Anorexia Nervosa
Conditions
Brief summary
Anorexia Nervosa is a serious life-threatening illness with a typical age of onset in adolescence; if not effectively treated, it has the potential to significantly impact adolescent development and quality of life. Research on executive functioning in anorexia nervosa indicates that it may be a viable target for intervention that could improve outcome. The current project focuses on determining whether or not the investigators can improve set-shifting in parents and affected adolescents in the hopes that improvements in set-shifting will, ultimately, improve outcome.
Detailed description
This application seeks support for a phased project. In the initial (R61) 2-year phase, the investigators will establish that Cognitive Remediation Therapy (CRT) can increase set-shifting in parents of and/or adolescents with Anorexia Nervosa (AN). The second aim is to determine the appropriate dose needed to achieve positive change in set-shifting. Attaining this milestone would trigger support for three additional years (R33) to confirm target engagement and appropriate dose. The investigators will also evaluate whether or not adding CRT to Family Based Treatment (FBT) will improve outcome compared to FBT alone. Set-shifting (a type of executive functioning often referred to as cognitive flexibility) inefficiencies are hypothesized to be an endophenotype of AN and are, therefore, heritable. Cognitive flexibility can be impacted negatively by situational factors such as malnutrition, stress, and anxiety. It is likely that both adolescents (who are malnourished) and parents (who are under stress) experience significant state-based reduction in their cognitive flexibility during AN and its treatment. While cognitive flexibility can be increased through CRT, there is a significant gap in the knowledge about how to apply CRT to the treatment of adolescent AN, specifically concerning the most appropriate target for CRT: parents or adolescents? The majority of research on CRT with adolescents with AN are pilot and feasibility studies and target set-shifting in adolescents, not parents. The investigators hypothesize that targeting parents may be more impactful for adolescent outcome. First, the investigators must determine if an increase set-shifting via CRT is possible. In the initial R61 phase, the investigators propose to recruit and randomly assign 54 families who have a child with AN to FBT, FBT with parent-focused CRT, or FBT with adolescent-focused CRT. Target engagement will be assessed via neuro-psychological assessment and self-report of cognitive and behavioral flexibility. If the investigators meet these proposed milestones in the R61 phase, they will proceed to the R33 phase. It is possible that one (N = 72 families) or both (N = 93 families) CRT conditions will be examined in the R33 phase. The investigators will confirm the findings from the R61 phase (target engagement and dose of CRT). The investigators will also examine adolescent outcome in FBT alone versus FBT+(parent or adolescent) CRT. They will gather preliminary data on putative moderators and/or mediators across both phases in order to inform results. This phased R61/R33 application is innovative in that it is the first to adapt CRT to parents only. Evidence supporting FBT+CRT to increase set-shifting in parents/adolescents will inform future efforts to leverage understanding of (heritable) neurobiology of AN in adolescents to improve outcome. Further, if CRT for parents significantly improves set-shifting, the investigators can focus efforts on how best to augment current treatments, support parents, and increase positive outcomes for the adolescent and reduce relapse. Even negative results would inform understanding of set-shifting inefficiencies as an endophenotype in AN, its measurement, and usefulness as a target in treatment.
Interventions
BEHAVIORALCognitive Remediation Therapy
Cognitive Remediation Therapy (CRT) is an adjunctive treatment focused on increasing set-shifting ability and developing meta-cognition.
BEHAVIORALFamily Based Treatment
Family Based Treatment (FBT) is an evidence based treatment in which parents are responsible for adolescent re-nourishment. They play an active role in treatment and their self-efficacy to make decisions regarding their child's treatment is empowered.
Sponsors
National Institute of Mental Health (NIMH)
Children's Hospital of Philadelphia
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Any study team member who is assessing for outcomes will not which participant/family is in which group.
Intervention model description
Random assignment to one of three groups.
Eligibility
Sex/Gender
ALL
Age
12 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adolescents 1. Age 12-18 2. Currently meets Diagnostic and Statistical Manual-5 criteria for Anorexia Nervosa 3. Medically stable for outpatient treatment 4. Fluent in English 5. No co-morbid condition that would exclude participation 6. Medical clearance from primary care physician and permission to speak to Primary Care Physician about clinical issues 7. Biological parent or primary caregiver willing to engage in treatment and who live with the adolescent Inclusion Criteria:Parents 1. Age \>18 2. Child with a diagnoses of AN 3. Both parents willing to participate 4. Fluent in English 5. No co-morbid condition that would exclude participation
Exclusion criteria
Adolescent 1. Adolescent outside age range 2. Adolescent adopted 3. Pregnant adolescent 4. Presence of: pervasive developmental disability, psychosis, bipolar disorder, substance abuse, autism spectrum disorder, or intellectual disability 5. Presence of: a brain disorder or injury (such as TBI) that could impact the ability to engage in treatment 6. Use of anti-psychotic medication 7. Concurrent psychosocial therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | 6 months of treatment | The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). Trail Making Test assesses flexibility in thinking. We use Condition 4 (Number-Letter Switching) to assess flexibility. |
| Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | 6 months of treatment | The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). Inhibition refers to the ability to inhibit a well learned or salient task in order to do something different; thus, it is related to flexibility. The D-KEFS Color-Word Interference Test (Condition 3: Inhibition) to assess ability to inhibit automatic responses. |
| Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | 6 months of treatment | The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The D-KEFS Color Word Interference (Condition 4: Inhibition/Switching) assess the ability to switch between alternating rules (a component of set shifting). |
| Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | 6 months of treatment | The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The D-KEFS Verbal Fluency assesses the ability to shift between concepts. The Switching Correct score is used to assess flexibility. |
| Change in Cognitive Flexibility - Sorting Test Description of DKEFS | 6 months of treatment | The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The Sorting Test assesses flexibility in thinking and problem solving. |
| Change in Self-Reported Shifting - BRIEF | 6 months of treatment | The Behavior Rating Inventory of Executive Functioning (BRIEF) is an ecologically valid clinical tool for measuring executive functioning across several domains in youth 5 to 18 years of age; the self-report version (BRIEF-2) was administered to adolescents. It has a comparable adult self-report version (BRIEF-A) normed for ages 18-90. Both versions of the BRIEF are normed by age and sex on a T-scale (mean = 50, SD = 10), and scores are considered clinically elevated if they are 65 or higher. Both have a number of clinical scales and indices. Lower scores indicate greater strengths in each area. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants, thus, we expect a reduction in scores for those in the CRT conditions. The BRIEF was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The BRIEF Shift assesses behavioral flexibility. |
| Dose of CRT | 6 months of treatment | Number of sessions necessary in order to change cognitive flexibility. This is the number of sessions needed for change to occur in cognitive flexibility. It is only calculated for the participants who received CRT and who had a significant change in flexibility above what was observed in FBT. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Family Based Treatment (FBT) Families will receive 15 sessions of FBT alone.
Family Based Treatment: Family Based Treatment (FBT) is an evidence based treatment in which parents are responsible for adolescent re-nourishment. They play an active role in treatment and their self-efficacy to make decisions regarding their child's treatment is empowered. | 63 |
| FBT w/ Parent-focused Cognitive Remediation Therapy Family Based Treatment with Parent-focused Cognitive Remediation Therapy (CRT): Families will receive 15 sessions of parent focused CRT followed Family Based Treatment over six months.
Cognitive Remediation Therapy: Cognitive Remediation Therapy (CRT) is an adjunctive treatment focused on increasing set-shifting ability and developing meta-cognition.
Family Based Treatment: Family Based Treatment (FBT) is an evidence based treatment in which parents are responsible for adolescent re-nourishment. They play an active role in treatment and their self-efficacy to make decisions regarding their child's treatment is empowered. | 57 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy Family Based Treatment with Adolescent-focused Cognitive Remediation Therapy (CRT): Families will receive 15 sessions of adolescent focused CRT followed by Family Based Treatment over six months.
Cognitive Remediation Therapy: Cognitive Remediation Therapy (CRT) is an adjunctive treatment focused on increasing set-shifting ability and developing meta-cognition.
Family Based Treatment: Family Based Treatment (FBT) is an evidence based treatment in which parents are responsible for adolescent re-nourishment. They play an active role in treatment and their self-efficacy to make decisions regarding their child's treatment is empowered. | 57 |
| Total | 177 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Physician Decision | 9 | 6 | 3 |
| Overall Study | Withdrawal by Subject | 12 | 3 | 3 |
Baseline characteristics
| Characteristic | Family Based Treatment (FBT) | FBT w/ Parent-focused Cognitive Remediation Therapy | FBT w/Adolescent-focused Cognitive Remediation Therapy | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 21 Participants | 19 Participants | 19 Participants | 59 Participants |
| Age, Categorical >=65 years | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Age, Categorical Between 18 and 65 years | 42 Participants | 37 Participants | 38 Participants | 117 Participants |
| Age, Continuous Adolescents | 15.51 years STANDARD_DEVIATION 1.81 | 15.21 years STANDARD_DEVIATION 1.53 | 15.25 years STANDARD_DEVIATION 1.61 | 15.335 years STANDARD_DEVIATION 1.641 |
| Age, Continuous Fathers | 50.65 years STANDARD_DEVIATION 5.98 | 49.93 years STANDARD_DEVIATION 6.82 | 48.97 years STANDARD_DEVIATION 4.82 | 49.88 years STANDARD_DEVIATION 5.87 |
| Age, Continuous Mothers | 48.18 years STANDARD_DEVIATION 3.61 | 47.46 years STANDARD_DEVIATION 6.25 | 47.30 years STANDARD_DEVIATION 2.997 | 47.66 years STANDARD_DEVIATION 4.42 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 1 Participants | 0 Participants | 4 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 58 Participants | 54 Participants | 55 Participants | 167 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 2 Participants | 2 Participants | 2 Participants | 6 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 6 Participants | 0 Participants | 6 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 4 Participants | 2 Participants | 1 Participants | 7 Participants |
| Race (NIH/OMB) White | 58 Participants | 49 Participants | 53 Participants | 160 Participants |
| Region of Enrollment United States | 63 Participants | 57 Participants | 57 Participants | 177 Participants |
| Sex: Female, Male Female | 39 Participants | 36 Participants | 35 Participants | 110 Participants |
| Sex: Female, Male Male | 24 Participants | 21 Participants | 22 Participants | 67 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 63 | 0 / 57 | 0 / 57 |
| other Total, other adverse events | 0 / 63 | 1 / 57 | 0 / 57 |
| serious Total, serious adverse events | 0 / 63 | 0 / 57 | 0 / 57 |
Outcome results
Primary
Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS
The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The D-KEFS Color Word Interference (Condition 4: Inhibition/Switching) assess the ability to switch between alternating rules (a component of set shifting).
Time frame: 6 months of treatment
Population: All available data is reported for mothers, fathers and adolescents separately. Some data is missing due to COVID-19 impacts on the ability to administer in-person assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T1 | 11.71 score on a scale | Standard Deviation 1.101 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T3 | 12.78 score on a scale | Standard Deviation 1.215 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T4 | 12.75 score on a scale | Standard Deviation 1.844 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T5 | 13.83 score on a scale | Standard Deviation 1.467 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T1 | 11.67 score on a scale | Standard Deviation 2.106 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T3 | 12.56 score on a scale | Standard Deviation 1.504 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T4 | 12.86 score on a scale | Standard Deviation 2.07 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T5 | 13.09 score on a scale | Standard Deviation 1.446 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T1 | 11.52 score on a scale | Standard Deviation 2.994 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T3 | 12.59 score on a scale | Standard Deviation 2.763 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T4 | 13.60 score on a scale | Standard Deviation 1.957 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T5 | 14.17 score on a scale | Standard Deviation 1.03 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T5 | 13.71 score on a scale | Standard Deviation 2.016 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T1 | 11.05 score on a scale | Standard Deviation 1.615 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T4 | 13.19 score on a scale | Standard Deviation 1.515 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T1 | 11.63 score on a scale | Standard Deviation 2.385 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T3 | 12.50 score on a scale | Standard Deviation 1.633 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T3 | 13.13 score on a scale | Standard Deviation 1.088 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T4 | 13.50 score on a scale | Standard Deviation 2.16 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T4 | 12.63 score on a scale | Standard Deviation 1.586 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T5 | 13.73 score on a scale | Standard Deviation 1.033 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T1 | 12.05 score on a scale | Standard Deviation 1.433 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T5 | 13.13 score on a scale | Standard Deviation 1.356 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T3 | 13.00 score on a scale | Standard Deviation 1.751 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T5 | 13.40 score on a scale | Standard Deviation 1.549 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T1 | 11.37 score on a scale | Standard Deviation 2.929 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T3 | 12.35 score on a scale | Standard Deviation 2.262 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T3 | 12.56 score on a scale | Standard Deviation 1.79 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T4 | 12.94 score on a scale | Standard Deviation 1.391 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Father - T5 | 13.00 score on a scale | Standard Deviation 1.414 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T4 | 13.29 score on a scale | Standard Deviation 2.114 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T1 | 11.95 score on a scale | Standard Deviation 2.041 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T3 | 12.78 score on a scale | Standard Deviation 1.7 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T1 | 11.61 score on a scale | Standard Deviation 1.914 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Mother - T4 | 13.35 score on a scale | Standard Deviation 1.801 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 of Color Word Interference of DKEFS | Adolescent - T5 | 13.27 score on a scale | Standard Deviation 2.154 |
Comparison: This analysis compares mothers in FBT to mothers in FBT+Parent-focused CRTp-value: 0.778generalized estimating equation
Comparison: This analysis compares mothers in FBT to mothers in FBT+Parent-focused CRTp-value: 0.297generalized estimating equation
Comparison: This analysis compares adolescents in FBT to adolescents in FBT+Adolescent-focused CRTp-value: 0.062generalized estimating equation
Primary
Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS
The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). Trail Making Test assesses flexibility in thinking. We use Condition 4 (Number-Letter Switching) to assess flexibility.
Time frame: 6 months of treatment
Population: All available data is reported for mothers, fathers and adolescents separately. Some data is missing due to COVID-19 impacts on the ability to administer in-person assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother- T1 | 11.89 score on a scale | Standard Deviation 0.875 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother - T3 | 11.14 score on a scale | Standard Deviation 2.742 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother - T4 | 12.18 score on a scale | Standard Deviation 0.874 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | 1Mother - T5 | 12.75 score on a scale | Standard Deviation 1.165 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T1 | 11.14 score on a scale | Standard Deviation 2.265 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T3 | 11.92 score on a scale | Standard Deviation 1.382 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T4 | 11.82 score on a scale | Standard Deviation 2.136 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T5 | 12.14 score on a scale | Standard Deviation 1.069 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T1 | 9.47 score on a scale | Standard Deviation 3.151 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T3 | 9.50 score on a scale | Standard Deviation 3.555 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T4 | 11.00 score on a scale | Standard Deviation 2.404 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T5 | 12.50 score on a scale | Standard Deviation 1.414 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T5 | 12.33 score on a scale | Standard Deviation 1.225 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother- T1 | 10.94 score on a scale | Standard Deviation 2.331 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T4 | 13.10 score on a scale | Standard Deviation 1.101 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T1 | 10.59 score on a scale | Standard Deviation 2.033 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother - T3 | 11.86 score on a scale | Standard Deviation 2.107 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T3 | 12.57 score on a scale | Standard Deviation 1.342 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T4 | 12.50 score on a scale | Standard Deviation 0.85 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother - T4 | 12.70 score on a scale | Standard Deviation 0.675 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T5 | 12.80 score on a scale | Standard Deviation 0.919 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T1 | 11.06 score on a scale | Standard Deviation 1.819 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | 1Mother - T5 | 13.11 score on a scale | Standard Deviation 0.782 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T3 | 11.71 score on a scale | Standard Deviation 1.773 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | 1Mother - T5 | 13.25 score on a scale | Standard Deviation 1.708 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T1 | 11.35 score on a scale | Standard Deviation 2.06 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T3 | 10.83 score on a scale | Standard Deviation 1.115 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T3 | 12.23 score on a scale | Standard Deviation 1.092 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T4 | 12.09 score on a scale | Standard Deviation 1.64 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Father - T5 | 13.00 score on a scale | Standard Deviation 1.549 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T4 | 11.64 score on a scale | Standard Deviation 1.567 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother- T1 | 11.47 score on a scale | Standard Deviation 1.663 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother - T3 | 12.00 score on a scale | Standard Deviation 1.663 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T1 | 10.94 score on a scale | Standard Deviation 1.144 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Mother - T4 | 12.27 score on a scale | Standard Deviation 1.191 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Condition 4 Trail Making Test of DKEFS | Adolescent - T5 | 11.50 score on a scale | Standard Deviation 1.643 |
Comparison: This analysis compares mothers in FBT to mothers in FBT+Parent-focused CRTp-value: 0.507generalized estimating equation
Comparison: This analysis compares fathers in FBT to fathers in FBT+Parent-focused CRTp-value: 0.017generalized estimating equation
Comparison: This analysis compares adolescents in FBT to adolescents in FBT+Adolescent-focused CRTp-value: 0.139generalized estimating equation
Primary
Change in Cognitive Flexibility - Sorting Test Description of DKEFS
The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The Sorting Test assesses flexibility in thinking and problem solving.
Time frame: 6 months of treatment
Population: All available data is reported for mothers, fathers and adolescents separately. Some data is missing due to COVID-19 impacts on the ability to administer in-person assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T1 | 11.94 score on a scale | Standard Deviation 3.334 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T3 | 12.21 score on a scale | Standard Deviation 2.119 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T4 | 12.80 score on a scale | Standard Deviation 1.814 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T5 | 13.86 score on a scale | Standard Deviation 1.464 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T1 | 11.80 score on a scale | Standard Deviation 2.331 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T3 | 12.15 score on a scale | Standard Deviation 2.478 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T4 | 12.50 score on a scale | Standard Deviation 2.224 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T5 | 14.00 score on a scale | Standard Deviation 1.789 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T1 | 11.37 score on a scale | Standard Deviation 2.712 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T3 | 11.33 score on a scale | Standard Deviation 2.229 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T4 | 13.22 score on a scale | Standard Deviation 1.856 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T5 | 12.171 score on a scale | Standard Deviation 0.488 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T5 | 12.00 score on a scale | Standard Deviation 2.582 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T1 | 11.47 score on a scale | Standard Deviation 1.972 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T4 | 14.00 score on a scale | Standard Deviation 2.404 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T1 | 11.65 score on a scale | Standard Deviation 1.693 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T3 | 12.38 score on a scale | Standard Deviation 1.446 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T3 | 13.85 score on a scale | Standard Deviation 2.478 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T4 | 12.20 score on a scale | Standard Deviation 2.044 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T4 | 14.00 score on a scale | Standard Deviation 2.449 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T5 | 14.60 score on a scale | Standard Deviation 2.366 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T1 | 12.94 score on a scale | Standard Deviation 2.358 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T5 | 13.22 score on a scale | Standard Deviation 1.787 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T3 | 11.54 score on a scale | Standard Deviation 1.808 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T5 | 16.25 score on a scale | Standard Deviation 1.258 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T1 | 12.35 score on a scale | Standard Deviation 2.29 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T3 | 11.00 score on a scale | Standard Deviation 2.793 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T3 | 12.92 score on a scale | Standard Deviation 1.676 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T4 | 12.82 score on a scale | Standard Deviation 2.136 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Father - T5 | 15.00 score on a scale | Standard Deviation 1.414 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T4 | 11.27 score on a scale | Standard Deviation 1.902 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T1 | 12.47 score on a scale | Standard Deviation 1.7 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T3 | 13.50 score on a scale | Standard Deviation 2.68 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T1 | 10.35 score on a scale | Standard Deviation 2.737 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Mother - T4 | 14.00 score on a scale | — |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Sorting Test Description of DKEFS | Adolescent - T5 | 11.17 score on a scale | Standard Deviation 2.483 |
Comparison: This analysis compares mothers in FBT to mothers in FBT+Parent-focused CRTp-value: 0.446generalized estimating equation
Comparison: This analysis compares fathers in FBT to fathers in FBT+Parent-focused CRTp-value: 0.647generalized estimating equation
Comparison: This analysis compares adolescents in FBT to adolescents in FBT+Adolescent-focused CRTp-value: 0.765generalized estimating equation
Primary
Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS
The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The D-KEFS Verbal Fluency assesses the ability to shift between concepts. Switching Accuracy assesses the number of times an accurate switch between categories occurs.
Time frame: 6 months of treatment
Population: All available data is reported for mothers, fathers and adolescents separately. Some data is missing due to COVID-19 impacts on the ability to administer in-person assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T4 | 14.06 score on a scale | Standard Deviation 3.043 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T3 | 11.56 score on a scale | Standard Deviation 1.617 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T1 | 11.90 score on a scale | Standard Deviation 3.567 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T4 | 12.20 score on a scale | Standard Deviation 3.299 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T5 | 11.58 score on a scale | Standard Deviation 1.975 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T5 | 12.00 score on a scale | Standard Deviation 1.758 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T1 | 11.81 score on a scale | Standard Deviation 3.628 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T3 | 11.63 score on a scale | Standard Deviation 2.929 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T3 | 11.68 score on a scale | Standard Deviation 3.528 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T4 | 12.71 score on a scale | Standard Deviation 4.286 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T5 | 12.45 score on a scale | Standard Deviation 2.911 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T1 | 11.45 score on a scale | Standard Deviation 3.634 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T5 | 11.21 score on a scale | Standard Deviation 2.155 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T1 | 11.95 score on a scale | Standard Deviation 2.549 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T4 | 12.63 score on a scale | Standard Deviation 3.284 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T1 | 10.37 score on a scale | Standard Deviation 3.89 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T3 | 12.19 score on a scale | Standard Deviation 1.559 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T4 | 12.06 score on a scale | Standard Deviation 3.958 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T1 | 11.68 score on a scale | Standard Deviation 3.637 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T4 | 12.13 score on a scale | Standard Deviation 2.9 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T3 | 11.13 score on a scale | Standard Deviation 2.705 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T3 | 11.56 score on a scale | Standard Deviation 1.59 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T5 | 12.00 score on a scale | Standard Deviation 1.414 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T5 | 12.07 score on a scale | Standard Deviation 1.335 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T5 | 11.93 score on a scale | Standard Deviation 1.486 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T1 | 11.95 score on a scale | Standard Deviation 4.183 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T3 | 11.24 score on a scale | Standard Deviation 2.166 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T4 | 13.65 score on a scale | Standard Deviation 3.968 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T1 | 11.50 score on a scale | Standard Deviation 2.854 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T3 | 11.56 score on a scale | Standard Deviation 2.549 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T4 | 12.00 score on a scale | Standard Deviation 3.386 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T5 | 11.53 score on a scale | Standard Deviation 1.846 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T1 | 11.28 score on a scale | Standard Deviation 2.321 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T3 | 10.88 score on a scale | Standard Deviation 2.233 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T4 | 10.18 score on a scale | Standard Deviation 4.261 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T5 | 12.13 score on a scale | Standard Deviation 1.356 |
Comparison: This analysis compares mothers in FBT to mothers in FBT+Parent-focused CRTp-value: 0.196generalized estimating equation
Comparison: This analysis compares fathers in FBT to fathers in FBT+Parent-focused CRTp-value: 0.812generalized estimating equation
Comparison: This analysis compares adolescents in FBT to adolescents in FBT+Adolescent-focused CRTp-value: 0.499generalized estimating equation
Primary
Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS
The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The D-KEFS Verbal Fluency assesses the ability to shift between concepts. The Switching Correct score is used to assess flexibility.
Time frame: 6 months of treatment
Population: All available data is reported for mothers, fathers and adolescents separately. Some data is missing due to COVID-19 impacts on the ability to administer in-person assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T5 | 12.45 score on a scale | Standard Deviation 2.911 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T3 | 12.47 score on a scale | Standard Deviation 3.717 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T1 | 11.55 score on a scale | Standard Deviation 3.677 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T3 | 10.89 score on a scale | Standard Deviation 3.411 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T5 | 11.92 score on a scale | Standard Deviation 4.033 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T4 | 11.80 score on a scale | Standard Deviation 3.707 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T4 | 13.00 score on a scale | Standard Deviation 4.195 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T5 | 12.42 score on a scale | Standard Deviation 3.288 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T1 | 11.81 score on a scale | Standard Deviation 3.628 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T1 | 12.10 score on a scale | Standard Deviation 3.478 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T3 | 11.68 score on a scale | Standard Deviation 3.528 |
| Family Based Treatment (FBT) | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T4 | 12.71 score on a scale | Standard Deviation 4.286 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T3 | 11.50 score on a scale | Standard Deviation 3.759 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T5 | 13.53 score on a scale | Standard Deviation 2.446 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T5 | 11.36 score on a scale | Standard Deviation 2.59 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T1 | 12.42 score on a scale | Standard Deviation 3.006 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T3 | 12.44 score on a scale | Standard Deviation 3.444 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T1 | 11.95 score on a scale | Standard Deviation 2.718 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T3 | 12.31 score on a scale | Standard Deviation 3.135 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T1 | 10.68 score on a scale | Standard Deviation 3.973 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T4 | 11.88 score on a scale | Standard Deviation 3.757 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T4 | 12.47 score on a scale | Standard Deviation 2.722 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T5 | 11.43 score on a scale | Standard Deviation 3.694 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T4 | 12.44 score on a scale | Standard Deviation 3.464 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T5 | 11.80 score on a scale | Standard Deviation 2.513 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T1 | 11.74 score on a scale | Standard Deviation 4.483 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T3 | 11.18 score on a scale | Standard Deviation 3.695 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T5 | 13.47 score on a scale | Standard Deviation 2.949 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T1 | 10.63 score on a scale | Standard Deviation 3.218 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T3 | 11.33 score on a scale | Standard Deviation 4.102 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T4 | 12.00 score on a scale | Standard Deviation 3.386 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Father - T5 | 11.73 score on a scale | Standard Deviation 4.399 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T1 | 11.50 score on a scale | Standard Deviation 1.917 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T3 | 9.88 score on a scale | Standard Deviation 3.967 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Adolescent - T4 | 9.41 score on a scale | Standard Deviation 4.459 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Cognitive Flexibility - Verbal Fluency Switching of DKEFS | Mother - T4 | 13.29 score on a scale | Standard Deviation 4.089 |
Comparison: This analysis compares mothers in FBT to mothers in FBT+Parent-focused CRTp-value: 0.069generalized estimating equation
Comparison: This analysis compares fathers in FBT to fathers in FBT+Parent-focused CRTp-value: 0.323generalized estimating equation
Comparison: This analysis compares adolescents in FBT to adolescents in FBT+Adolescent-focused CRTp-value: 0.225generalized estimating equation
Primary
Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS
The Delis Kaplan Executive Functioning System (D-KEFS) is a standardized assessment of executive functioning normed for ages 8-89 years of age. Raw scores are transformed to scaled scores: the mean is 10 with a standard deviation of 3. Higher scores indicate better performance on the test. Specific sub-tests were chosen to assess inhibitory control and cognitive flexibility. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants. The D-KEFS was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). Inhibition refers to the ability to inhibit a well learned or salient task in order to do something different; thus, it is related to flexibility. The D-KEFS Color-Word Interference Test (Condition 3: Inhibition) to assess ability to inhibit automatic responses.
Time frame: 6 months of treatment
Population: All available data is reported for mothers, fathers and adolescents separately. Some data is missing due to COVID-19 impacts on the ability to administer in-person assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T3 | 12.72 score on a scale | Standard Deviation 1.565 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T5 | 13.67 score on a scale | Standard Deviation 1.923 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T3 | 11.47 score on a scale | Standard Deviation 2.348 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T4 | 12.67 score on a scale | Standard Deviation 1.676 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T5 | 12.83 score on a scale | Standard Deviation 1.642 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother -T1 | 11.95 score on a scale | Standard Deviation 2.291 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T1 | 11.14 score on a scale | Standard Deviation 2.689 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T3 | 11.94 score on a scale | Standard Deviation 1.798 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T4 | 13.06 score on a scale | Standard Deviation 1.436 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T4 | 12.43 score on a scale | Standard Deviation 1.742 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T5 | 12.55 score on a scale | Standard Deviation 1.753 |
| Family Based Treatment (FBT) | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent-T1 | 10.76 score on a scale | Standard Deviation 2.3 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T4 | 12.25 score on a scale | Standard Deviation 1.528 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent-T1 | 11.95 score on a scale | Standard Deviation 2.272 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T1 | 12.11 score on a scale | Standard Deviation 1.941 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T4 | 12.75 score on a scale | Standard Deviation 2.84 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T3 | 12.94 score on a scale | Standard Deviation 1.482 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T5 | 12.93 score on a scale | Standard Deviation 1.668 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother -T1 | 11.84 score on a scale | Standard Deviation 1.608 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T4 | 13.31 score on a scale | Standard Deviation 1.448 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T3 | 12.06 score on a scale | Standard Deviation 1.237 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T5 | 13.67 score on a scale | Standard Deviation 1.291 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T5 | 13.14 score on a scale | Standard Deviation 1.61 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T3 | 13.06 score on a scale | Standard Deviation 1.436 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T5 | 13.00 score on a scale | Standard Deviation 2.204 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother -T1 | 12.21 score on a scale | Standard Deviation 2.175 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T3 | 12.94 score on a scale | Standard Deviation 2.014 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T4 | 13.12 score on a scale | Standard Deviation 1.996 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Mother - T5 | 13.33 score on a scale | Standard Deviation 1.718 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T1 | 11.63 score on a scale | Standard Deviation 2.52 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T3 | 12.50 score on a scale | Standard Deviation 2.176 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T4 | 13.00 score on a scale | Standard Deviation 1.581 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Father - T5 | 12.80 score on a scale | Standard Deviation 1.74 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent-T1 | 11.11 score on a scale | Standard Deviation 3.008 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T3 | 1.35 score on a scale | Standard Deviation 2.548 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Inhibition - Condition 3 of Color-Word Interference, DKEFS | Adolescent - T4 | 12.76 score on a scale | Standard Deviation 2.412 |
Comparison: This analysis compare mothers in FBT to mothers in FBT+CRTpp-value: 0.389generalized estimating equation
Comparison: This analysis compares fathers in FBT to fathers in FBT+Parent-focused CRTp-value: 0.447generalized estimating equation
Comparison: This analysis compares adolescents in FBT to adolescents in FBT+Adolescent-focused CRTp-value: <0.001generalized estimating equation
Primary
Change in Self-Reported Shifting - BRIEF
The Behavior Rating Inventory of Executive Functioning (BRIEF) is an ecologically valid clinical tool for measuring executive functioning across several domains in youth 5 to 18 years of age; the self-report version (BRIEF-2) was administered to adolescents. It has a comparable adult self-report version (BRIEF-A) normed for ages 18-90. Both versions of the BRIEF are normed by age and sex on a T-scale (mean = 50, SD = 10), and scores are considered clinically elevated if they are 65 or higher. Both have a number of clinical scales and indices. Lower scores indicate greater strengths in each area. The hypothesis is that Cognitive Remediation Therapy (CRT) will increase flexibility in participants, thus, we expect a reduction in scores for those in the CRT conditions. The BRIEF was administered at baseline (T1), after 4 weeks (T2), approximately 9 weeks (T3), approximately 17 weeks (T4), and end of treatment (T5). The BRIEF Shift assesses behavioral flexibility.
Time frame: 6 months of treatment
Population: All available data is reported for mothers, fathers and adolescents separately. Some data is missing due to COVID-19 impacts on the ability to administer in-person assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Mother - T1 | 58.38 score on a scale | Standard Deviation 6.953 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Mother - T3 | 56.47 score on a scale | Standard Deviation 8.65 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Mother - T4 | 56.07 score on a scale | Standard Deviation 9.996 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Mother - T5 | 55.92 score on a scale | Standard Deviation 8.361 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Father - T1 | 50.67 score on a scale | Standard Deviation 11.625 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Father - T3 | 52.17 score on a scale | Standard Deviation 11.658 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Father - T4 | 50.71 score on a scale | Standard Deviation 9.98 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Father - T5 | 47.55 score on a scale | Standard Deviation 7.381 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Adolescent - T1 | 60.86 score on a scale | Standard Deviation 9.926 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Adolescent - T3 | 58.71 score on a scale | Standard Deviation 12.494 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Adolescent - T4 | 60.36 score on a scale | Standard Deviation 12.125 |
| Family Based Treatment (FBT) | Change in Self-Reported Shifting - BRIEF | Adolescent - T5 | 58.18 score on a scale | Standard Deviation 10.226 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T5 | 50.38 score on a scale | Standard Deviation 9.726 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T1 | 53.21 score on a scale | Standard Deviation 7.843 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T4 | 59.25 score on a scale | Standard Deviation 8.993 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T1 | 55.58 score on a scale | Standard Deviation 12.389 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T3 | 56.31 score on a scale | Standard Deviation 11.001 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T3 | 59.69 score on a scale | Standard Deviation 8.592 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T4 | 52.50 score on a scale | Standard Deviation 11.77 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T4 | 55.75 score on a scale | Standard Deviation 12.557 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T5 | 57.13 score on a scale | Standard Deviation 10.453 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T1 | 59.58 score on a scale | Standard Deviation 9.924 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T5 | 55.67 score on a scale | Standard Deviation 12.21 |
| FBT w/ Parent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T3 | 55.13 score on a scale | Standard Deviation 11.618 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T5 | 53.27 score on a scale | Standard Deviation 11.823 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T1 | 53.43 score on a scale | Standard Deviation 9.3 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T3 | 55.59 score on a scale | Standard Deviation 11.571 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T3 | 46.63 score on a scale | Standard Deviation 7.94 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T4 | 47.25 score on a scale | Standard Deviation 8.103 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Father - T5 | 48.07 score on a scale | Standard Deviation 8.681 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T4 | 54.82 score on a scale | Standard Deviation 12.812 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T1 | 51.79 score on a scale | Standard Deviation 9.92 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T3 | 54.28 score on a scale | Standard Deviation 11.509 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T1 | 58.16 score on a scale | Standard Deviation 10.399 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Mother - T4 | 52.94 score on a scale | Standard Deviation 11.771 |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Change in Self-Reported Shifting - BRIEF | Adolescent - T5 | 54.87 score on a scale | Standard Deviation 10.789 |
Comparison: This analysis compares mothers in FBT to mothers in FBT+Parent-focused CRTp-value: 0.425generalized estimating equation
Comparison: This analysis compares fathers in FBT to fathers in FBT+Parent-focused CRTp-value: 0.63generalized estimating equation
Comparison: This analysis compares adolescents in FBT to adolescents in FBT+Adolescent-focused CRTp-value: 0.854generalized estimating equation
Primary
Dose of CRT
Number of sessions necessary in order to change cognitive flexibility. This is the number of sessions needed for change to occur in cognitive flexibility. It is only calculated for the participants who received CRT and who had a significant change in flexibility above what was observed in FBT.
Time frame: 6 months of treatment
Population: As parents did not hit a-priori milestones, we only calculated the number (count) of sessions needed for adolescents to have measurable improvement in cognitive flexibility.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Family Based Treatment (FBT) | Dose of CRT | 0 Number of sessions |
| FBT w/Adolescent-focused Cognitive Remediation Therapy | Dose of CRT | 8 Number of sessions |