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.

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Available from: Adam B. Lewin, Aug 27, 2014
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    • "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]. "
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