Understudied Clinical Dimensions in Pediatric Obsessive Compulsive Disorder

Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida College of Medicine, 800 Sixth Street South, Saint Petersburg, FL 33701, USA.
Child Psychiatry and Human Development (Impact Factor: 1.93). 12/2010; 41(6):675-91. DOI: 10.1007/s10578-010-0196-z
Source: PubMed


The present study aimed to assess the phenomenology and treatment sensitivity of insight, avoidance, indecisiveness, overvalued responsibility, pervasive slowness, and pathological doubting among youth with Obsessive-compulsive disorder (OCD) using the ancillary items on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). These factors are believed to be relevant to the clinical presentation of youth with OCD but remain understudied. Eighty-nine youth with OCD were administered the CY-BOCS, including six subsidiary items aimed at the constructs of interest in this research. Participants also completed measures of OCD symptom clusters, depressive and anxious symptoms, externalizing/internalizing behavioral problems, and functional impairment. Associations between OCD symptom clusters and insight, avoidance, indecisiveness, overvalued responsibility, pervasive slowness, and pathological doubting are presented. Low insight, significant avoidance, indecisiveness, pervasive slowness and excessive sense of responsibility were all related to elevations in functional impairment. Clinical improvement in OCD severity was related to reductions in avoidance, doubting, and sense of responsibility. The six ancillary items of the CY-BOCS appear to be a practical and valid assessment of several constructs that are prognostically linked to cognitive-behavioral therapy outcomes in youth with OCD. Implications for clinicians are discussed.

Download full-text


Available from: Adam B. Lewin, Aug 27, 2014
  • Source
    • "Beyond anxiety sensitivity, other variables may hold relevance in understanding which individuals may experience compounded impairment. Insight into the degree to which obsessive–compulsive symptoms are recognized by the person as absurd, excessive, and senseless has been linked to obsessive–compulsive symptom severity and functional impairment in past studies of adults [17] and children with OCD [18] [19]. Additionally, individuals with poor insight into their OCD symptomology have exhibited more complicated clinical presentations and poorer treatment response when compared to individuals with higher insight [17] [20]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The current study examined correlates, moderators, and mediators of functional impairment in 98 treatment-seeking adults with obsessive-compulsive disorder (OCD). Participants completed or were administered measures assessing obsessive-compulsive symptom severity, functional impairment, resistance against symptoms, interference due to obsessive-compulsive symptoms, depressive symptoms, insight, and anxiety sensitivity. Results indicated that all factors, except insight into symptoms, were significantly correlated with functional impairment. The relationship between obsessive-compulsive symptom severity and functional impairment was not moderated by patient insight, resistance against obsessive-compulsive symptoms, or anxiety sensitivity. Mediational analyses indicated that obsessive-compulsive symptom severity mediated the relationship between anxiety sensitivity and obsessive-compulsive related impairment. Indeed, anxiety sensitivity may play an important contributory role in exacerbating impairment through increases in obsessive-compulsive symptom severity. Depressive symptoms mediated the relationship between obsessive-compulsive symptom severity and obsessive-compulsive related impairment. Implications for assessment and treatment are discussed.
    Comprehensive psychiatry 11/2013; 55(3). DOI:10.1016/j.comppsych.2013.10.014 · 2.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive-behavioral therapy (CBT) is a first-line treatment for obsessive-compulsive disorder (OCD) in adults and children due to its efficacy, maintenance of therapeutic gains after treatment withdrawal, safety, and tolerability. The current article reviews research regarding the theoretical underpinnings of CBT, pragmatics regarding CBT implementation, and efficacy findings, while also highlighting barriers to efficacious treatment (ie, age, comorbidity, geography), methods of addressing such issues, and areas in need of further study.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The amount of spent fuel generated in Germany up to 2040 has been estimated at 8950 thm. By this time 5500 thm of vitrified high level waste will have accumulated. Both types of waste will be finally disposed of in one underground repository. Potential host rocks are rock salt, granite and mudrock. Up to now several performance assessment studies have been carried out in order to identify the main parameters governing the long-term safety of such repositories. The disposal concepts investigated differ widely in the water content of the rock formations, the engineered barrier systems and the sorption capacities of the various materials. To cite this article: W. Brewitz, U. Noseck, C. R. Physique 3 (2002) 879–889.
    Comptes Rendus Physique 09/2002; 3(7):879-889. DOI:10.1016/S1631-0705(02)01359-2 · 2.04 Impact Factor
Show more