Parent- and child-reported executive functioning and response to psychotherapy in pediatric obsessive-compulsive disorder: Results from the TECTO study.

Executive function (EF) difficulties in pediatric obsessive-compulsive disorder (OCD) are suggested to interact with psychotherapy response. We investigated the role of parent- and self-rated EF in a randomized trial comparing cognitive-behavioral therapy (CBT) and psychoeducation with relaxation tr...

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Published in:European Child & Adolescent Psychiatry Vol. 35; no. 7; pp. 2211 - 2224
Main Authors: Ritter, Melanie, Uhre, Valdemar, Christensen, Sofie Heidenheim, Korsbjerg, Nicoline Løcke Jepsen, Lønfeldt, Nicole Nadine, Pretzmann, Linea, Thoustrup, Christine Lykke, Mora-Jensen, Anna-Rosa Cecilie, JessicaPlessen, Kerstin, Jepsen, Jens Richard Møllegaard, Vangkilde, Signe, Uhre, Camilla Funch, Pagsberg, Anne Katrine, Blair, Robert James
Format: research tables/charts Journal Article
Published: Springer Nature Jul2026
Online Access:View this record in EBSCOhost
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      dt: Jul2026
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00787-026-03013-7
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        atl: Parent- and child-reported executive functioning and response to psychotherapy in pediatric obsessive-compulsive disorder: Results from the TECTO study.
      aug:
        au:
          Ritter, Melanie
          Uhre, Valdemar
          Christensen, Sofie Heidenheim
          Korsbjerg, Nicoline Løcke Jepsen
          Lønfeldt, Nicole Nadine
          Pretzmann, Linea
          Thoustrup, Christine Lykke
          Mora-Jensen, Anna-Rosa Cecilie
          JessicaPlessen, Kerstin
          Jepsen, Jens Richard Møllegaard
          Vangkilde, Signe
          Uhre, Camilla Funch
          Pagsberg, Anne Katrine
          Blair, Robert James
        affil: https://ror.org/05bpbnx46 Child and Adolescent Mental Health Center, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Gentofte Hospitalsvej 3A, 2900, Hellerup, Copenhagen, Denmark
      sug:
        subj:
          Parents
          Patients
          Self Report
          Executive Function Evaluation
          Cognitive Therapy
          Obsessive-Compulsive Disorder Therapy
          Obsessive-Compulsive Disorder Therapy
          Symptom Burden Evaluation
          Pediatric Care
          Human
          Denmark
          Scales
          Child
          Adolescence
          Secondary Analysis
          Multivariate Analysis of Variance
          Univariate Statistics
          Multiple Linear Regression
          Repeated Measures
          Analysis of Variance
          Post Hoc Analysis
          Emotional Regulation
          Memory, Short Term
          Task Performance and Analysis
          Psychotherapy
          Child: 6-12 years
          Adolescent: 13-18 years
      ab: Executive function (EF) difficulties in pediatric obsessive-compulsive disorder (OCD) are suggested to interact with psychotherapy response. We investigated the role of parent- and self-rated EF in a randomized trial comparing cognitive-behavioral therapy (CBT) and psychoeducation with relaxation training (PRT). We investigated the extent to which: (1) EF difficulties are evident in non-medicated pediatric OCD patients; (2) difficulties improve during psychotherapy; and (3) EF moderates symptom alleviation. We included 114 patients with OCD (aged 8–17 years), who received 14 sessions of CBT or PRT. EF was assessed before and after treatment with both the parent-rated (full age span) and self-rated (age 11–17 years) Behavior Rating Inventory of Executive Function, 2nd version (BRIEF-2). All BRIEF-2 subdomains were reported. OCD symptom severity was assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). We assessed seventy-four non-psychiatric control children within a similar time interval. Parent- and self-ratings indicated EF difficulties in OCD patients compared with non-psychiatric controls across BRIEF-2 subdomains. Self-rated flexibility difficulties were associated with more severe OCD symptoms pre-treatment. Parents and children reported EF improvement after psychotherapy across subdomains. Parent-rated self-monitoring improved after CBT but not PRT. EF improvement was not associated with symptom alleviation in patients. Finally, emotional control, working memory, and task-completion ability moderated OCD-symptom improvement. EF difficulties are evident at the group level in pediatric OCD and show improvement following psychotherapy with minimal differences between CBT and PRT. Although EF improvement is not associated with symptom alleviation, several subdomains of EF pre-treatment moderate the treatment effect.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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