Category: Child / Adolescent - Anxiety
Obsessive compulsive disorder (OCD) is a chronic, disabling disorder affecting 1-2% of children (Geller, 2006; Zohar, 1999). Consistent with cognitive models of OCD, children with OCD tend to show heightened beliefs about responsibility and harm, importance and control of thoughts, and perfectionism and certainty (Reynolds & Reeves, 2008). Salkovskis and colleagues proposed that specific early childhood experiences could lead to the development of inflated responsibility beliefs (1999). Heightened levels of these experiences have been found in individuals with OCD and they have been found to correlate with obsessive beliefs (e.g. Coles, Schofield, & Nota 2008; Smári et al., 2010). However, only one study has examined these pathways in children (Lawrence & Williams, 2011). The Pathways to Inflated Responsibility Beliefs Scale – Child and Parent version (PIRBS-CV/PV) were created to measure childhood experiences proposed to confer vulnerability to OCD in children (Salkovskis et al., 1999). The PIRBS-CV and PV were adapted from the 23-item adult version of the PIRBS (Coles & Schofield, 2008). The present study aims to investigate the cognitive etiological model of OCD by examining the relation between childhood experiences, obsessive beliefs and symptoms in children. We hypothesized that childhood experiences rated by the child and parents will correlate with child obsessive beliefs and symptoms.
Participants to date include 23 children age 7-16 (M= 11.52, SD= 2.79) diagnosed with primary OCD according to DSM-5 criteria (ADIS-V; Brown & Barlow, 2014) their mothers (N= 23) and fathers (N=13). Eighty-seven percent of children were Caucasian. Parents and children completed measures to assess for early childhood experiences proposed to confer vulnerability to OCD (PIRBS-CV/PV), child OCD symptom severity (Obsessive Compulsive Inventory- Child Version; Foa, et al., 2010), and obsessive beliefs (Obsessive Beliefs Scale-Child Version; Coles et. al., 2010). PIRBS-CV/PV total scores demonstrated good internal consistency (Chronbach’s a = .72-.80). Total childhood experiences in the domains hypothesized to confer risk for OCD, heightened responsibility for one’s age, and actions that seemed to influence or cause something bad to happen, were correlated with beliefs regarding responsibility and the need to prevent harm (r= .56, p= .01; r = .36, p = .09; r= .51; p= .02) based on children’s reports of their experiences, but not parents’ reports of their child’s experiences. Total experiences and heightened responsibility were related to OCD symptom frequency and the relation trended toward significance based on mother’s reports of their child’s experiences and symptoms (r=.35, p= .10; r=.40; p=.06), but not based on child reports of their experiences and symptoms. Father reports of their child’s experiences with actions that influenced or caused harm were significantly related to father reports of their child’s distress related to OCD symptoms (r= .58, p= .05). These results provide mixed support for the childhood experiences proposed by Salkovskis et al (1999) to confer vulnerability to OCD. Data collection is ongoing.