Journal of the American Academy of Child & Adolescent Psychiatry
Four-Factor Structure of Obsessive-Compulsive Disorder Symptoms in Children, Adolescents, and Adults
Section snippets
Participants
Participants were evaluated independently at one of the following outpatient clinics: the Harvard Pediatric OCD Clinic at McLean Hospital, Belmont, MA; the Service de psychopathologie de l'enfant et de l'adolescent (Child and Adolescent Psychopathology Clinic), Robert Debré Hospital, Paris; the TS/OCD clinic at the Yale Child Study Center, New Haven, CT; and the Adult OCD clinics at Yale University and Brown University. All of the subjects had a definitive diagnosis of OCD according to DSM-IV
Descriptive Analyses
Lifetime mean symptom sums and lifetime frequencies of any symptom for each nonmiscellaneous Y-BOCS and CYBOCS checklist category for each age group, and related age group differences are listed in Table 1. Within all of the age groups, the presence of any aggressive obsessions and any checking compulsions had the highest lifetime frequencies compared with other symptom categories. Similarly, the presence of any sexual obsessions and any hoarding compulsions had the lowest lifetime frequencies
CFAs
Fit of the Unconstrained Four-Factor Model in the Three Age Groups. The hypothesized four-factor structure tested in this study included the following dimensions—factor 1: sexual/aggressive/religious/somatic/checking; factor 2: symmetry/ordering/repeating/counting; factor 3: contamination/cleaning; and factor 4: hoarding obsessions/compulsions.
The initial step in the present multiple-group CFA procedure (test of the unconstrained model) set out to determine whether the hypothesis that the
Discussion
This study indicates that the four-factor category-based OCD symptom dimension structure defined in the only previous symptom CFA provides an adequate fit for the data in independent child, adolescent, and adult age groups (with equal factor loadings across age groups). Fit indices across the three groups are similar to those reported for the Summerfeldt et al.7 independent adult sample. As such, the first CFA study on adult OCD has now been replicated in an independent multiple age group
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Connectome-wide Functional Connectivity Abnormalities in Youth With Obsessive-Compulsive Symptoms
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2020, Journal of Anxiety DisordersCitation Excerpt :The scales produce an obsession severity score (0–20), a compulsion severity score (0–20), and a total severity score (0–40). The CY-BOCS has demonstrated good reliability and validity in previous work (Stewart et al., 2008; Storch et al., 2004). The severity scales in the current study also demonstrated good internal consistency (α = .78).
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2020, Journal of Obsessive-Compulsive and Related DisordersCitation Excerpt :Nonetheless, there were a few important presentational differences between child and adult OCD patients that emerged even when the total number of presentations was controlled for. First, religious obsessions comprised a larger portion of total obsessions for children, consistent with findings from several past studies (Geller et al., 2001; Mancebo et al., 2008) and contradicting others (e.g., Farrell et al., 2006; Hanna, 1995; Stewart et al., 2008). This suggests that children with OCD may be particularly sensitive to obsessions involving religious themes, perhaps because they are still embedded in a family context in which their religion is essentially chosen, which in turn increases pressure to uphold ritualistic practices or moral obligations (Peris & Rozenman, 2016).
Reviewed and accepted by Deputy Editor John Walkup, M.D.
Grant support was provided by the Obsessive-Compulsive Foundation (S.E.S., M.C.R., D.AG.); McIngvale Foundation (S.E.S., D.L.P., D.A.G.); Harvard Scholar in Medicine Award (S.E.S.); CIHR Postgraduate Fellowship (S.E.S.); University of Ottawa International Fellowship (S.E.S.); Tourette Syndrome Association (M.C.R.); NIMH-K08-MH01481 (D.A.G.); NINDS-R01-NS16648 (D.L.P.) and MH49351 (J.F.L.). The authors thank Erin Hendrickson and Casey Walsh for their assistance with manuscript preparation and the reviewers for their valuable feedback.
This article is the subject of an editorial by Drs. Marc Riddle and Marco Grados in this issue.