Neurocognitive Correlates of Cognitive Behavioral Therapy (CBT) in Children and Adolescents with Obsessive-Compulsive Disorder (OCD) - a Sub-Study to the "TECTO" Randomized Controlled Trial
Creators: name: Ritter, Melanie
Publisher: name: OSF Registries
Year: 2023
Subjects: subject: Clinical Psychology
subject: Psychiatry and Psychology
subject: Medicine and Health Sciences
subject: Cognitive Psychology
subject: Social and Behavioral Sciences
subject: Psychology
subject: FOS: Psychology
subject: CBT
subject: OCD
subject: RCT
subject: adolescent
subject: child
subject: cognition
subject: cognitive control
subject: cognitive-behavioral therapy
subject: effect mediation
subject: effect modification
subject: executive functioning
subject: exposure
subject: mental health
subject: neurocognition
subject: neuropsychology
subject: obsessive-compulsive disorder
subject: psychiatry
subject: psychology
subject: randomized controlled trial

description: Background and aims: Atypical neurocognitive functioning has been found in children with obsessive-compulsive disorder (OCD) and is proposed a possible moderator and/or mediator of the symptom-reduction following psychotherapy. The recommended first-line treatment for pediatric OCD is cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP). This study aims to investigate neurocognitive correlates of family-based CBT (F-CBT) with ERP in children with OCD. The study is nested in the Danish superiority randomized controlled trial (RCT) “TECTO”, which assesses benefits and harms of 14 sessions of F-CBT with ERP, compared to an active control intervention of psychoeducation and relaxation therapy (PRT), in children and adolescents (age 8-17) with OCD. Clinical assessment: OCD symptom-reduction following therapy (the primary outcome of the TECTO-trial) is measured with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) total score. Neurocognitive assessment: Neurocognitive status is assessed with tests and pre-selected outcomes from the Cambridge Neuropsychological Test Automated Battery (CANTAB), the Delis-Kaplan Executive Function System (D-KEFS), the age-appropriate version of the Wechsler Scales (WISC-V; WAIS-IV), Purdue Pegboard test, Weather Predicion Learning Task, and the Behavior Rating Inventory of Executive Function (BRIEF). The test battery is focusing on the domains of cognitive flexibility (set-shifting ability), planning ability, risk-taking and and decision-making, working memory capacity, verbal and nonverbal fluency, motor skills, processing speed, and daily-life executive functioning. Objectives and research hypotheses: 1. MODERATION. The primary objective of this study is determining whether pre-treatment neurocognitive functioning moderates treatment response. We hypothesize that level of pre-treatment neurocognition will moderate the efficacy of symptom alleviation during treatment, particularly for F-CBT (H1). 2. MEDIATION. The secondary objective is to determine whether neurocognitive functioning improvement mediates treatment response. We hypothesize that treatment response, particularly to F-CBT, will be associated with significantly improved neurocognitive functioning (H2a) and that the level of improvement during treatment, particularly for F-CBT, will mediate the reduction in OCD symptoms (H2b).