Cognitive behavior therapy (CBT) for young people with obsessive compulsive disorder (OCD) has recently been enhanced to target family environment factors. However, the process of change for OCD symptoms and family factors during treatment is not well understood. Uniquely, we explored patterns of change for OCD symptoms and a range of family variables throughout Baseline, Early, Mid, and Late treatment phases of family-based CBT (FCBT) for 15 young people with OCD using multiple informants. We predicted a linear reduction in OCD symptom severity and family accommodation (FA) across treatment phases, however the investigation into other family factor change patterns was exploratory. OCD symptom severity, FA, parental distress tolerance (DT), and conflict all showed significant linear change patterns across treatment phases according to multiple informants. In addition, the largest proportion of change for these variables typically occurred during the first third of treatment, highlighting the importance of identifying participants with and without early gains in future research. Blame also showed a significant linear change pattern, although with small reductions between treatment phases. Preliminary bivariate analyses sought to better understand whether family factor change predicted subsequent OCD severity change or vice versa. Similar patterns emerged across informants, including identification of OCD severity as a significant predictor of change for Blame at subsequent treatment phases. Analyses also showed bi-directional effects for DT and OCD symptoms across informants, where DT predicted OCD severity at subsequent treatment phases and vice versa. These outcomes support further research aimed at understanding the role of family factors in pediatric OCD symptom change.

针对患有强迫症 (OCD) 的年轻人的认知行为疗法 (CBT) 最近得到加强，以针对家庭环境因素。然而，强迫症症状和家庭因素在治疗过程中的变化过程尚不清楚。独特的是，我们利用多名知情者，探索了 15 名患有强迫症的年轻人在基于家庭的 CBT (FCBT) 的基线、早期、中期和晚期治疗阶段的强迫症症状的变化模式和一系列家庭变量。我们预测在整个治疗阶段强迫症症状严重程度和家庭适应（FA）会线性降低，但是对其他家庭因素变化模式的调查是探索性的。据多名知情人士透露，强迫症症状的严重程度、FA、父母的痛苦耐受力（DT）和冲突在整个治疗阶段都显示出显着的线性变化模式。此外，这些变量的最大比例变化通常发生在治疗的前三分之一期间，这凸显了在未来研究中识别有或没有早期获益的参与者的重要性。尽管治疗阶段之间略有减少，但责备也显示出显着的线性变化模式。初步的双变量分析试图更好地了解家庭因素的变化是否可以预测随后的强迫症严重程度的变化，反之亦然。受访者中也出现了类似的模式，包括将强迫症的严重程度确定为后续治疗阶段责备变化的重要预测因素。分析还显示了 DT 和强迫症症状对受访者的双向影响，其中 DT 预测了后续治疗阶段的强迫症严重程度，反之亦然。这些结果支持进一步的研究，旨在了解家庭因素在儿科强迫症症状变化中的作用。