Effects of some factors to treatment response in adolescent patients with obsessive compulsive disorder: Metacognitions, obsessive beliefs, emotion regulation difficulties and expressed emotions of family

Purpose: The purpose of this study is the investigation of factors such as metacognition, emotional regulation difficulties, emotional expression and parents 'psychiatric symptoms that affect adolescents' response to treatment in OCD. Method: 35 adolescents between the ages of 12-18 who were diagnosed with OCD and parents of these patients are included in this study. Children's Yale-Brown Obsessive Compulsive Scale was administered to the patients twice in total at the first meeting and at the 12th week. All adolescents were provided to fill in Shortened Level of Expressed Emotion Scale in Adolescents, Difficulties in Emotion Regulation Scale-Short Form, Meta-Cognitions Questionnaire for Children and Adolescent. All parents were asked to fill in Obsessive Belief Questionnaire-44, The Symptom Checklist-90, Expressed Emotion Scale and Difficulties in Emotion Regulation Scale-Short Form. Since there were not eligible/adequate CBT therapists, patients were followed with medical treatment and the treatment responses were followed by the researcher. Basic statistical analyzes were made with the data obtained; a multivariate model was created in the light of correlations and theoretical knowledge, and the model was tested by path analysis. Results: In this study it was observed that emotion regulation difficulties and metacognitive beliefs of adolescents were related to each other in many sub-factors, and metacognition was not associated with the treatment response. The difficulty of accepting emotions of adolescents and the level of irritability perceived from the family are negatively related to the treatment response. The emotional over-involvement and protectiveness reported by the mothers and "obsession" scores showed a negative relationship with the treatment response. In addition to the positive relationship between fathers' high emotional expression and their children's metacognitive monitoring beliefs, "anger" scores are positively related with the difficulty of accepting emotions of children and the severity of OCD at the end of treatment. Moreover, depressive symptoms and obsessions in mothers were found to be associated with their children's nonacceptance of emotional responses. The level of irritability perceived by adolescents from obsessive mothers was found higher than others. Conclusions: As a result, the difficulty of accepting emotions of adolescents with OCD, perceived irritability, the mother's over-involvement and protectiveness, and obsessional symptoms have negative effects on the treatment response. These findings suggest that in the treatment of adolescents with OCD, the use of inclusive therapy methods for the family as recommended in children and approaches to the difficulty of accepting negative emotions may be beneficial.