCD symptoms for more than 6 months;
4. CY-BOCS total score > 16;
5. IQ > 80;
6. Informed consent of parents and child.
Exclusion criteria
Use of the following medication:
1. SSRI;
2. TCA;
3. Anti-psychotic medication.
For neurobiological measures (fMRI):
1. Claustrophobia;
2. Metal on body.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL707 |
| NTR-old | NTR717 |
| Other | : N/A |
| ISRCTN | ISRCTN07851536 |