No evidence of differences in cognitive control in children with autism spectrum disorder or obsessive-compulsive disorder: An fMRI study

Obsessive–compulsive disorder and autism spectrum disorder commonly co-occur. Adapted cognitive behavior therapy for obsessive–compulsive disorder in adults with autism spectrum disorder has not previously been evaluated outside the United Kingdom. In this study, 19 adults with obsessive–compulsive disorder and autism spectrum disorder were treated using an adapted cognitive behavior therapy protocol that consisted of 20 sessions focused on exposure with response prevention. The primary outcome was the clinician-rated Yale–Brown Obsessive–Compulsive Scale. Participants were assessed up to 3 months after treatment. There were significant reductions on the Yale–Brown Obsessive–Compulsive Scale at post-treatment (d = 1.5), and improvements were sustained at follow-up (d = 1.2). Self-rated obsessive–compulsive disorder and depressive symptoms showed statistically significant reductions. Improvements in general functioning and quality of life were statistically non-significant. Three participants (16%) were responders at post-treatment and four (21%) were in remission from obsessive–compulsive disorder. At follow-up, three participants (16%) were responders and one (5%) was in full remission. Adapted cognitive behavior therapy for obsessive–compulsive disorder in adults with co-occurring autism spectrum disorder is associated with reductions in obsessive–compulsive symptoms and depressive symptoms. However, outcomes are modest; few patients were completely symptom free, and treatment engagement was low with few completed exposures and low adherence to homework assignments. We identify and discuss the need for further treatment refinement for this vulnerable group.

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Clinical and Research Insights Into the Assessment and Treatment of Anxiety and Obsessive-Compulsive Disorder in Youth With Autism Spectrum Disorder

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2017.07.212 ◽

2017 ◽

Vol 56 (10) ◽

pp. S54

Author(s):

Brenna B. Maddox ◽

Lawrence Scahill

Keyword(s):

Autism Spectrum Disorder ◽

Obsessive Compulsive Disorder ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Assessment And Treatment

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A Case Report of Intensive Exposure-Based Cognitive Behavioral Therapy for a Child With Comorbid Autism Spectrum Disorder and Obsessive-Compulsive Disorder

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.31.2.118 ◽

2017 ◽

Vol 31 (2) ◽

pp. 118-123

Author(s):

Katie L. Merricks ◽

Joshua M. Nadeau ◽

Amaya Ramos ◽

Eric A. Storch

Keyword(s):

Autism Spectrum Disorder ◽

Cognitive Behavioral Therapy ◽

Obsessive Compulsive Disorder ◽

Treatment Modality ◽

Behavioral Therapy ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Cognitive Behavioral ◽

Obsessive Compulsive ◽

Compulsive Disorder

Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) has proven to be an effective treatment modality for children with obsessive-compulsive disorder (OCD). Less research exists demonstrating efficacy for this treatment modality among children with comorbid diagnoses of OCD and autism spectrum disorder (ASD), and virtually, nothing has been reported examining intensive interventions for the most severe cases. As such, this article discusses the treatment of an adolescent male with severe OCD comorbid with ASD, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic tic disorder using a cognitive behavioral approach and ERP. We conclude with recommendations for continued clinical research to understand approaches to help nonresponders to standard therapeutic approaches with this challenging population.

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