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Gepubliceerd in: Journal of Child and Family Studies 8/2016

13-05-2016 | Original Paper

Parental Accommodation Predicts Symptom Severity at Long-Term Follow-Up in Children with Obsessive–Compulsive Disorder: A Preliminary Investigation

Gepubliceerd in: Journal of Child and Family Studies | Uitgave 8/2016

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Abstract

Pediatric obsessive–compulsive disorder (OCD) is a chronic condition affecting millions of children. Though well intentioned, accommodation (i.e., a parent’s attempt to assuage their child’s distress and anxiety) is thought to increase OCD symptom severity and may cause greater OCD-related impairment. The present study sought to examine the relative contribution of parental accommodation in predicting OCD symptom severity. Children between the ages of 6 and 18 (and their parents) participated in a prospective, longitudinal study investigating the course of pediatric OCD utilizing a longitudinal design. Data was collected at intake (n = 30) and two-years (n = 22) post-intake controlling for age, anxiety and depression. Parental accommodation (measured at intake) significantly predicted OCD symptom severity and was the strongest predictor at both intake and two-year follow-up. These preliminary findings highlight the importance of further research seeking to delineate factors relevant to the development and maintenance of accommodation as well as parent-level variables that might mediate the relationship between accommodation and OCD symptom severity.
Literatuur
go back to reference Albert, U., Bogetto, F., Maina, G., Saracco, P., Brunatto, C., & Mataix-Cols, D. (2010). Family accommodation in obsessive-compulsive disorder: Relation to symptom dimensions, clinical and family characteristics. Psychiatry Research, 179(2), 204–211.CrossRefPubMed Albert, U., Bogetto, F., Maina, G., Saracco, P., Brunatto, C., & Mataix-Cols, D. (2010). Family accommodation in obsessive-compulsive disorder: Relation to symptom dimensions, clinical and family characteristics. Psychiatry Research, 179(2), 204–211.CrossRefPubMed
go back to reference American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn., text rev.) (Vol. 4). Washington, DC: Author. American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn., text rev.) (Vol. 4). Washington, DC: Author.
go back to reference Barrett, P. M., Farrell, L., Pina, A. A., Peris, T. S., & Piacentini, J. (2008). Evidence-based psychosocial treatments for child and adolescent obsessive-compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 37(1), 131–155.CrossRefPubMed Barrett, P. M., Farrell, L., Pina, A. A., Peris, T. S., & Piacentini, J. (2008). Evidence-based psychosocial treatments for child and adolescent obsessive-compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 37(1), 131–155.CrossRefPubMed
go back to reference Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553.CrossRefPubMed Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553.CrossRefPubMed
go back to reference Calvocoressi, L., Lewis, B., Harris, M., Trufan, S. J., Goodman, W. K., McDougle, C. J., & Price, L. H. (1995). Family accommodation in obsessive-compulsive disorder. American Journal of Psychiatry, 152(3), 441–443.CrossRefPubMed Calvocoressi, L., Lewis, B., Harris, M., Trufan, S. J., Goodman, W. K., McDougle, C. J., & Price, L. H. (1995). Family accommodation in obsessive-compulsive disorder. American Journal of Psychiatry, 152(3), 441–443.CrossRefPubMed
go back to reference Calvocoressi, L., Mazure, C. M., Kasl, S. V., Skolnick, J., Fisk, D., Vegso, S. J., et al. (1999). Family accommodation of obsessive-compulsive symptoms: Instrument development and assessment of family behavior. Journal of Nervous and Mental Diseases, 187(10), 636–642.CrossRef Calvocoressi, L., Mazure, C. M., Kasl, S. V., Skolnick, J., Fisk, D., Vegso, S. J., et al. (1999). Family accommodation of obsessive-compulsive symptoms: Instrument development and assessment of family behavior. Journal of Nervous and Mental Diseases, 187(10), 636–642.CrossRef
go back to reference First, M., Spitzer, R., Gibbon, M., & et al. (1996). Structured clinical interview for DSM_IV Axis I disorder, Patient Edition (SCID-P). First, M., Spitzer, R., Gibbon, M., & et al. (1996). Structured clinical interview for DSM_IV Axis I disorder, Patient Edition (SCID-P).
go back to reference Flessner, C. A., Freeman, J. B., Sapyta, J., Garcia, A., Franklin, M. E., March, J. S., & Foa, E. (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.CrossRefPubMedPubMedCentral Flessner, C. A., Freeman, J. B., Sapyta, J., Garcia, A., Franklin, M. E., March, J. S., & Foa, E. (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.CrossRefPubMedPubMedCentral
go back to reference Flessner, C. A., Sapyta, J., Garcia, A., Freeman, J. B., Franklin, M. E., Foa, E., & March, J. (2009). Examining the psychometric properties of the family accommodation scale-parent-report (FAS-PR). Journal of Psychopathology and Behavioral Assessment, 31(1), 38–46.PubMedPubMedCentral Flessner, C. A., Sapyta, J., Garcia, A., Freeman, J. B., Franklin, M. E., Foa, E., & March, J. (2009). Examining the psychometric properties of the family accommodation scale-parent-report (FAS-PR). Journal of Psychopathology and Behavioral Assessment, 31(1), 38–46.PubMedPubMedCentral
go back to reference Freeman, J. B., Garcia, A. M., Coyne, L., Ale, C., Przeworski, A., Himle, M., et al. (2008). Early childhood OCD: Preliminary findings from a family-based cognitive-behavioral approach. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 593–602.CrossRefPubMedPubMedCentral Freeman, J. B., Garcia, A. M., Coyne, L., Ale, C., Przeworski, A., Himle, M., et al. (2008). Early childhood OCD: Preliminary findings from a family-based cognitive-behavioral approach. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 593–602.CrossRefPubMedPubMedCentral
go back to reference Geller, D. A. (2006). Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatric Clinics of North America, 29(2), 353–370.CrossRefPubMed Geller, D. A. (2006). Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatric Clinics of North America, 29(2), 353–370.CrossRefPubMed
go back to reference Geller, D. A., Biederman, J., Griffin, S., Jones, J., & Lefkowitz, T. R. (1996). Comorbidity of juvenile obsessive-compulsive disorder with disruptive behavior disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 35(12), 1637–1646.CrossRefPubMed Geller, D. A., Biederman, J., Griffin, S., Jones, J., & Lefkowitz, T. R. (1996). Comorbidity of juvenile obsessive-compulsive disorder with disruptive behavior disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 35(12), 1637–1646.CrossRefPubMed
go back to reference Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., & Charney, D. S. (1989a). The Yale-Brown obsessive compulsive scale. II. Validity. Archives of General Psychiatry, 46(11), 1012–1016.CrossRefPubMed Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., & Charney, D. S. (1989a). The Yale-Brown obsessive compulsive scale. II. Validity. Archives of General Psychiatry, 46(11), 1012–1016.CrossRefPubMed
go back to reference Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., et al. (1989b). The Yale-Brown obsessive compulsive scale. I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006–1011.CrossRefPubMed Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., et al. (1989b). The Yale-Brown obsessive compulsive scale. I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006–1011.CrossRefPubMed
go back to reference Hanna, G. L. (1995). Demographic and clinical-features of obsessive-compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34(1), 19–27.CrossRefPubMed Hanna, G. L. (1995). Demographic and clinical-features of obsessive-compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34(1), 19–27.CrossRefPubMed
go back to reference Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 980–988.CrossRefPubMed Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 980–988.CrossRefPubMed
go back to reference Kovacs, M. (1992). Children’s depression inventory. New York: Multi-Health Systems. Kovacs, M. (1992). Children’s depression inventory. New York: Multi-Health Systems.
go back to reference Langley, A. K., Lewin, A. B., Bergman, R. L., Lee, J. C., & Piacentini, J. (2010). Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder. European Journal of Child and Adolescent Psychiatry, 19(8), 637–645.CrossRef Langley, A. K., Lewin, A. B., Bergman, R. L., Lee, J. C., & Piacentini, J. (2010). Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder. European Journal of Child and Adolescent Psychiatry, 19(8), 637–645.CrossRef
go back to reference Leon, A. C. (2011). Evaluation of psychiatric interventions in an observational study: Issues in design and analysis. Dialogues in Clinical Neuroscience, 13(2), 191–198.PubMedPubMedCentral Leon, A. C. (2011). Evaluation of psychiatric interventions in an observational study: Issues in design and analysis. Dialogues in Clinical Neuroscience, 13(2), 191–198.PubMedPubMedCentral
go back to reference Lewin, A. B., Storch, E. A., Geffken, G. R., Goodman, W. K., & Murphy, T. K. (2006). A neuropsychiatric review of pediatric obsessive-compulsive disorder: Etiology and efficacious treatments. Neuropsychiatric Disorders and Treatment, 2(1), 21–31. Lewin, A. B., Storch, E. A., Geffken, G. R., Goodman, W. K., & Murphy, T. K. (2006). A neuropsychiatric review of pediatric obsessive-compulsive disorder: Etiology and efficacious treatments. Neuropsychiatric Disorders and Treatment, 2(1), 21–31.
go back to reference Lin, H. Q., Katsovich, L., Ghebremichael, M., Findley, D. B., Grantz, H., Lombroso, P. J., et al. (2007). Psychosocial stress predicts future symptom severities in children and adolescents with Tourette syndrome and/or obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, 48(2), 157–166.CrossRefPubMedPubMedCentral Lin, H. Q., Katsovich, L., Ghebremichael, M., Findley, D. B., Grantz, H., Lombroso, P. J., et al. (2007). Psychosocial stress predicts future symptom severities in children and adolescents with Tourette syndrome and/or obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, 48(2), 157–166.CrossRefPubMedPubMedCentral
go back to reference Maina, G., Saracco, P., Albert, U., & Bogetto, F. (2006). Family-focused treatments for obsessive-compulsive disorder. Clinical Neuropsychiatry, 3(6), 382–390. Maina, G., Saracco, P., Albert, U., & Bogetto, F. (2006). Family-focused treatments for obsessive-compulsive disorder. Clinical Neuropsychiatry, 3(6), 382–390.
go back to reference Mancebo, M. C., Garcia, A. M., Pinto, A., Freeman, J. B., Przeworski, A., Stout, R., et al. (2008). Juvenile-onset OCD: Clinical features in children, adolescents and adults. Acta Psychiatrica Scandinavica, 118(2), 149–159.CrossRefPubMedPubMedCentral Mancebo, M. C., Garcia, A. M., Pinto, A., Freeman, J. B., Przeworski, A., Stout, R., et al. (2008). Juvenile-onset OCD: Clinical features in children, adolescents and adults. Acta Psychiatrica Scandinavica, 118(2), 149–159.CrossRefPubMedPubMedCentral
go back to reference March, J. S., Parker, J. D., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The Multidimensional Anxiety Scale for Children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 554–565.CrossRefPubMed March, J. S., Parker, J. D., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The Multidimensional Anxiety Scale for Children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 554–565.CrossRefPubMed
go back to reference Merlo, L. J., Lehmkuhl, H. D., Geffken, G. R., & Storch, E. A. (2009). Decreased family accommodation associated with improved therapy outcome in pediatric obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 77(2), 355–360.CrossRefPubMedPubMedCentral Merlo, L. J., Lehmkuhl, H. D., Geffken, G. R., & Storch, E. A. (2009). Decreased family accommodation associated with improved therapy outcome in pediatric obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 77(2), 355–360.CrossRefPubMedPubMedCentral
go back to reference Miller, I. W., Bishop, S., Norman, W. H., & Maddever, H. (1985). The modified Hamilton rating scale for depression: Reliability and validity. Psychiatry Research, 14(2), 131–142.CrossRefPubMed Miller, I. W., Bishop, S., Norman, W. H., & Maddever, H. (1985). The modified Hamilton rating scale for depression: Reliability and validity. Psychiatry Research, 14(2), 131–142.CrossRefPubMed
go back to reference Peris, T. S., Bergman, R. L., Asarnow, J. R., Langley, A., McCracken, J. T., & Piacentini, J. (2010). Clinical and cognitive correlates of depressive symptoms among youth with obsessive compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 39(5), 616–626.CrossRefPubMedPubMedCentral Peris, T. S., Bergman, R. L., Asarnow, J. R., Langley, A., McCracken, J. T., & Piacentini, J. (2010). Clinical and cognitive correlates of depressive symptoms among youth with obsessive compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 39(5), 616–626.CrossRefPubMedPubMedCentral
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
go back to reference Piacentini, J., Bergman, R. L., Chang, S., Langley, A., Peris, T., Wood, J. J., & McCracken, J. (2011). Controlled comparison of family cognitive behavioral therapy and psychoeducation/relaxation training for child obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 50(11), 1149–1161.CrossRefPubMedPubMedCentral Piacentini, J., Bergman, R. L., Chang, S., Langley, A., Peris, T., Wood, J. J., & McCracken, J. (2011). Controlled comparison of family cognitive behavioral therapy and psychoeducation/relaxation training for child obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 50(11), 1149–1161.CrossRefPubMedPubMedCentral
go back to reference Piacentini, J., Peris, T. S., Bergman, R. L., Chang, S., & Jaffer, M. (2007). Functional impairment in childhood OCD: Development and psychometrics properties of the child obsessive-compulsive impact scale-revised (COIS-R). Journal of Clinical Child and Adolescent Psychology, 36(4), 645–653.CrossRefPubMed Piacentini, J., Peris, T. S., Bergman, R. L., Chang, S., & Jaffer, M. (2007). Functional impairment in childhood OCD: Development and psychometrics properties of the child obsessive-compulsive impact scale-revised (COIS-R). Journal of Clinical Child and Adolescent Psychology, 36(4), 645–653.CrossRefPubMed
go back to reference Pinto, A., Mancebo, M. C., Eisen, J. L., Pagano, M. E., & Rasmussen, S. A. (2006). The Brown Longitudinal Obsessive Compulsive Study: Clinical features and symptoms of the sample at intake. Journal of Clinical Psychiatry, 67(5), 703–711.CrossRefPubMedPubMedCentral Pinto, A., Mancebo, M. C., Eisen, J. L., Pagano, M. E., & Rasmussen, S. A. (2006). The Brown Longitudinal Obsessive Compulsive Study: Clinical features and symptoms of the sample at intake. Journal of Clinical Psychiatry, 67(5), 703–711.CrossRefPubMedPubMedCentral
go back to reference Rasmussen, S. A., & Eisen, J. L. (1992). The epidemiology and clinical features of obsessive compulsive disorder. Psychiatric Clinics of North America, 15(4), 743–758.PubMed Rasmussen, S. A., & Eisen, J. L. (1992). The epidemiology and clinical features of obsessive compulsive disorder. Psychiatric Clinics of North America, 15(4), 743–758.PubMed
go back to reference Saylor, C. F., Finch, A. J, Jr, Spirito, A., & Bennett, B. (1984). The children’s depression inventory: A systematic evaluation of psychometric properties. Journal of Consulting and Clinical Psychology, 52(6), 955–967.CrossRefPubMed Saylor, C. F., Finch, A. J, Jr, Spirito, A., & Bennett, B. (1984). The children’s depression inventory: A systematic evaluation of psychometric properties. Journal of Consulting and Clinical Psychology, 52(6), 955–967.CrossRefPubMed
go back to reference Scahill, L., Riddle, M. A., McSwiggin-Hardin, M., Ort, S. I., King, R. A., Goodman, W. K., et al. (1997). Children’s Yale-Brown obsessive compulsive scale: Reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(6), 844–852.CrossRefPubMed Scahill, L., Riddle, M. A., McSwiggin-Hardin, M., Ort, S. I., King, R. A., Goodman, W. K., et al. (1997). Children’s Yale-Brown obsessive compulsive scale: Reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(6), 844–852.CrossRefPubMed
go back to reference Steketee, G., & Van Noppen, B. (2003). Family approaches to treatment for obsessive compulsive disorder. Revista Brasileira Psiquiatria, 25(1), 43–50.CrossRef Steketee, G., & Van Noppen, B. (2003). Family approaches to treatment for obsessive compulsive disorder. Revista Brasileira Psiquiatria, 25(1), 43–50.CrossRef
go back to reference Stengler-Wenzke, K., Kroll, M., Matschinger, H., & Angermeyer, M. C. (2006). Quality of life of relatives of patients with obsessive-compulsive disorder. Comprehensive Psychiatry, 47(6), 523–527.CrossRefPubMed Stengler-Wenzke, K., Kroll, M., Matschinger, H., & Angermeyer, M. C. (2006). Quality of life of relatives of patients with obsessive-compulsive disorder. Comprehensive Psychiatry, 47(6), 523–527.CrossRefPubMed
go back to reference Storch, E. A., Geffken, G. R., Merlo, L. J., Jacob, M. L., Murphy, T. K., Goodman, W. K., et al. (2007). Family accommodation in pediatric obsessive-compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 36(2), 207–216.CrossRefPubMed Storch, E. A., Geffken, G. R., Merlo, L. J., Jacob, M. L., Murphy, T. K., Goodman, W. K., et al. (2007). Family accommodation in pediatric obsessive-compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 36(2), 207–216.CrossRefPubMed
go back to reference Valleni-Basile, L. A., Garrison, C. Z., Jackson, K. L., Waller, J. L., McKeown, R. E., Addy, C. L., & Cuffe, S. P. (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.CrossRefPubMed Valleni-Basile, L. A., Garrison, C. Z., Jackson, K. L., Waller, J. L., McKeown, R. E., Addy, C. L., & Cuffe, S. P. (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.CrossRefPubMed
go back to reference Wood, J. J., Piacentini, J. C., Bergman, R. L., McCracken, J., & Barrios, V. (2002). Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: Child and parent versions. Journal of Clinical Child and Adolecsent Psychology, 31(3), 335–342.CrossRef Wood, J. J., Piacentini, J. C., Bergman, R. L., McCracken, J., & Barrios, V. (2002). Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: Child and parent versions. Journal of Clinical Child and Adolecsent Psychology, 31(3), 335–342.CrossRef
go back to reference Zohar, A. H. (1999). The epidemiology of obsessive-compulsive disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 8(3), 445–460.PubMed Zohar, A. H. (1999). The epidemiology of obsessive-compulsive disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 8(3), 445–460.PubMed
Metagegevens
Titel
Parental Accommodation Predicts Symptom Severity at Long-Term Follow-Up in Children with Obsessive–Compulsive Disorder: A Preliminary Investigation
Publicatiedatum
13-05-2016
Gepubliceerd in
Journal of Child and Family Studies / Uitgave 8/2016
Print ISSN: 1062-1024
Elektronisch ISSN: 1573-2843
DOI
https://doi.org/10.1007/s10826-016-0408-7

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