Samenvatting
Inleiding: Hoewel de symptomen van een dwangstoornis duidelijk zijn, is het niet bekend wat het essentiële probleem ervan is. Kennis hierover kan consequenties hebben voor het behandelbeleid. Methode: Twee psychologische verklaringsmodellen en recent onderzoek naar behandeleffectiviteit worden besproken. Resultaten: Het cognitieve verklaringsmodel is niet aangetoond juist, maar heeft een invloedrijke vorm van behandeling gegenereerd (cognitieve therapie). Het model dat gedrag (met name herhalen) als het centrale probleem ziet, is experimenteel aangetoond. Op grond van dit model is de belangrijkste behandelstrategie exposure en responspreventie. Uit een recente meta-analyse blijkt dat cognitieve gedragstherapie (CGT) en de combinatie van CGT met medicatie effectieve behandelvormen zijn (grote effect size hebben). Als CGT wordt uitgevoerd door gespecialiseerde behandelaars is er geen verschil in effect tussen CGT en CGT gecombineerd met medicatie. Cognitive Bias Modification (CBM) en korte intensieve therapie zijn nieuwe vormen van behandeling. Conclusie: Onderzoek naar verklaringsmodellen voor de dwangstoornis is van belang voor het verbeteren van de behandeling. CGT is effectief maar zou uitgevoerd moeten worden door gespecialiseerde behandelaars. Dat het combineren van CGT met medicatie het effect van CGT vergroot is niet aangetoond. Ouders betrekken bij de behandeling is essentieel.
Abstract
Objective: Although the symptomatology of obsessive compulsive disorders is clear, the essential problem is not. Understanding this can have consequences for treatment. Method: Two psychological models are discussed as well as recent research into effectiveness of treatment. Results: The cognitive model of OCD has not been conclusively established, but it has led to an influential form of treatment (cognitive therapy). The model, in which behaviour (repetition) is the central problem, has been experimentally proved. Based on this model, exposure and response prevention are key to the treatment strategy. A recent meta-analysis has shown that cognitive behavioural therapy (CBT) and the combination of CBT with medication can have large effects. Cognitive Bias Modification (CBM) and Intensive Therapy are new treatment modalities. Conclusion: Research into models of OCD is important for improving treatment. CBT is effective, but should be given by specialists. Whether the combination of CBT and medication is more effective than CBT has not been established. Parents should be involved in the treatment.
Prof. dr. Else de Haan, bijzonder hoogleraar (em) cognitieve gedragstherapie bij kinderen en jongeren. Expertise Centrum Dwang Angst en Tics, Academisch Centrum voor Kinder- en Jeugdpsychiatrie, De Bascule, Amsterdam.
Dr. Lidewij H. Wolters, gz-psycholoog i.o., postdoc onderzoeker, Expertise Centrum Dwang Angst en Tics, Academisch Centrum voor Kinder- en Jeugdpsychiatrie, De Bascule, Amsterdam. Academisch Medisch Centrum, afdeling Kinder- en Jeugdpsychiatrie, Amsterdam. Norwegian University of Science and Technology, Faculty of Medicine, Trondheim.
Dr. Elske Salemink, cognitief gedragstherapeut, onderzoeker, Expertise Centrum Dwang Angst en Tics, Academisch Centrum voor Kinder- en Jeugdpsychiatrie, De Bascule, Amsterdam; Addiction, Development and Psychopathology lab (Adapt Lab), Afdeling Ontwikkelingspsychologie, Universiteit van Amsterdam.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatuur
Aacap, American Academy of Child and Adolescent Psychiatry Committee on Quality Issues (2012). Practice parameter for the assessment and treatment of children and adolescents with obsessive compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 98–113. doi:10.1016/j.jaac.2011.09.019.
Abramowitz, J. S., Whiteside, S. P., & Deacon, B. J. (2005). The effectiveness of treatment for pediatric obsessive-compulsive disorder: A meta-analysis. Behaviour Therapy, 36, 55–63. doi:10.1016/S0005-7894(05)80054-1.
APA (2013). Diagnostic and statistical manual of mental disorders. Fifth Edition. American Psychiatric Association.
Coles, M. E., Radomsky, A. S., & Horng, B. (2006). Exploring the boundaries of memory distrust from repeated checking: Increasing external validity and examining theresholds. Behaviour Research and Therapy, 44, 995–1006. doi:10.1016/j.brat.2005.08.001, 16174515.
Cook, E. H., Wagner, K. D., Marsch, J. S., Biederman, J., Landau, P., Wolkow, R., & Messig, M. (2001). Long-term sertraline treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1175–1181. doi:10.1097/00004583-200110000-00011, 11589530.
Cougle, J. R., & Lee, H. J. (2014). Pathological and non-pathological features of obsessive-compulsive disorder: Revisiting basic assumptions of cognitive models Journal of Obsessive-Compulsive and Related Disorders, 3, 12–20. doi:10.1016/j.jocrd.2013.11.002.
Flessner, C. A., Freeman, J. B., Sapyta, J., Garcia, A., Franklin, M. E., March, J. S., et al. (2011). Predictors of Parental Accommodation in Pediatric Obsessive-Compulsive Disorder: Findings from the Pediatric Obsessive- Compulsive Disorder Treatment Study (POTS) Trial. Journal of the American Academy of Child and Adolescent Psychiatry, 50(7), 716–725.
Franklin, M. E., Sapyta, J., Freeman, J. B., Khanna, M., Compton, S., Almirall, D., et al. (2011). Cognitive Behavior Therapy Augmentationof Pharmacotherapy in Pediatric Obsessive-Compulsive Disorder. The Pediatric OCD Treatment Study II (POTS II). Randomized Controlled Trial. JAMA, 306, 1224–1232. doi:10.1001/jama.2011.1344, 3495326,21934055.
Freeman, J., Garcia, A., Frank, H., Benito, K., Conelea, C., Walther, M., et al. (2014). Evidence base update for psychosocial treatments for pediatric obsessive-compulsive disorder. Journal of Clinical Child & Adolescent Psychology, 43(1), 7–26. doi:10.1080/15374416.2013.804386.
Freeman, J. B., Choate-Summers, M. L., Garcia, A. M., Moore, P. S., Sapyta, J. J., Khanna, M. S., et al. (2009). The Pediatric Obsessive-Compulsive Disorder Treatment Study II: rationale, design and methods. Child and Adolescent Psychiatry and Mental Health, 3, 1–15. doi:10.1186/1753-2000-3-4.
Garcia, A. M., Sapyta, J. J., Moore, Ph. S., Freeman, J. B., Franklin, M. E., March, J. S., et al. (2010). Predictors and moderators of treatment outcome in the Pediatric Obsessive Compulsive Treatment Study (POTS I). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 1024–1033. doi:10.1016/j.jaac.2010.06.013, 2943932, 20855047.
Geller, D. A., Biederman, J., Steward, S. E., Mullin, B., Martin, A., Spencer, T., et al. (2003). Which SSRI? A meta-analysis of pharmacotherapy trials in pediatric obsessieve-compulsive disorder. The American Journal of Psychiatry, 160, 1919–1928. doi:10.1176/appi.ajp.160.11.1919, 14594734.
Gillan, C. M., & Sahakian, B. J. (2015). Which is the driver, the obsessions or the compulsions, in OCD? Neuropsychopharmacology Reviews, 40, 247–248. doi:10.1038/npp.2014.201, 25482176.
Hollander E, & Zohar J. (2004). Beyond refractory obsessions and anxiety states: toward remission. Journal of Clinical Psychiatry, 4, 3–5.
Hollander, E., Kim, S., Braun, A., Simeon, D., & Zohar, J. (2009). Cross-cutting issues and future directions for the OCD spectrum. Psychiatry Research, 170, 3–6. doi:10.1016/j.psychres.2008.07.015, 19811839.
Hout, M. van den, & Kindt, M. (2003). Waarom herhaald controleren twijfel aan het geheugen niet wegneemt. Directieve Therapie, 25, 74–81.
Lau, J. Y. (2013). Cognitive bias modification of interpretations: A viable treatment for child and adolescent anxiety?. Behaviour Research and Therapy, 51, 614–622. doi:10.1016/j.brat.2013.07.001, 23916630.
Leckman, J. F., Walker, D. E., Goodman, W. K., Pauls, D. L., & Cohen, D. J. (1994). ‘Just right’ perceptions associated with compulsive behavior in Tourette’s syndrom. American Journal of Psychiatry, 151, 675–680. doi:10.1176/ajp.151.5.675, 8166308.
Menne-Lothmann, C., Viechtbauer, W., Höhn, P., Kasanova, Z., Haller, S. P., Drukker, M., et al. (2014). How to boost positive interpretations? A meta-analysis of the effectiveness of cognitive bias modification for interpretation. PloS One, 9(6), e100925. doi:10.1371/journal.pone.0100925, 4072710, 24968234.
Merlo, L. J., Lehmkuhl, H. D., Geffken, G. R., & Storch, E. A. (2009). Decreased family accommodation associated with improved therapy outcome in pediatric obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 77, 355–360. doi:10.1037/a0012652, 2886196, 19309195.
Pediatric OCD Treatment Study Team [POTS (2004). Cognitive-behavior therapy, sertraline, and their combination with children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA, 292, 1969–1976.
Peris, T. S. & Piacentini, J. (2013). Optimizing treatment for complex cases of childhood obsessive compulsive A preliminary trial. Journal of Clinical Child and Adolescent Psychology, 42, 1–8. doi:10.1080/15374416.2012.673162, 3447122, 22548378.
Peris, T. S., Sugar, C. A., Bergman, R. L., Chang, S., Langley, A., & Piacentini, J. (2012). Family factors predict treatment outcome for pediatric obsessive compulsive disorder. Journal of Consulting and Clinical Psychology, 80, 255–263. doi:10.1037/a0027084, 3378322, 22309471.
Radomsky, A. S., Dugas, M. J., Alcolado, G. M., & Lavoie, S. L. (2014). When more is less: Doubt, repetition, memory, metamemory, and compulsive checking in OCD. Behaviour Research and Therapy, 59, 30–39. doi:10.1016/j.brat.2014.05.008, 24952303.
Salemink, E., Wolters, L. & Haan, E de (2015). Augmentation of treatment as usual with online cognitive bias modification of interpretationtraining in adolescents with obsessive compulsive disorder. A pilotstudy. Journal of Behavior Therapy and Experimental Psychiatry. doi:10.1016/j.jbtep.2015.02.003.
Sánchez-Meca, J., Rosa-Alcázar, A. I., Iniesta-Sepúlveda, M., & Rosa-Alcázar, A. (2014). Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive–compulsive disorder: A meta-analysis. Journal of Anxiety Disorders, 28, 31–44. doi:10.1016/j.janxdis.2013.10.007, 24334214.
Salkoviskis, P. M. (1985). Obsessional-compulsive problems. A cognitive-behavioral analysis. Behaviour Research and Therapy, 23, 347–372.
Skarphedinsson, G., Weidle, B., Thomsen, P. H., Dahl, K., Torp, N. C., Nissen, J. B., et al. (2014). Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive–compulsive disorder that were non-responders to cognitive-behavior therapy:a randomized controlled trial. European Child and Adolescent Psychiatry, PMID: 25239489
Storch, E. A., Geffken, G. R., Merlo, L. J., Jacob, M. L., Murphy, T. K., Goodman, W. K., et al. (2007a). Family accommodation in Pediatric Obsessive – Compulsive Disorder, Journal of Clinical Child & Adolescent Psychology, 37, 207–216. doi:10.1080/15374410701277929.
Storch, E. A., Geffken, G. R., Merlo, L. J., Mann, G., Duke, D., Munson, M., et al. (2007b). Family-based cognitive-behavioral therapy for pediatric obsessive–compulsive disorder: Comparison of intensive and weekly approaches. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 469–478. doi:10.1097/chi.0b013e31803062e7, 17420681.
Storch, E. A., Abramowitz, J., & Goodman, W. K (2008a). Where does obsessive-compulsive disorder belong in DSM-V? Depression and Anxiety, 25, 336–347. doi:10.1002/da.20488, 18412060.
Storch, E. A., Merlo, L. J., Lehmkuhl, H., Geffken, G. R., Jacob, M., Ricketts, E., et al. (2008b). Cognitive-behavioral therapy for obsessive–compulsive disorder: A non-randomized comparison of intensive and weekly approaches. Journal of Anxiety Disorders, 22, 1146–1158. doi:10.1016/j.janxdis.2007.12.001, 18242950.
Storch, E. A., Bussing, R., Small, B. J., Geffken, G. R., McNamara, J. P., Rahman, O., et al. (2013). Randomized, Placebo-Controlled Trial of Cognitive-Behavioral Therapy Alone or Combined with Sertraline in the Treatment of Pediatric Obsessive-Compulsive Disorder. Behaviour Research and Therapy, 51, 823–829. doi:10.1016/j.brat.2013.09.007, 3908957, 24184429.
Toffolo, M. B. J., Hout, M. A. van den, Hooge, I. T. C., Engelhard, I. M. & Cath, D. C. (2013). Mild uncertainty promotes checking behavior in Subclinical Obsessive-Compulsive Disorder. Clinical Psychological Science, 1, 103–109.
Watson, H. J. & Rees, C. S. (2008). Meta-analysis of randomized, controlled treatment trials for pediatric obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, 49(5), 489–498. doi:10.1111/j.1469-7610.2007.01875.x, 18400058.
Whiteside, S. P., & Brown Jacobsen, A. (2010). An uncontrolled examination of a 5-day intensive treatment for Pediatric OCD. Behavior Therapy 41, 414–422. doi:10.1016/j.beth.2009.11.003, 20569789.
Wolters, L.H. (2013). Towards improving treatment for childhood OCD: analyzing mediating mechanisms & non-response. Academisch proefschrift.
Wolters, L.H., Haan, E. de, Hogendoorn, S.M., Boer, F., & Prins, P.J.M. (in voorbereiding). Severe pediatric OCD and co-morbid autistic symptoms: Effectiveness of cognitive behavioral monotherapy.
Wu, M. S., Lewin, A. B., Murphy, T. M., Geffken, G. R., & Storch, E. A. (2014) Phenomenological considerations of family accommodation: Related clinical characteristics and family factors in pediatric obsessive–compulsive disorder. Journal of Obsessive Compulsive and Related disorders, 3, 228–235. doi:10.1016/j.jocrd.2014.05.003.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Copyright information
© 2016 Bohn Stafleu van Loghum
About this chapter
Cite this chapter
de Haan, E., Wolters, L.H., Salemink, E. (2016). De dwangstoornis bij kinderen en jongeren, verklaringsmodellen en behandeling: een overzicht van nieuwe ontwikkelingen. In: Begeer, S., et al. Transformaties in de jeugdzorg. Bohn Stafleu van Loghum, Houten. https://doi.org/10.1007/978-90-368-1495-9_8
Download citation
DOI: https://doi.org/10.1007/978-90-368-1495-9_8
Published:
Publisher Name: Bohn Stafleu van Loghum, Houten
Print ISBN: 978-90-368-1494-2
Online ISBN: 978-90-368-1495-9
eBook Packages: Dutch language eBook collection