The author reviews 7 different types of mood induction procedures for use with children and discusses these procedures in light of a number of critical methodological issues. The issues considered are administration, participant characteristics, measurement, mood quality, and demand characteristics. The author proposes a broad framework for the future investigation of mood induction procedures for children that includes comparative outcome studies, parametric studies, and more comprehensive mood measurement. Several issues are outlined that investigators might consider when designing experiments to test the generality of negative mood induction studies to clinical depression, including specificity or comorbidity, intensity or severity, age, and sex.

Despite advances in pharmacotherapy for obsessive-compulsive disorder (OCD), medication treatments are not always effective. This pilot project examined the feasibility of a structured behavioral therapy program in the treatment of children and adolescents with OCD. Ten subjects with a primary diagnosis of OCD were invited to participate in the treatment program. Seven youngsters, 5 boys and 2 girls (age range 10.8-15.8, mean 13.0 years), participated and were treated for a mean of 14 sessions. These 7 subjects showed a broad range of OCD severity, as measured by the Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS score range 12-29). Five subjects were also receiving antiobsessional medication (dose was not changed during the trial), and 2 subjects were treated without medication. All 7 youngsters showed a clinically significant reduction in the CYBOCS score at treatment endpoint (mean change 61%, range 30%-90%, effect size 2.04, p < 0.05), and the therapeutic gains were stable for at least 3 months after treatment. One of 5 children who had been receiving concurrent antiobsessional medication was able to tolerate a dose reduction following behavioral treatment. Two to three booster sessions within 6 months posttreatment were effective in preventing relapse in 4 of 6 subjects. The 3 children who declined behavioral treatment showed no improvement at 3-month and 6-month follow-up. Behavioral treatment appeared to be a useful adjunct to medication in children and adolescents with OCD. Further research could evaluate whether behavioral treatment would lower the dose requirements for children receiving antiobsessional medications. Randomized clinical trials are also needed to confirm the effectiveness of behavioral therapy alone or in combination with medication.

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