Sexual obsessions in children and adolescents: Prevalence, clinical correlates, response to cognitive-behavior therapy and long-term follow up

Purpose Those with anxiety use safety behaviors when attempting to prevent negative outcomes. There is evidence that these behaviors contribute to the persistence of anxiety disorders. Safety behaviors have been prominent in the cognitive behavior therapy literature during the last decade, particularly with social phobia management. However, nothing is known of safety behavior use by those who stutter. This is surprising given the high prevalence of social phobia in the stuttering population who seek clinical help. Method Clinical psychologists and speech-language pathologists (SLPs) created a list of safety behaviors that might be used by adults during treatment for stuttering. Participants were 160 SLPs who were asked whether they advised adults who stutter to use any of these safety behaviors. Results SLPs commonly recommend safety behaviors during stuttering management. Factor structures were found for the following 5 safety behavior categories: (a) general safety behaviors, (b) practice and rehearsal, (c) general avoidance, (d) choosing safe and easy people, and (e) control-related safety behaviors. Conclusions There is a need to determine the frequency with which adults who receive stuttering treatment follow these clinician recommendations. In addition, there is a need to experimentally determine whether following such recommendations prevents fear extinction at long-term follow-up.

Download Full-text

Long-term efficacy of Internet-based cognitive behavior therapy for obsessive–compulsive disorder with or without booster: a randomized controlled trial

Psychological Medicine ◽

10.1017/s0033291714000543 ◽

2014 ◽

Vol 44 (13) ◽

pp. 2877-2887 ◽

Cited By ~ 35

Author(s):

E. Andersson ◽

S. Steneby ◽

K. Karlsson ◽

B. Ljótsson ◽

E. Hedman ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cognitive Behavior ◽

Long Term Effects ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Term Efficacy

BackgroundAs relapse after completed cognitive behavior therapy (CBT) for obsessive–compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program.MethodA total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT.ResultsThe entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58–2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan–Meier analysis also indicated a significantly slower relapse rate in the booster group.ConclusionsThe results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.

Download Full-text

Long-term outcomes of therapist-guided Internet-delivered cognitive behavior therapy for pediatric obsessive-compulsive disorder

npj Digital Medicine ◽

10.1038/s41746-020-00327-x ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Fabian Lenhard ◽

Erik Andersson ◽

David Mataix-Cols ◽

Christian Rück ◽

Kristina Aspvall ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cost Effective ◽

Cognitive Behavior ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Long Run

Abstract Cognitive behavior therapy (CBT) is the recommended first-line intervention for children and adolescents with obsessive-compulsive disorder (OCD), but is not broadly accessible. Internet-delivered CBT (ICBT) with minimal therapist support is efficacious and cost-effective, at least in the short term. Whether the therapeutic gains of ICBT for OCD are sustained in the long run is unknown. In this study, 61 adolescents with OCD who participated in a randomized trial of ICBT were followed-up 3 and 12 months after treatment. The proportion of treatment responders and remitters remained stable from post-treatment to 3-month follow-up and increased significantly from 3-month to 12-month follow-up. This study suggests that the gains of ICBT for youth with OCD are not only maintained long-term, but that further improvements continue to occur during follow-up.

Download Full-text

Long-term outcomes of therapist-guided Internet-delivered cognitive behavior therapy for pediatric obsessive-compulsive disorder: A naturalistic one-year follow-up

10.31234/osf.io/3nk2s ◽

2020 ◽

Author(s):

Fabian Lenhard ◽

Erik Andersson ◽

David Mataix-Cols ◽

Christian Rück ◽

Kristina Aspvall ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cost Effective ◽

Cognitive Behavior ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Long Run

Cognitive behavior therapy (CBT) is the recommended first-line intervention for children and adolescents with obsessive-compulsive disorder (OCD), but is not broadly accessible. Internet-delivered CBT (ICBT) with minimal therapist support is efficacious and cost-effective, at least in the short term. Whether the therapeutic gains of ICBT for OCD are sustained in the long run is unknown. In the current study, 61 adolescents with OCD who participated in a randomized trial of ICBT were followed-up 3 and 12 months after treatment. The proportion of treatment responders and remitters remained stable from post-treatment to 3-month follow-up but significantly increased from 3-month to 12-month follow-ups. This study suggests that the gains of ICBT for youth with OCD are not only maintained long-term, but that further improvements continue to occur during follow-up.

Download Full-text

Outcome After Treatment of Spinal Ependymoma in Children and Adolescents: Long-Term Follow-up of a Single Consecutive Institutional Series of 33 Patients Treated Over Eight Decades

World Neurosurgery ◽

10.1016/j.wneu.2021.02.131 ◽

2021 ◽

Author(s):

Tryggve Lundar ◽

Bernt Johan Due-Tønnessen ◽

Radek Frič ◽

Jarle Sundseth ◽

Petter Brandal ◽

...

Keyword(s):

Children And Adolescents ◽

Spinal Ependymoma ◽

Long Term Follow Up

Download Full-text

Long-term follow-up of differentiated thyroid carcinoma in children and adolescents

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0194 ◽

2020 ◽

Vol 33 (11) ◽

pp. 1431-1441

Author(s):

Montserrat Negre Busó ◽

Amparo García Burillo ◽

Marc Simó Perdigó ◽

Pere Galofré Mora ◽

Maria Boronat de Ferrater ◽

...

Keyword(s):

Complete Remission ◽

Thyroid Carcinoma ◽

Children And Adolescents ◽

Differentiated Thyroid Carcinoma ◽

Radioiodine Treatment ◽

Persistent Disease ◽

Stage 4 ◽

Long Term Follow Up

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

Download Full-text