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A Meta-Analysis of the Effectiveness and Efficiency of Dcycloserine-Augmented Exposure Therapy with Treatment Resistant Pediatric OCD Patients.

Record Type:	Language materials, manuscript : Monograph/item
Title/Author:	A Meta-Analysis of the Effectiveness and Efficiency of Dcycloserine-Augmented Exposure Therapy with Treatment Resistant Pediatric OCD Patients./
Author:	Sullivan, Paul J.
Description:	1 online resource (129 pages)
Notes:	Source: Dissertation Abstracts International, Volume: 79-05(E), Section: B.
Contained By:	Dissertation Abstracts International79-05B(E).
Subject:	Psychology. -
Online resource:	click for full text (PQDT)
ISBN:	9780355519037

A Meta-Analysis of the Effectiveness and Efficiency of Dcycloserine-Augmented Exposure Therapy with Treatment Resistant Pediatric OCD Patients.
Sullivan, Paul J.

A Meta-Analysis of the Effectiveness and Efficiency of Dcycloserine-Augmented Exposure Therapy with Treatment Resistant Pediatric OCD Patients. - 1 online resource (129 pages)

Source: Dissertation Abstracts International, Volume: 79-05(E), Section: B.

Thesis (Ph.D.)--Palo Alto University, 2017.

Includes bibliographical references

Many youth suffer from Obsessive-Compulsive Disorder (OCD). Practice parameters recommend the implementation of Cognitive Behavioral Therapy (CBT) as well as Selective Serotonin Reuptake Inhibitors (SSRIs) to intervene with this population. However, not all pediatric OCD patients respond to these empirically supported treatments. If patients do not respond adequately to pharmacological interventions and CBT they are classified as "treatment resistant." Currently, a standard of care does not exist for these youth. These patients are in urgent need of newer strategies to alleviate symptoms. D-Cycloserine (DCS), a partial glutamate agonist, shows promise as an adjunctive intervention with CBT. This study explored whether DCS-augmented ERP is an effective and efficient form of intervention by consolidating the current literature into a meta-analysis. Utilizing a random effects model, effect sizes were calculated using Cohen's d and Hedges' g. Scores on the Child Yale-Brown Obsessive-Compulsive Scale (CY-BOCS; Scahill et al., 1997) served as the primary outcome measure for all analyses. Of 1,945 potential abstracts examined for review, five studies met inclusion criteria and were analyzed. The pooled population consisted of a total of 230 youth. Of these participants, 116 received DCS-augmented exposures compared to 109 who received placebo and five who received ERP alone. A random effects meta-analysis found an overall positive, very small, statistically non-significant effect size for DCS-augmented therapy relative to placebo-assisted exposures from pre-to post-treatment on total CY-BOCS scores (Cohen's d= 0.12, 95% CI= [-0.14, 0.38], z-value= 0.91, p-value= 0.36; Hedges' g= 0.12, 95% CI= [-0.14, 0.37], z-value= 0.91, p-value= 0.36). This result indicates a small, positive effect approaching statistical significance on symptom reduction at post-treatment for those receiving DCS. A second random effects meta-analysis found an overall, extremely small, statistically non-significant effect size for DCS relative to placebo from pre- to mid-treatment total CY-BOCS scores (Cohen's d= 0.02, 95% CI= [-0.25, 0.29], z-value= 0.12, p-value= 0.90; Hedges' g= 0.02, 95% CI= [-0.25, 0.28], z-value= 0.11, p-value= 0.91). Thus, DCS was minimally efficient compared to placebo at reducing symptoms at mid-treatment. Further studies are needed to examine moderating variables in order to determine which subtypes of OCD benefit most from DCS.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2018

Mode of access: World Wide Web

ISBN: 9780355519037Subjects--Topical Terms:

555998
Psychology.
Index Terms--Genre/Form:

554714
Electronic books.

A Meta-Analysis of the Effectiveness and Efficiency of Dcycloserine-Augmented Exposure Therapy with Treatment Resistant Pediatric OCD Patients.
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504 $a Includes bibliographical references
520 $a Many youth suffer from Obsessive-Compulsive Disorder (OCD). Practice parameters recommend the implementation of Cognitive Behavioral Therapy (CBT) as well as Selective Serotonin Reuptake Inhibitors (SSRIs) to intervene with this population. However, not all pediatric OCD patients respond to these empirically supported treatments. If patients do not respond adequately to pharmacological interventions and CBT they are classified as "treatment resistant." Currently, a standard of care does not exist for these youth. These patients are in urgent need of newer strategies to alleviate symptoms. D-Cycloserine (DCS), a partial glutamate agonist, shows promise as an adjunctive intervention with CBT. This study explored whether DCS-augmented ERP is an effective and efficient form of intervention by consolidating the current literature into a meta-analysis. Utilizing a random effects model, effect sizes were calculated using Cohen's d and Hedges' g. Scores on the Child Yale-Brown Obsessive-Compulsive Scale (CY-BOCS; Scahill et al., 1997) served as the primary outcome measure for all analyses. Of 1,945 potential abstracts examined for review, five studies met inclusion criteria and were analyzed. The pooled population consisted of a total of 230 youth. Of these participants, 116 received DCS-augmented exposures compared to 109 who received placebo and five who received ERP alone. A random effects meta-analysis found an overall positive, very small, statistically non-significant effect size for DCS-augmented therapy relative to placebo-assisted exposures from pre-to post-treatment on total CY-BOCS scores (Cohen's d= 0.12, 95% CI= [-0.14, 0.38], z-value= 0.91, p-value= 0.36; Hedges' g= 0.12, 95% CI= [-0.14, 0.37], z-value= 0.91, p-value= 0.36). This result indicates a small, positive effect approaching statistical significance on symptom reduction at post-treatment for those receiving DCS. A second random effects meta-analysis found an overall, extremely small, statistically non-significant effect size for DCS relative to placebo from pre- to mid-treatment total CY-BOCS scores (Cohen's d= 0.02, 95% CI= [-0.25, 0.29], z-value= 0.12, p-value= 0.90; Hedges' g= 0.02, 95% CI= [-0.25, 0.28], z-value= 0.11, p-value= 0.91). Thus, DCS was minimally efficient compared to placebo at reducing symptoms at mid-treatment. Further studies are needed to examine moderating variables in order to determine which subtypes of OCD benefit most from DCS.
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538 $a Mode of access: World Wide Web
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