Internet Delivered CBT for OCD in Adolescents With ASD - A Clinical Case Series

Not Applicable

Completed

Brief Summary: The aim of this study is to test the feasibility and acceptability of an internet-delivered cognitive behavior therapy (ICBT) intervention originally developed for neurotypical adolescents with obsessive compulsive disorder (OCD) in adolescents with OCD and autism spectrum disorder (ASD). This feasibility study will inform us how to adapt the original intervention to the specific needs of patients with ASD.

Detailed Description: To evaluate the effectiveness of ICBT for OCD in adolescents with ASD, this study will use a single case experimental design with weekly measures during two phases: A-B. The A-phase will consist of baseline measures at least three weeks prior to treatment. The B-phase will consist of the 12 weeks ICBT-program as well as one measure post-treatment. Single case descriptions of each participant will be presented. Weekly measures on the Obsessional Compulsive Inventory - Child version (OCI-CV) will be analyzed through visual inspection of each participants graph and through computation of Percentage of Non-overlapping Data (PND). PND is a frequently used effect measure in SCED and reflects how large percentage of the measurements during the treatment-phase that do not overlap with any of the measurements during the base-line phase.

To assess the feasibility and comprehension of the ICBT treatment semi-structured interviews (face-to-face or telephone) will be conducted with participants and parents weekly during the four first weeks of ICBT and semi-weekly during the rest of the treatment. Detailed notes will be taken during each interview and will serve as content material for a thematic analysis trying to determine possible accommodations to the ICBT protocol to better suit patients with ASD.

Recruitment & Eligibility

Inclusion Criteria

a diagnosis of OCD as defined by DSM-5 [40]
a diagnosis of autism defined by DSM-5
a total score of ≥ 16 on the Children's Yale-Brown Obsessive-Compulsive Scale, CY-BOCS [14]
age between 12 and 17 years
ability to read and write Swedish
access to the internet
a parent that is able to co-participate in the treatment
Participants on psychotropic medication must have been on a stable dose for the last 6 weeks prior to baseline assessment

Exclusion Criteria

psychosis or bipolar disorder, severe eating disorder
suicidal ideation
subject not able to read or understand the basics of the ICBT material
completed CBT for OCD within last 12 months (defined as at least 5 sessions of CBT including exposure and response prevention)
ongoing psychological treatment for OCD or another anxiety disorder

Arm && Interventions

Group	Intervention	Description
Internet-delivered CBT	Internet-delivered Cognitive Behavior Therapy	12 weeks of internet-delivered cognitive behavior therapy provided through a secure internet platform and online clinician contact

Primary Outcome Measures

Name	Time	Method
Obsessional Compulsive Inventory - Child version, OCI-CV	Change from baseline to 12 weeks	Self-rated OCD symptom levels

Secondary Outcome Measures

Name	Time	Method
Education, Work and Social Adjustment Scale - child and parent version, EWSAS	Change from baseline to 12 weeks	Global functioning
Children's Yale Brown Obsessive Compulsive Scale	Change from baseline to 12 weeks	Clinician-rated OCD symptom levels
Mini International Neuropsychiatric Interview for Children and Adolescents, MINI-KID	Baseline	psychiatric screening of comorbidity
Clinical Global Impression - Severity, CGI-S	Change from baseline to 12 weeks	Global symptom levels
Clinical Global Impression - Improvement, CGI-I	Post treatment(12 weeks)	Global symptom improvement
Children's Global Assessment Scale, CGAS	Change from baseline to 12 weeks	Global level of functioning
Children´s Depression Inventory - Short version	Change from baseline to 12 weeks	Symptom level of depressive mood
Strength and difficulties, SDQ	Change from baseline to 12 weeks	General psychopathology
Family Accommodation Scale, Parent-Report, FAS-PR	Change from baseline to 12 weeks	Parental accommodation to OCD symptoms
Patient ICBT Adherence Rating, PIAR	after 6 weeks and at post treatment(12 weeks)	Patient Adherence to internet delivered CBT

Locations (2): Karolinska Institutet
🇸🇪
Stockholm, Sweden
Karolinska insititute
🇸🇪
Stockholm, Sweden