Development and validation of the Youth Obsessive-Compulsive Symptoms Scale (YOCSS)

Towards a better understanding of adolescent obsessive-compulsive personality traits and obsessive-compulsive symptoms from growth trajectories of perfectionism

Although there is increasing attention for the interrelationship between obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD), their shared characteristics in terms of childhood trait antecedents remain understudied. Perfectionism may be a viable candidate trait antecedent, given its role in the clinical manifestation of both OCPD and OCD in adulthood, and the evidence that perfectionism reflects a dispositional tendency observable from childhood onwards. However, little is known about childhood trajectories of perfectionism with prospective links to later OCPD versus OCD. Using latent growth curve modeling, this study explored the baseline and growth of childhood perfectionism in 485 community and referred children (55.5% girls, 7.17-14.78 years old, Mage = 10.74, SD = 1.50) across three waves. Adolescent OCPD traits and OCD symptoms were measured in Wave 4. An overall decreasing trend of perfectionism from childhood through adolescence appeared, without inter-individual differences in growth. Individual differences in baseline levels of childhood perfectionism were significant, and equally predicting adolescent OCPD and OCD outcomes. At a more specific level, childhood perfectionism predicted most strongly the rigid perfectionism component of OCPD, and the orderliness/cleanliness/perfectionism and obsession domain of OCD. This demonstrates the value of childhood perfectionism for understanding differential outcomes of adolescent OCPD traits and OCD symptoms.

Screening for Pediatric Obsessive-Compulsive Disorder Using the Obsessive-Compulsive Inventory-Child Version

The study assessed the ability of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) to detect pediatric obsessive-compulsive disorder (OCD) using receiver operating characteristic analyses. The sample consisted of 114 cases with current OCD, 340 cases with other psychiatric disorders (OPD), and 301 healthy controls (HC) ages 7 to 18 years. All 755 participants were assessed with two semi-structured interviews and seven rating scales. In a comparison of current OCD cases and all other participants, the optimal OCI-CV cut-score was 11 with an area under the curve (AUC) of .88. In a comparison of current OCD cases and OPD cases, the optimal OCI-CV cut-score was 11 with an AUC of .82. In a comparison of current OCD cases and HC, the optimal OCI-CV cut-score was 10 with an AUC of .94. The results indicate that the OCI-CV provides an effective screen for pediatric OCD using empirically derived cut-scores.

My Child's thoughts frighten me: Maladaptive effects associated with parents' interpretation and management of children's intrusive thoughts

BACKGROUND AND OBJECTIVES

Environmental factors explain substantial variance in youth's obsessive-compulsive symptoms (OCS) and much of this research has focused upon overt parenting behaviors (e.g., accommodation). No work, however, has examined how parents' internal processes (e.g., perception of children's intrusions) influence youth's OCS. Based upon the cognitive theory of obsessions, we propose that parents' misappraisal of children's intrusions as threatening will be positively associated with (a) the number of maladaptive intrusion management strategies recommended by the parent, as well as (b) children's obsessive beliefs, (c) interpretation biases, and (d) OCS severity.

METHODS

Twenty-seven children (M = 12.81; SD = 3.43) and the parent most involved in childcare completed diagnostic interviews and self-report questionnaires. In the laboratory, we induced obsessional anxiety in youth through a standardized in vivo paradigm (e.g., think about a personalized harm-related negative event occurring). Parents rated how they interpreted their children's unwanted thought and the intrusion management strategies they would recommend.

RESULTS

Parents who interpreted their children's intrusions as threatening recommended more maladaptive intrusion management strategies and their misappraisal positively and significantly correlated with the severity of children's obsessive beliefs, interpretation biases, and OCS, even after controlling for co-occurring internalizing symptoms.

LIMITATIONS

Small sample and cross-sectional design precludes causal conclusions.

CONCLUSIONS

Parents' misinterpretation of children's intrusions may operate as a mechanism by which OCS are generationally transmitted. Results can inform OC prevention programs that target parents' cognitive biases in their own psychotherapy.

Quality of life in children and adolescents with obsessive-compulsive disorder: a systematic review and meta-analysis

Obsessive-compulsive disorder (OCD) is a seriously impairing psychiatric condition that affects 1%-3% of youth. Investigating the quality of life (QOL) is an important issue for treatment planning of this disorder, as targeting symptoms without taking it into account may bias assessment and prognosis when the patient presents with reduced symptoms that do not correspond to improved QOL. However, QOL in young individuals with OCD has been understudied. This meta-analysis summarized current evidence that assessed differences in global, social and school QOL dimensions, between children/adolescents with OCD and screened controls. Age, sex and OCD severity were examined as moderators. Case-control studies were included if children/adolescents with primary OCD were compared with screened controls on validated self-reported QOL outcomes. Online databases (January 1966-January 2016) were searched. Five case-control studies were included (n=543, 17 effect sizes overall). On global QOL, a large effect size emerged (d=-1.16, P<0.001), suggesting that individuals with OCD had lower global QOL than controls. Moderate effect sizes emerged for school (d=-0.61, P<0.01) and social QOL (d=-0.54, P<0.01), respectively, indicating worse QOL on these domains for individuals with OCD. For samples with higher OCD severity, global QOL of individuals with OCD was lower than that for controls (β=-0.02, P<0.05). For samples with lower percentages of females, global QOL of individuals with OCD was more impaired (β=0.02, P<0.001). Age was not correlated with effect sizes. Assessment and treatment should target QOL for young males suffering from more severe OCD. The small number of included studies highlighted that QOL is under-recognized. Future research should focus on additional QOL domains and compare which ones are impaired among individuals with OCD compared with other psychiatric conditions. Overall, the results pointed out the importance of addressing QOL in both practice and research on assessment and treatment of children/adolescents with this condition.

Obsessive-compulsive symptoms in children and adolescents: symptomatology, impairment and quality of life

Although the "presence of obsessive-compulsive (OC) symptoms" and "OC-related impairment" are the main criteria to diagnose obsessive-compulsive disorder, the significance of symptomatology versus impairment in explaining quality of life remains unclear. The present study relies on two samples including 462 children (8-11 years old) and 265 children and adolescents (10-17 years old) and explores how self-ratings of specific OC symptoms and OC impairment are associated with father ratings of childhood quality of life. Hierarchical regression analysis was used to investigate the additive effect of OC impairment beyond OC symptomatology (and vice versa) in predicting quality of life. The results demonstrated that specific OC symptoms and OC impairment are differentially related to quality of life, underscoring the additive value of OC impairment beyond OC symptomatology, whereas the reverse was not the case. This finding highlights the importance of measuring impairment besides symptomatology to identify those OC features in childhood that are most significantly related to decreased quality of life.