DIRT IS NOT DANGEROUS

Abstract

Dysfunctional beliefs are assumed to play an important role in OCD. A new type of treatment is the Cognitive Bias Modification of Interpretation (CBM-I) training: a computerized paradigm developed to modify dysfunctional interpretations in for example OCD, anxiety, and depression. A meta-analysis focusing on adult samples revealed that CBM-I training was successful in increasing positive interpretations and decreasing negative mood states (Menne-Lothmann et al., 2014). A recent meta-analysis on the effect of CBM in child samples also shows a positive effect on interpretations, but not on mental health outcomes (Cristea, Mogoase, David, & Cuijpers, 2015). However, effects of CBM-I in children are not unequivocal. Due to a lack of studies in this field, and methodological differences and limitations it is too early to draw conclusions about the effect of CBM-I for children and adolescents with emotional disorders. Our pilot study (Salemink, Wolters, & de Haan, 2015) was the first study examining the effect of a CBM-I in children with clinical OCD. The results of this study showed that patients who received eight sessions of CBM-I training reported fewer obsessive compulsive symptoms after training, and clinicians’ ratings showed fewer obsessive symptoms, in contrast to the placebo group. As a next step, we improved the training and conducted a larger randomized controlled trial to further examine the effectiveness of a CBM-I training in children and adolescents with OCD. Participants were 79 children and adolescents between 8 and 18 years old ( M 13.7; SD 3.0) referred for outpatient treatment of OCD. Participants were randomly assigned to 12 sessions of CBM-I in 4 weeks ( N = 39) or to a waitlist of 4 weeks ( N = 40). In the second part of the study, all participants received manualized cognitive behavioral therapy. Among other measurements, the CY-BOCS, a clinician-rated semi-structured interview, was used to assess severity of OC symptoms. Results showed a significant decrease of OCD severity (CY-BOCS score) in the CBM-I condition, but not in the waitlist condition. These results are promising and possible applications of the CBM-I training in the treatment of pediatric OCD will be discussed.