AUTHOR=Rosa-Alcázar Ángel , Rosa-Alcázar Ana I. , Parada-Navas José Luis , Olivares-Olivares Pablo J. , Rosa-Alcázar Encarnación 

TITLE=Predictors of Parental Accommodation and Response Treatment in Young Children With Obsessive-Compulsive Disorder

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.737062

DOI=10.3389/fpsyt.2021.737062

ISSN=1664-0640

ABSTRACT=Background: Cognitive-Behavioral Family-Based Treatment (CBFT) is the treatment standard in very young children with OCD, which includes the same core components of CBT with significant family involvement. Although the latter reports high rates of remission, some children do not improve with treatments. Therefore, it is necessary to identify possible moderating variables such as comorbidity, severity of disorder, years of onset, parental anxiety, parental accommodation. This study has two main aims: 1) To propose a predictive model on family accommodation (father and mother) taking into account variables related to the children (severity of   obsessive-compulsive responses, internalizing and externalizing symptoms and comorbidity) and with the parents before intervention (worry, accommodation of one parental member over the other). 2) To examine the mediating role of externalizing symptoms and mother accommodation in the relation between initial severity and   improvement of severity of obsessive-compulsive responses in children aged 5 to 8 years. 
Method. Participants: 56 children with Obsessive-Compulsive Disorder (Mean = 6.61, SD = 0.76) and their parents. 79% of the sample was men. Procedure: Treatment was implemented by two clinicians specialized in OCD (over 15 years of experience). Clinicians were trained to administer CBT protocol in the uniform. 
Results: Mother's accommodation was associated with child variables (CBCL-externalizing and initial Severity, CY-BOCS). Father´s accommodation could be explained by parent variables (mother´s accommodation and worry). Simple mediation model tested using the SPSS macro PROCESS, supported the relation of the initial severity of symptoms with that following intervention, through the simple indirect effect of externalizing symptoms of the child. 
Conclusions: Comorbidities with externalizing symptoms, father´s worry and mother´s accommodation were variables that should be controlled in treatment of pediatric OCD.