Veeger Julia D K, Stapersma Luuk, Lebowitz Eli R, Zijlstra Bonne, Lindauer Ramón, Utens Elisabeth M W J, Huijser Chaim
Amsterdam UMC, Location University of Amsterdam, Department of Child and Adolescent Psychiatry, Amsterdam, the Netherlands.
Academic Center for Child and Adolescent Psychiatry Levvel. Amsterdam, the Netherlands.
Contemp Clin Trials Commun. 2025 Feb 11;44:101456. doi: 10.1016/j.conctc.2025.101456. eCollection 2025 Apr.
Pediatric obsessive-compulsive disorder (OCD) is a severely impairing disorder, associated with high levels of family accommodation (FA). Approximately 40 % of youth do not benefit from first-line treatment options (cognitive behavioral therapy or pharmacotherapy). Supportive Parenting for Anxious Childhood Emotions (SPACE) is a parent-based treatment, teaching parents to reduce FA and increase supportive parenting, thereby aiming to improve the child's OCD. This article presents the protocol of a multiple baseline single-case experimental design (SCED) study to test the efficacy of SPACE in reducing OCD severity and FA in youth with OCD.
This SCED consists of a baseline, treatment, and follow-up phase. In total 25 youth (7-18 years) with OCD, who previously received cognitive behavioral therapy (CBT) unsuccessfully, aborted treatment early, or were not able to receive CBT due to too high levels of OCD/anxiety, and their parents will be included. They will be randomly allocated to one of three baseline phase options (4, 6 or 8 weeks). The treatment phase consists of 12 weekly sessions of SPACE with parents. Throughout all phases, OCD severity and FA will be briefly assessed thrice a week. Standard clinical measurements assessing OCD severity and FA and secondary parameters will be conducted at six timepoints, till 6 months follow-up.
Combining the innovative SPACE treatment with a SCED provides detailed insight into the relationship between OCD and FA over time. Studying this in clinical practice in complex cases that are normally understudied, helps to improve more personalized care for youth with OCD.
儿童强迫症(OCD)是一种严重的致残性疾病,与高水平的家庭迁就(FA)有关。约40%的青少年无法从一线治疗方案(认知行为疗法或药物疗法)中获益。针对儿童焦虑情绪的支持性养育(SPACE)是一种基于家长的治疗方法,教导家长减少家庭迁就并增加支持性养育,从而旨在改善孩子的强迫症。本文介绍了一项多基线单病例实验设计(SCED)研究的方案,以测试SPACE在降低强迫症青少年的强迫症严重程度和家庭迁就方面的疗效。
该SCED包括基线、治疗和随访阶段。总共将纳入25名患有强迫症的青少年(7 - 18岁),他们之前接受认知行为疗法(CBT)未成功、过早中止治疗或因强迫症/焦虑水平过高而无法接受CBT,以及他们的父母。他们将被随机分配到三个基线阶段选项之一(4周、6周或8周)。治疗阶段包括与家长进行12次每周一次的SPACE课程。在所有阶段,强迫症严重程度和家庭迁就将每周简要评估三次。在六个时间点进行评估强迫症严重程度和家庭迁就以及次要参数的标准临床测量,直至随访6个月。
将创新的SPACE治疗与SCED相结合,能随着时间推移深入了解强迫症与家庭迁就之间的关系。在通常未得到充分研究的复杂病例的临床实践中进行研究,有助于改善对强迫症青少年更个性化的护理。