Skip to main content
Top
Gepubliceerd in: Child Psychiatry & Human Development 5/2021

12-10-2020 | Original Article

Core Motivations of Childhood Obsessive-Compulsive Disorder: The Role of Harm Avoidance and Incompleteness

Auteurs: Meghan Schreck, Christopher Georgiadis, Abbe Garcia, Kristen Benito, Brady Case, Jennifer Herren, Michael Walther, Jennifer Freeman

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 5/2021

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

In an effort to improve patient conceptualization and targeted treatment, researchers have sought to accurately classify OCD subtypes. To date, the most common form of OCD classification has used the content of symptom topography as opposed to functional links between symptoms to categorize OCD. The aim of the current study was to explore the associations between these two forms of OCD classification. Participant topographical symptoms were self-reported using the Obsessive-Compulsive Inventory-Child Version (OCI-CV). Clinicians assessed whether participant symptoms were motivated by harm avoidance and/or incompleteness. Structural equation modeling was employed to explore the associations between harm avoidance and incompleteness and symptom dimensions in youth with OCD. Results showed that harm avoidance was significantly associated with doubting/checking, obsessing, and neutralizing symptoms, whereas incompleteness was associated with doubting/checking, ordering, and neutralizing symptoms. Findings are consistent with child and adult literature and highlight the importance of assessing the underlying function of OC behaviors.
Literatuur
1.
go back to reference Geller DA (2006) Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatr Clin North Am 29:353–370PubMedCrossRef Geller DA (2006) Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatr Clin North Am 29:353–370PubMedCrossRef
2.
go back to reference Piacentini J, Bergman RL, Keller M, McCracken J (2003) Functional impairment in children and adolescents with obsessive-compulsive disorder. J Child Adolesc Psychopharmacol 13:S61–S69PubMedCrossRef Piacentini J, Bergman RL, Keller M, McCracken J (2003) Functional impairment in children and adolescents with obsessive-compulsive disorder. J Child Adolesc Psychopharmacol 13:S61–S69PubMedCrossRef
4.
go back to reference Freeman J, Benito K, Herren J, Kemp J, Sung J, Georgiadis C et al (2018) Evidence base update of psychosocial treatments for pediatric obsessive-compulsive disorder: evaluating, improving, and transporting what works. J Clin Child Adolesc Psychol 47:669–698PubMedCrossRef Freeman J, Benito K, Herren J, Kemp J, Sung J, Georgiadis C et al (2018) Evidence base update of psychosocial treatments for pediatric obsessive-compulsive disorder: evaluating, improving, and transporting what works. J Clin Child Adolesc Psychol 47:669–698PubMedCrossRef
5.
go back to reference Katerberg H, Delucchi KL, Stewart SE, Lochner C, Denys DAJP, Stack DE et al (2010) Symptom dimensions in OCD: item-level factor analysis and heritability estimates. Behav Genet 40:505–517PubMedPubMedCentralCrossRef Katerberg H, Delucchi KL, Stewart SE, Lochner C, Denys DAJP, Stack DE et al (2010) Symptom dimensions in OCD: item-level factor analysis and heritability estimates. Behav Genet 40:505–517PubMedPubMedCentralCrossRef
6.
go back to reference McKay D, Abramowitz JS, Calamari JE, Kyrios M, Radomsky A, Sookman D et al (2004) A critical evaluation of obsessive-compulsive disorder subtypes: symptoms versus mechanisms. Clin Psychol Rev 24:283–313PubMedCrossRef McKay D, Abramowitz JS, Calamari JE, Kyrios M, Radomsky A, Sookman D et al (2004) A critical evaluation of obsessive-compulsive disorder subtypes: symptoms versus mechanisms. Clin Psychol Rev 24:283–313PubMedCrossRef
7.
go back to reference Stewart SE, Rosario MC, Brown TA, Carter AS, Leckman JF, Sukhodolsky D et al (2007) Principal components analysis of obsessive-compulsive disorder symptoms in children and adolescents. Biol Psychiatry 61:285–291PubMedCrossRef Stewart SE, Rosario MC, Brown TA, Carter AS, Leckman JF, Sukhodolsky D et al (2007) Principal components analysis of obsessive-compulsive disorder symptoms in children and adolescents. Biol Psychiatry 61:285–291PubMedCrossRef
8.
go back to reference Baer L (1994) Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders. J Clin Psychiatry 55(Suppl):18–23PubMed Baer L (1994) Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders. J Clin Psychiatry 55(Suppl):18–23PubMed
9.
go back to reference Leckman JF, Grice DE, Boardman J, Zhang H, Vitale A, Bondi C et al (1997) Symptoms of obsessive-compulsive disorder. Am J Psychiatry 154:911–917PubMedCrossRef Leckman JF, Grice DE, Boardman J, Zhang H, Vitale A, Bondi C et al (1997) Symptoms of obsessive-compulsive disorder. Am J Psychiatry 154:911–917PubMedCrossRef
10.
go back to reference Summerfeldt LJ, Kloosterman PH, Antony MM, Richter MA, Swinson RP (2004) The relationship between miscellaneous symptoms and major symptom factors in obsessive-compulsive disorder. Behav Res Ther 42:1453–1467PubMedCrossRef Summerfeldt LJ, Kloosterman PH, Antony MM, Richter MA, Swinson RP (2004) The relationship between miscellaneous symptoms and major symptom factors in obsessive-compulsive disorder. Behav Res Ther 42:1453–1467PubMedCrossRef
13.
go back to reference Skinner BF (1953) Science and human behavior. Free Press, New York Skinner BF (1953) Science and human behavior. Free Press, New York
14.
go back to reference Mataix-Cols D, Rosario-Campos MC, Leckman JF (2005) A multidimensional model of obsessive-compulsive disorder. Am J Psychiatry 162:228–238PubMedCrossRef Mataix-Cols D, Rosario-Campos MC, Leckman JF (2005) A multidimensional model of obsessive-compulsive disorder. Am J Psychiatry 162:228–238PubMedCrossRef
15.
go back to reference McKay D, Piacentini J, Greisberg S, Graae F, Jaffer M, Miller J (2006) The structure of childhood obsessions and compulsions: dimensions in an outpatient sample. Behav Res Ther 44:137–146PubMedCrossRef McKay D, Piacentini J, Greisberg S, Graae F, Jaffer M, Miller J (2006) The structure of childhood obsessions and compulsions: dimensions in an outpatient sample. Behav Res Ther 44:137–146PubMedCrossRef
16.
go back to reference Röper G, Rachman S (1976) Obsessional-compulsive checking: experimental replication and development. Behav Res Ther 14:25–32PubMedCrossRef Röper G, Rachman S (1976) Obsessional-compulsive checking: experimental replication and development. Behav Res Ther 14:25–32PubMedCrossRef
17.
go back to reference Röper G, Rachman S, Hodgson R (1973) An experiment on obsessional checking. Behav Res Ther 11:271–277PubMedCrossRef Röper G, Rachman S, Hodgson R (1973) An experiment on obsessional checking. Behav Res Ther 11:271–277PubMedCrossRef
18.
go back to reference Storch EA, Lack C, Merlo LJ, Marien WE, Geffken GR, Grabill K et al (2007) Associations between miscellaneous symptoms and symptom dimensions: an examination of pediatric obsessive-compulsive disorder. Behav Res Ther 45:2593–2603PubMedCrossRef Storch EA, Lack C, Merlo LJ, Marien WE, Geffken GR, Grabill K et al (2007) Associations between miscellaneous symptoms and symptom dimensions: an examination of pediatric obsessive-compulsive disorder. Behav Res Ther 45:2593–2603PubMedCrossRef
19.
go back to reference Clark DA (2012) Cognitive-behavioral therapy for OCD. Guilford Press, New York Clark DA (2012) Cognitive-behavioral therapy for OCD. Guilford Press, New York
20.
go back to reference Frost RO, Steketee G (2002) Cognitive approaches to obsessions and compulsions: theory, assessment, and treatment. Elsevier, Oxford Frost RO, Steketee G (2002) Cognitive approaches to obsessions and compulsions: theory, assessment, and treatment. Elsevier, Oxford
22.
go back to reference Obsessive Compulsive Cognitions Working Group (1997) Cognitive assessment of obsessive-compulsive disorder. Behav Res Ther 35:667–681CrossRef Obsessive Compulsive Cognitions Working Group (1997) Cognitive assessment of obsessive-compulsive disorder. Behav Res Ther 35:667–681CrossRef
23.
go back to reference Obsessive Compulsive Cognitions Working Group (2001) Development and initial validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory. Behav Res Ther 39:987–1006CrossRef Obsessive Compulsive Cognitions Working Group (2001) Development and initial validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory. Behav Res Ther 39:987–1006CrossRef
24.
go back to reference Obsessive Compulsive Cognitions Working Group (2003) Psychometric validation of the Obsessive Beliefs Questionnaire and Interpretation of Intrusions Inventory: Part 1. Behav Res Ther 41:863–878CrossRef Obsessive Compulsive Cognitions Working Group (2003) Psychometric validation of the Obsessive Beliefs Questionnaire and Interpretation of Intrusions Inventory: Part 1. Behav Res Ther 41:863–878CrossRef
25.
go back to reference Obsessive Compulsive Cognitions Working Group (2005) Psychometric validation of the Obsessive Beliefs Questionnaire and Interpretation of Intrusions Inventory: Part 2: Factor analyses and testing of a brief version. Behav Res Ther 43:1527–1542CrossRef Obsessive Compulsive Cognitions Working Group (2005) Psychometric validation of the Obsessive Beliefs Questionnaire and Interpretation of Intrusions Inventory: Part 2: Factor analyses and testing of a brief version. Behav Res Ther 43:1527–1542CrossRef
26.
go back to reference Coles ME, Frost RO, Heimberg RG, Rhéaume J (2003) “Not just right experiences”: perfectionism, obsessive-compulsive features and general psychopathology. Behav Res Ther 41:681–700PubMedCrossRef Coles ME, Frost RO, Heimberg RG, Rhéaume J (2003) “Not just right experiences”: perfectionism, obsessive-compulsive features and general psychopathology. Behav Res Ther 41:681–700PubMedCrossRef
27.
go back to reference Summerfeldt LJ (2004) Understanding and treating incompleteness in obsessive-compulsive disorder. J Clin Psychol 60:1155–1168PubMedCrossRef Summerfeldt LJ (2004) Understanding and treating incompleteness in obsessive-compulsive disorder. J Clin Psychol 60:1155–1168PubMedCrossRef
29.
go back to reference Rosario-Campos MC, Miguel EC, Quatrano S, Chacon P, Ferrao Y, Findley D et al (2006) The Dimensional Yale-Brown Obsessive–Compulsive Scale (DY-BOCS): an instrument for assessing obsessive–compulsive symptom dimensions. Mol Psychiatry 11:495–504PubMedCrossRef Rosario-Campos MC, Miguel EC, Quatrano S, Chacon P, Ferrao Y, Findley D et al (2006) The Dimensional Yale-Brown Obsessive–Compulsive Scale (DY-BOCS): an instrument for assessing obsessive–compulsive symptom dimensions. Mol Psychiatry 11:495–504PubMedCrossRef
30.
go back to reference Abramowitz JS, Deacon BJ, Olatunji BO, Wheaton MG, Berman NC, Losardo D et al (2010) Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale. Psychol Assess 22:180PubMedCrossRef Abramowitz JS, Deacon BJ, Olatunji BO, Wheaton MG, Berman NC, Losardo D et al (2010) Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale. Psychol Assess 22:180PubMedCrossRef
31.
go back to reference Summerfeldt LJ, Kloosterman PH, Antony MM, Swinson RP (2014) Examining an obsessive-compulsive core dimensions model: structural validity of harm avoidance and incompleteness. J Obs Compuls Relat Disord 3:83–94 Summerfeldt LJ, Kloosterman PH, Antony MM, Swinson RP (2014) Examining an obsessive-compulsive core dimensions model: structural validity of harm avoidance and incompleteness. J Obs Compuls Relat Disord 3:83–94
32.
go back to reference Rasmussen SA, Eisen JL (1992) The epidemiology and differential diagnosis of obsessive compulsive disorder. J Clin Psychiatry 53:4–10PubMed Rasmussen SA, Eisen JL (1992) The epidemiology and differential diagnosis of obsessive compulsive disorder. J Clin Psychiatry 53:4–10PubMed
33.
go back to reference Ecker W, Gönner S (2008) Incompleteness and harm avoidance in OCD symptom dimensions. Beh Res Ther 46:895–904CrossRef Ecker W, Gönner S (2008) Incompleteness and harm avoidance in OCD symptom dimensions. Beh Res Ther 46:895–904CrossRef
34.
go back to reference Bragdon LB, Coles ME (2017) Examining heterogeneity of obsessive-compulsive disorder: evidence for subgroups based on motivations. J Anxiety Disord 45:64–71PubMedCrossRef Bragdon LB, Coles ME (2017) Examining heterogeneity of obsessive-compulsive disorder: evidence for subgroups based on motivations. J Anxiety Disord 45:64–71PubMedCrossRef
37.
go back to reference Foa EB, Coles M, Huppert JD, Pasupuleti RV, Franklin ME, March J (2010) Development and validation of a child version of the obsessive compulsive inventory. Behav Ther 41:121–132PubMedCrossRef Foa EB, Coles M, Huppert JD, Pasupuleti RV, Franklin ME, March J (2010) Development and validation of a child version of the obsessive compulsive inventory. Behav Ther 41:121–132PubMedCrossRef
38.
go back to reference Jones AM, De Nadai AS, Arnold EB, McGuire JF, Lewin AB, Murphy TK et al (2012) Psychometric properties of the obsessive compulsive inventory: child version in children and adolescents with obsessive-compulsive disorder. Child Psychiatry Hum Dev 44:137–151CrossRef Jones AM, De Nadai AS, Arnold EB, McGuire JF, Lewin AB, Murphy TK et al (2012) Psychometric properties of the obsessive compulsive inventory: child version in children and adolescents with obsessive-compulsive disorder. Child Psychiatry Hum Dev 44:137–151CrossRef
39.
go back to reference Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI, King RA, Goodman WK et al (1997) Children’s Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry 36:844–852PubMedCrossRef Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI, King RA, Goodman WK et al (1997) Children’s Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry 36:844–852PubMedCrossRef
40.
go back to reference Storch EA, Murphy TK, Geffken GR, Soto O, Sajid M, Allen P et al (2004) Psychometric evaluation of the Children’s Yale-Brown Obsessive-Compulsive Scale. Psychiatry Res 129:91–98PubMedCrossRef Storch EA, Murphy TK, Geffken GR, Soto O, Sajid M, Allen P et al (2004) Psychometric evaluation of the Children’s Yale-Brown Obsessive-Compulsive Scale. Psychiatry Res 129:91–98PubMedCrossRef
41.
go back to reference McKay D, Piacentini J, Greisberg S, Graae F, Jaffer M, Miller J et al (2003) The Children’s Yale-Brown Obsessive-Compulsive Scale: item structure in an outpatient setting. Psychol Assess 15:578–581PubMedCrossRef McKay D, Piacentini J, Greisberg S, Graae F, Jaffer M, Miller J et al (2003) The Children’s Yale-Brown Obsessive-Compulsive Scale: item structure in an outpatient setting. Psychol Assess 15:578–581PubMedCrossRef
42.
go back to reference Stewart SE, Rosario MC, Baer L, Carter AS, Brown TA, Scharf JM et al (2008) Four-factor structure of obsessive-compulsive disorder symptoms in children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry 47:763–772PubMedCrossRef Stewart SE, Rosario MC, Baer L, Carter AS, Brown TA, Scharf JM et al (2008) Four-factor structure of obsessive-compulsive disorder symptoms in children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry 47:763–772PubMedCrossRef
43.
go back to reference Muthén LK, Muthén BO (2012) Mplus user’s guide, 7th edn. Muthén & Muthén, Los Angeles Muthén LK, Muthén BO (2012) Mplus user’s guide, 7th edn. Muthén & Muthén, Los Angeles
44.
go back to reference Brown TA (2006) Confirmatory factor analysis for applied research. The Guilford Press, New York Brown TA (2006) Confirmatory factor analysis for applied research. The Guilford Press, New York
46.
go back to reference Cougle JR, Fitch KE, Jacobson S, Lee H (2013) A multi-method examination of the role of incompleteness in compulsive checking. J Anxiety Disord 27:231–239PubMedCrossRef Cougle JR, Fitch KE, Jacobson S, Lee H (2013) A multi-method examination of the role of incompleteness in compulsive checking. J Anxiety Disord 27:231–239PubMedCrossRef
47.
go back to reference Szechtman H, Woody E (2004) Obsessive-compulsive disorder as a disturbance of security motivation. Psychol Rev 111:111–127PubMedCrossRef Szechtman H, Woody E (2004) Obsessive-compulsive disorder as a disturbance of security motivation. Psychol Rev 111:111–127PubMedCrossRef
48.
go back to reference Boisseau CL, Sibrava NJ, Garnaat SL, Mancebo MC, Eisen JL, Rasmussen SA (2018) The Brown Incompleteness Scale (BINCS): measure development and initial evaluation. J Obs Compuls Relat Disord 16:66–71 Boisseau CL, Sibrava NJ, Garnaat SL, Mancebo MC, Eisen JL, Rasmussen SA (2018) The Brown Incompleteness Scale (BINCS): measure development and initial evaluation. J Obs Compuls Relat Disord 16:66–71
49.
go back to reference Evans DW, Milanak ME, Medeiros B, Ross JL (2002) Magical beliefs and rituals in young children. Child Psychiatry Hum Dev 33(1):43–58PubMedCrossRef Evans DW, Milanak ME, Medeiros B, Ross JL (2002) Magical beliefs and rituals in young children. Child Psychiatry Hum Dev 33(1):43–58PubMedCrossRef
51.
go back to reference Samuels JF, Bienvenu OJ III, Pinto A, Fyer AJ, McCracken JT, Rauch SL, Murphy DL, Grados MA, Greenberg BD, Knowles JA, Piacentini J (2007) Hoarding in obsessive–compulsive disorder: results from the OCD Collaborative Genetics Study. Behav Res Ther 45:673–686PubMedCrossRef Samuels JF, Bienvenu OJ III, Pinto A, Fyer AJ, McCracken JT, Rauch SL, Murphy DL, Grados MA, Greenberg BD, Knowles JA, Piacentini J (2007) Hoarding in obsessive–compulsive disorder: results from the OCD Collaborative Genetics Study. Behav Res Ther 45:673–686PubMedCrossRef
52.
go back to reference Cherian AE, Frost RO (2007) Treating compulsive hoarding. In: Antony MM, Purdon C, Summerfeldt LJ (eds) Psychological treatment of obsessive-compulsive disorder: fundamentals and beyond. American Psychological Association, Washington DC, pp 231–249. https://doi.org/10.1037/11543-010CrossRef Cherian AE, Frost RO (2007) Treating compulsive hoarding. In: Antony MM, Purdon C, Summerfeldt LJ (eds) Psychological treatment of obsessive-compulsive disorder: fundamentals and beyond. American Psychological Association, Washington DC, pp 231–249. https://​doi.​org/​10.​1037/​11543-010CrossRef
53.
go back to reference Melli G, Chiorri C, Carraresi C, Stopani E, Bulli F (2015) The two dimensions of contamination fear in obsessive-compulsive disorder: Harm avoidance and disgust avoidance. J Obs Compuls Relat Disord 6:124–131 Melli G, Chiorri C, Carraresi C, Stopani E, Bulli F (2015) The two dimensions of contamination fear in obsessive-compulsive disorder: Harm avoidance and disgust avoidance. J Obs Compuls Relat Disord 6:124–131
54.
go back to reference Rozenman M, Peris T, Bergman RL, Chang S, O’Neill J, McCracken JT, Piacentini J (2017) Distinguishing fear versus distress symptomatology in pediatric OCD. Child Psychiatry Hum Dev 48:63–72PubMedPubMedCentralCrossRef Rozenman M, Peris T, Bergman RL, Chang S, O’Neill J, McCracken JT, Piacentini J (2017) Distinguishing fear versus distress symptomatology in pediatric OCD. Child Psychiatry Hum Dev 48:63–72PubMedPubMedCentralCrossRef
55.
go back to reference Summers BJ, Fitch KE, Cougle JR (2014) Visual, tactile, and auditory “not just right” experiences: associations with obsessive-compulsive symptoms and perfectionism. Behav Ther 45:678–689PubMedCrossRef Summers BJ, Fitch KE, Cougle JR (2014) Visual, tactile, and auditory “not just right” experiences: associations with obsessive-compulsive symptoms and perfectionism. Behav Ther 45:678–689PubMedCrossRef
Metagegevens
Titel
Core Motivations of Childhood Obsessive-Compulsive Disorder: The Role of Harm Avoidance and Incompleteness
Auteurs
Meghan Schreck
Christopher Georgiadis
Abbe Garcia
Kristen Benito
Brady Case
Jennifer Herren
Michael Walther
Jennifer Freeman
Publicatiedatum
12-10-2020
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development / Uitgave 5/2021
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-020-01075-5

Andere artikelen Uitgave 5/2021

Child Psychiatry & Human Development 5/2021 Naar de uitgave