Park Jennifer M, Small Brent J, Geller Daniel A, Murphy Tanya K, Lewin Adam B, Storch Eric A
Department of Psychology, University of South Florida, 4202 E Fowler Ave, PCD 4118G, Tampa, FL 33611, USA.
School of Aging Studies, University of South Florida, Tampa, FL, USA.
J Child Fam Stud. 2014 Jul 1;23(5):863-871. doi: 10.1007/s10826-013-9742-1.
Clinical studies in adults and children with obsessive-compulsive disorder (OCD) have shown that d-cycloserine (DCS) can improve treatment response by enhancing fear extinction learning during exposure-based psychotherapy. Some have hypothesized that improved treatment response is a function of increased compliance and engagement in therapeutic homework tasks, a core component of behavioral treatment. The present study examined the relationship between DCS augmented cognitive-behavioral therapy (CBT) and homework compliance in a double-blind, placebo controlled trial with 30 youth with OCD. All children received 10 CBT sessions, the last seven of which included exposure and response prevention paired with DCS or placebo dosed 1 h before the session started. Results suggested that DCS augmented CBT did not predict improved homework compliance over the course of treatment, relative to the placebo augmented CBT group. However, when groups were collapsed, homework compliance was directly associated with treatment outcome. These findings suggest that while DCS may not increase homework compliance over time, more generally, homework compliance is an integral part of pediatric OCD treatment outcome.
针对患有强迫症（OCD）的成人和儿童的临床研究表明，d - 环丝氨酸（DCS）可通过在基于暴露的心理治疗过程中增强恐惧消退学习来改善治疗反应。一些人推测，治疗反应的改善是治疗依从性提高以及参与治疗家庭作业任务增多的结果，而治疗家庭作业任务是行为治疗的核心组成部分。本研究在一项针对30名患有强迫症的青少年的双盲、安慰剂对照试验中，考察了DCS强化认知行为疗法（CBT）与家庭作业依从性之间的关系。所有儿童均接受10次CBT治疗，其中最后7次包括暴露与反应阻止，并在每次治疗开始前1小时给予DCS或安慰剂。结果表明，相对于安慰剂强化CBT组，在治疗过程中，DCS强化CBT并不能预测家庭作业依从性的改善。然而，当将两组合并时，家庭作业依从性与治疗结果直接相关。这些发现表明，虽然随着时间推移DCS可能不会提高家庭作业依从性，但一般来说，家庭作业依从性是儿童强迫症治疗结果的一个组成部分。
