Moderators of Symptom Self-Ratings in Pediatric Patients with Obsessive-Compulsive Disorder During a Digital...

Obsessive-compulsive disorder (OCD) is a common mental health concern in young people, as it is often severe and can become chronic without adequate psychotherapeutic intervention. As a first-line treatment, cognitive behavioral therapy (CBT) has been extensively studied in both face-to-face and online trials. However, low remission rates may indicate that not all young patients benefit from treatment. To further improve the effectiveness of digital CBT, treatment moderators should be investigated thoroughly. We analyzed data from n = 12 children and adolescents with OCD who received 14 weeks of digital sensor-assisted CBT via videoconferences (vCBT). We assessed patients' self-ratings of OCD symptom course, affect, and arousal and examined the effects of potential moderating variables (e.g., treatment satisfaction, technical usability, self-regulation, self-control, and self-efficacy) on treatment outcomes. The results revealed a significant improvement in obsessive thoughts and compulsive behavior during online CBT. Higher treatment satisfaction and perceived usability of technical devices was associated with greater decreases in obsessive thoughts and compulsive behavior. A significant moderating effect on self-rated decreases in symptoms was also found for patients with higher levels of self-efficacy, self-regulation, and self-control. Our results highlight that digital sensor-assisted CBT led to a subjective decrease in symptoms. The moderating effects of patient satisfaction and usability on symptom improvement emphasize the need for participative design approaches in the development of digital mental health interventions. The different constructs of mastery and volition appear to be moderators of decreases in OCD symptoms and should be further investigated in future trials with larger patient samples.Clinical trial registration: [ www.ClinicalTrials.gov ], identifier [NCT05291611], first submission: 2021-12-10.