Exposure and response prevention versus stress management training for adults and adolescents with obsessive compulsive disorder: A randomized clinical trial

• Published in: Behaviour research and therapy 2024-01, Vol.172, p.104458-104458, Article 104458
• Main Authors: Himle, Joseph A., Grogan-Kaylor, Andrew, Hiller, Matthew A., Mannella, Kristin A., Norman, Luke J., Abelson, James L., Prout, Aileen, Shunnarah, Angela A., Becker, Hannah C., Russman Block, Stefanie R., Taylor, Stephan F., Fitzgerald, Kate D.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Adults; Child; Exposure and response prevention; Humans; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - diagnosis; Obsessive-Compulsive Disorder - therapy; Stress management; Treatment Outcome
• ISSN: 0005-7967; 1873-622X; 1873-622X
• DOI: 10.1016/j.brat.2023.104458

Though exposure and response prevention (ERP) is a well-proven treatment for OCD across the lifespan, prior RCTs have not studied adolescent and adult patients with the same ERP protocol relative to an active comparator that controls for non-specific effects of treatment. This approach assesses differences in the effect of OCD-specific exposures in affected adolescents and adults and in response to ERP compared to a stress-management control therapy (SMT). This assessor-blinded, parallel, 2-arm, randomized, ambulatory clinical superiority trial randomized adolescents (aged 12–18) and adults (24–46) with OCD (N = 126) to 12 weekly sessions of ERP or SMT. OCD severity was measured before, during and after treatment using the child or adult version of the Yale-Brown Obsessive Compulsive Scale (C/Y-BOCS), depending on participant age. We predicted that ERP would produce greater improvement in OCD symptoms than SMT and that there would be no significant post-treatment differences across age groups. ERP (n = 63) produced significantly greater improvements on C/Y-BOCS scores at post-treatment than SMT (n = 63) (Effect size = −0.72, CI = −0.52 to −0.91, p