Evidence map›Paper›PMID 42034899›Full record

Trial reportBehaviour research and therapy2026

Homework adherence in exposure-based CBT for youth with obsessive-compulsive disorder: Clinical outcomes and predictors across treatment.

Abigail E Pine, Qimin Liu, Eric A Storch, Daniel A Geller, Brent J Small, Sabine Wilhelm, Joseph F McGuire

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Behaviour research and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Abigail E PineDivision of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Developmental Behavioral Health, Kennedy Krieger Institute, Baltimore, MD, USA.
Qimin LiuDepartment of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
Eric A StorchDepartment of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Daniel A GellerMassachusetts General Hospital, Boston, MA, USA; Harvard University Medical School, Boston, MA, USA.
Brent J SmallUniversity of North Carolina, Chapel Hill, NC, USA.
Sabine WilhelmMassachusetts General Hospital, Boston, MA, USA; Harvard University Medical School, Boston, MA, USA.
Joseph F McGuireDivision of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Developmental Behavioral Health, Kennedy Krieger Institute, Baltimore, MD, USA. Electronic address: jfmcguire@jhmi.edu.

Funding

Sleep and Circadian Dysfunction, Brain and Neurobehavioral Development in AutismP50HD103538 · NICHD · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI S. Ali Fatemi, Bradley L Schlaggar · 2020 to 2026
$9.9M
2/2-D-Cycloserine Augmentation of CBT for Pediatric OCDR01MH093402 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI GELLER, DANIEL A · 2011 to 2014
$1.7M
1/2-D-Cycloserine Augmentation of CBT for Pediatric OCDR01MH093381 · NIMH · UNIVERSITY OF SOUTH FLORIDA · PI STORCH, ERIC A. · 2011 to 2014
$1.2M
NICHD NIH HHS P50 HD103538NIMH NIH HHS R01 MH093381NIMH NIH HHS R01 MH093402
6 · The paper itself

Abstract

Exposure-based cognitive behavioral therapy (CBT) is the frontline treatment for pediatric obsessive-compulsive disorder (OCD), but not all youth fully respond to this treatment. While multiple factors may influence CBT response, homework adherence in CBT is a modifiable target that can improve treatment outcomes. This report examines the relationship between homework adherence and clinical outcomes in a large sample of youth with OCD who received exposure-based CBT. Here, 137 youth with OCD between 7 and 17 years old (M = 12.42, SD = 2.88) participated in a randomized controlled trial of exposure-based CBT. Homework adherence was monitored weekly, and OCD severity was assessed by independent evaluators masked to treatment condition using gold-standard rating scales. Mixed-effects linear and logistic regression models examined the relationship between homework adherence, reductions in OCD severity, treatment response, and clinical remission at post-treatment. Follow-up investigations explored differences in patterns between early- and late-homework adherence. Finally, baseline clinical predictors of homework adherence were explored. There was a significant predictive relationship between greater homework adherence and reduced OCD severity, greater incidence of treatment response, and greater incidence of clinical remission at post-treatment. Greater homework adherence later in treatment-as opposed to earlier in treatment-was most impactful in predicting positive clinical outcomes in exposure-based CBT. Presence of co-occurring ADHD was a significant predictor of decreased homework adherence. Taken together, findings provide insight into a modifiable therapeutic target that can improve treatment outcomes in exposure-based CBT.

Indexed as

Cognitive Behavioral TherapyImplosive TherapyObsessive-Compulsive DisorderPatient ComplianceAdolescentChildFemaleHumansMaleSeverity of Illness IndexTreatment OutcomeExposure-based CBTHomework adherencePediatric OCD

Identifiers

PMID42034899
PMCPMC13197964

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.