Swipe om te navigeren naar een ander artikel
Obsessive–compulsive disorder (OCD) in youth is frequently associated with disruptive behaviors such as attacks of rage or temper. A common but insufficiently understood form of disruptive behavior in OCD is forceful attempts to impose symptom accommodation on family members. This study examined: (a) the phenomenology of coercive–disruptive behaviors in pediatric OCD, (b) child and family correlates of coercive–disruptive behavior; and (c) indirect effects of coercive–disruptive behavior on OCD symptom severity, mediated by family accommodation. We addressed these aims by evaluating the families of 61 treatment-seeking youth diagnosed with OCD, using structured interviews and maternal report scales. Most mothers reported coercive–disruptive behavior. Coercive–disruptive behavior was associated with severity of OCD symptoms, but not with particular symptom dimensions. Coercive–disruptive behavior was associated with anxiety, oppositionality and hyperactivity, but not with depression or inattentiveness. At the family level, coercive–disruptive behavior was associated with family accommodation and related parental distress but not with dimensions of family style. Hierarchical regression indicated that the family-level variable of accommodation contributed to predicting coercive–disruptive behavior, above and beyond child-level variables. The indirect pathway through family accommodation accounted for 97.13 % of the total effect of coercive–disruptive behaviors on OCD severity, supporting the mediational model. Overall, the data suggest that coercive–disruptive behaviors are common in youth with OCD and are more strongly linked to youth clinical features than to family style. Coercive–disruptive behaviors are a cause for concern and may lead to increased family accommodation, which has frequently been found to predict worse clinical outcomes.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Bird, H. R., Canino, G. J., Davies, M., Duarte, C. S., Febo, V., Ramirez, R., et al. (2006). A study of disruptive behavior disorders in Puerto Rican youth: I. Background, design, and survey methods. Journal of the American Academy of Child and Adolescent Psychiatry, 45(9), 1032–1041. PubMedCrossRef
Bussing, R., Fernandez, M., Harwood, M., Wei, H., Garvan, C. W., Eyberg, S. M., et al. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: Psychometric properties and normative ratings from a school district sample. Assessment, 15(3), 317–328. PubMedCentralPubMedCrossRef
Flessner, C. A., Freeman, J. B., Sapyta, J., Garcia, A., Franklin, M. E., March, J. S., et al. (2011). Predictors of parental accommodation in pediatric obsessive–compulsive disorder: Findings from the pediatric obsessive–compulsive disorder treatment study (POTS) trial. Journal of the American Academy of Child and Adolescent Psychiatry, 50(7), 716–725. PubMedCentralPubMedCrossRef
Garcia, A. M., Sapyta, J. J., Moore, P. S., Freeman, J. B., Franklin, M. E., March, J. S., et al. (2010). Predictors and moderators of treatment outcome in the pediatric obsessive compulsive treatment study (POTS I). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 1024–1033. PubMedCentralPubMedCrossRef
Jester, J. M., Nigg, J. T., Adams, K., Fitzgerald, H. E., Puttler, L. I., Wong, M. M., et al. (2005). Inattention/hyperactivity and aggression from early childhood to adolescence: Heterogeneity of trajectories and differential influence of family environment characteristics. Development and Psychopathology, 17(1), 99–125. PubMedCentralPubMedCrossRef
Keller, H., Lohaus, A., Kuensemueller, P., Abels, M., Yovsi, R., Voelker, S., et al. (2004). The bio-culture of parenting: Evidence from five cultural communities. Parenting: Science and Practice, 4(1), 25–50. CrossRef
Kenny, D. A. (2011). SPSS Macro. http://davidakenny.net/dtt/mediate.htm
Kovacs, M. (1992). Children’s depression inventory. New York: Multi-Helath Systems.
Krebs, G., Bolhuis, K., Heyman, I., Mataix-Cols, D., Turner, C., & Stringaris, A. (2013). Temper outbursts in paediatric obsessive–compulsive disorder and their association with depressed mood and treatment outcome. Journal of Child Psychology and Psychiatry and Allied Disciplines, 54(3), 313–322. CrossRef
Lebowitz, E. R. (2013). Parent-based treatment for childhood and adolescent OCD. Journal of Obsessive–Compulsive and Related Disorders, 2(4), 425–431. CrossRef
Lebowitz, E. R., & Omer, H. (2013). Treating childhood and adolescent anxiety: A guide for caregivers. NJ: Wiley. CrossRef
Lebowitz, E. R., Omer, H., Hermes, H., & Scahill, L. (2013a). Parent training for childhood anxiety disorders: The SPACE program. Cognitive and Behavioral Practice. doi: 10.1016/j.cbpra.2013.10.004.
Lebowitz, E. R., Scharfstein, L., & Jones, J. (2014a). Child-report of family accommodation in pediatric anxiety disorders: Comparison and integration with mother-report. Child Psychiatry and Human Development. doi: 10.1007/s10578-014-0491-1.
Lebowitz, E. R., Scharfstein, L. A., & Jones, J. (2014b). Comparing family accommodation in pediatric obsessive–compulsive disorder, anxiety disorders, and non-anxious children. Depression and Anxiety. doi: 10.1002/da.22251.
Lebowitz, E. R., Vitulano, L. A., Mataix-Cols, D., & Leckman, J. (2011b). Editorial perspective: When OCD takes over…the family! Coercive and disruptive behaviours in paediatric obsessive compulsive disorder. Journal of Child Psychology and Psychiatry and Allied Disciplines, 52(12), 1249–1250. CrossRef
Moos, R. H., & Moos, B. S. (1994). Family environment scale manual. Washington: Consulting Psychologists Press.
Peris, T. S., Bergman, R. L., Langley, A., Chang, S., McCracken, J. T., & Piacentini, J. (2008). Correlates of accommodation of pediatric obsessive–compulsive disorder: Parent, child, and family characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 47(10), 1173–1181. PubMedCentralPubMedCrossRef
Swanson, J. M., Kraemer, H. C., Hinshaw, S. P., Arnold, L. E., Conners, C. K., Abikoff, H. B., et al. (2001). Clinical relevance of the primary findings of the MTA: Success rates based on severity of ADHD and ODD symptoms at the end of treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 40(2), 168–179. PubMedCrossRef
Valleni-Basile, L. A., Garrison, C. Z., Jackson, K. L., Waller, J. L., McKeown, R. E., Addy, C. L., et al. (1994). Frequency of obsessive–compulsive disorder in a community sample of young adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 33(6), 782–791. PubMedCrossRef
- Clinical and Family Correlates of Coercive–Disruptive Behavior in Children and Adolescents with Obsessive–Compulsive Disorder
Eli R. Lebowitz
Eric A. Storch
James F. Leckman
- Springer US