Lifetime Potentially Traumatic Events and Cognitive-Behavioral Therapy Outcomes in Pediatric Obsessive-Compulsive Disorder
Bibliographic record
Abstract
Objective This study evaluated impacts of traumatic stress, a social determinant of health, on cognitive behavioral therapy (CBT) outcomes in pediatric obsessive-compulsive disorder (OCD). Closing this literature gap is crucial for optimizing individual treatment approaches in pediatric OCD and limiting misinterpretation of OCD symptoms in the context of a trauma history. Method Ninety-eight OCD-affected youth (8-19 years) completed an evidence-based CBT group program. Lifetime potentially traumatic events (PTE) were assessed at baseline by type and cumulative load with the Traumatic Events Screening Inventory - Parent Report Revised. Longitudinal treatment outcome measures assessed OCD-related symptom severity, functional and family impairment, and family accommodation at baseline, mid-and end-of-treatment, and 1-month follow-up. Specifically, functional impairment was assessed via the Child OCD Impact Scale-Revised. Results Lifetime PTE load was not associated with any CBT outcomes ( p s > .218). In exploratory analyses, associations of specific trauma types with timing and directionality of functional impairment changes were as follows: physical abuse was associated with differences in early treatment response ( β = 12.2, 95% CI [2.0, 22.4], p = .020); emotional abuse was associated with differences in maintenance of gains at 1-month follow-up ( β = 10.0, 95% CI [1.6, 18.4], p = .021); and the death of someone close was associated with differences in outcomes at mid- ( β = –9.1, 95% CI [-15.3, -3.1], p = .006) and endpoint ( β = –6.9, 95% CI [-13.4, -0.4], p = .040). Emotional abuse was also associated with reduced maintenance of family functioning improvement at 1-month follow-up ( β = 7.8, 95% CI [0.5, 15.1], p = .040). Conclusion Preliminary results suggest that cumulative trauma exposure did not significantly impact CBT outcomes in pediatric OCD. Exploratory analyses suggest that specific trauma types may be associated with different patterns of functional improvement during treatment phases, highlighting potential areas for future research in the pediatric OCD literature .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".