Understanding Anxiety
Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is characterized by unwanted, intrusive thoughts (obsessions), which often compel sufferers to repeatedly perform ritualistic behaviors or routines (compulsions) in order to ease their anxiety. These compulsions are excessive and often illogical. Common obsessions include, but are not limited to, fears of contamination by dirt or germs, excessive concern regarding order, fear that one will cause harm to a loved one, excessive doubting, preoccupation with throwing things away that are of little value, and bothersome religious or sexual thoughts. Common compulsions include, but are not limited to, excessive handwashing, repeated checking, hoarding, repetition of words, phrases or activities, touching or arranging, and mental rituals (e.g., excessive praying or use of special words or “good” thoughts to neutralize “bad” thoughts).

Youth with OCD spend a significant amount of their time (at least one hour per day) engaging in rituals. This significantly interferes with everyday activities and can cause problems with schoolwork, school attendance, family relationships, and peer relations. Rituals, such as excessive handwashing, can pose health risks, such washing hands until they are raw or bleed. Most adults with OCD typically recognize that their rituals are irrational, but feel unable to control or stop them. Most children do not realize that their behavior is irrational or excessive.

OCD affects approximately 2-3% of children and adolescents. Typical onset occurs between 9-12 years old. There appear to two peaks, one in early childhood and one in early adolescence. Evidence suggests that those with early onset OCD tend to have a family history of OCD. Boys tend to develop OCD before puberty, whereas girls are more likely to develop it during adolescence.

References:

  • Albano, A. M., Chorpita, B. F., & Barlow, D. H. (1996). Childhood anxiety disorders. In E.J. Marsh & R. A. Barkley (Eds.), Child psychopathology (pp. 196-241). New York: Guilford Press.
  • Hanna, G. (1995). Demographic and clinical features of obsessive-compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 19-27.
  • Piacentini, J., & Graae, F. (1997). Childhood OCD. In  E. Hollander & D. Stein (Eds.), Obsessive-compulsive disorders: Diagnosis, etiology, treatment (pp. 23-46). New York: Marcel Dekker.
  • Swedo, S. E., Rapoport, J. L., Leonard, H., Lenane, M., & Cheslow, D. (1989). Obsessive-compulsive disorder in children and adolescents: Clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry, 46, 335-341.

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Symptoms

Obsessions — unwanted intrusive thoughts

  • Constant, irrational worry about dirt, germs, or contamination.
  • Excessive concern with order, arrangement, or symmetry.
  • Fear that negative or aggressive thoughts or impulses will cause personal harm or harm to a loved one.
  • Preoccupation with losing or throwing away objects with little or no value.
  • Excessive concern about accidentally or purposefully injuring another person.
  • Feeling overly responsible for the safety of others.
  • Distasteful religious and sexual thoughts or images.
  • Doubting that is irrational or excessive. Compulsions — ritualistic behaviors and routines to ease anxiety or distress
  • Cleaning — Repeatedly washing one’s hands, bathing, or cleaning household items, often for hours at a time.
  • Checking — Checking and re-checking several to hundreds of times a day that the doors are locked, the stove is turned off, the hairdryer is unplugged, etc.
  • Repeating — Inability to stop repeating a name, phrase, or simple activity (such as going through a doorway over and over).
  • Hoarding — Difficulty throwing away useless items such as old newspapers or magazines, bottle caps, or rubber bands.
  • Touching and arranging
  • Mental rituals — Endless reviewing of conversations, counting; repetitively calling up “good” thoughts to neutralize “bad” thoughts or obsessions; or excessive praying and using special words or phrases to neutralize obsessions.

Coping Cat Parents

CopingCatParents.com was developed to serve as a comprehensive and evidence-based resource on child and adolescent anxiety. Here you will get only information backed by research and tips and strategies that have evidence to support their use. We have brought together relevant resources, tools, and tips from the experts in the field that will be informative, and help you feel confident as you move forward in helping your child. 
 
Click on any of the links below to learn more:

Symptom Checker

If you’re not sure where to start, take a moment to complete our “Symptom Checker”. Our symptom checker allows you to click on the symptoms that are consistent with what you’re seeing in your child and provides personalized feedback on your child’s symptom status and recommendations for next steps.  
 
By answering a few short questions, you will get some feedback about which categories to learn more about next.
 
                                                                         

Child Anxiety Tales

The Child Anxiety Tales program is an online parent-training program designed to equip parents with skills and strategies they’ll need to help their children better manage anxiety. The program is based on the latest evidence in the treatment of child anxiety and on cognitive-behavioral principals shown to be effective in helping anxious youth. Child Anxiety Tales is an interactive and engaging program that can be completed at your own pace from the privacy and convenience of your own computer. It is not a treatment but an online educational program for parents. 
 
Click below to view a demo or to learn more: