Article

Journal of Abnormal Child Psychology

, Volume 40, Issue 1, pp 133-143

A Structural Equation Analysis of Family Accommodation in Pediatric Obsessive-Compulsive Disorder

  • Nicole E. CaporinoAffiliated withDepartment of Psychology, University of South FloridaDepartment of Pediatrics, University of South Florida
  • , Jessica MorganAffiliated withDepartment of Pediatrics, University of South Florida
  • , Jason BecksteadAffiliated withCollege of Nursing, University of South Florida
  • , Vicky PharesAffiliated withDepartment of Psychology, University of South Florida
  • , Tanya K. MurphyAffiliated withDepartment of Pediatrics, University of South FloridaDepartment of Psychiatry, University of South Florida
  • , Eric A. StorchAffiliated withDepartment of Psychology, University of South FloridaDepartment of Pediatrics, University of South FloridaDepartment of Psychiatry, University of South FloridaDepartment of Pediatrics, University of South Florida Email author 

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Abstract

Family accommodation of symptoms is counter to the primary goals of cognitive-behavioral therapy for pediatric obsessive-compulsive disorder (OCD) and can pose an obstacle to positive treatment outcomes. Although increased attention has been given to family accommodation in pediatric OCD, relatively little is known about associated child and parent characteristics, and their mediating/moderating effects. This study examined a structural equation model of parent and child variables related to parent reports of family accommodation. Sixty-one children with OCD (ages 6–17 years, 39% female) and their parents were recruited from a university-based clinic. They were administered clinician- and parent-rated measures of child OCD symptom severity, OCD-specific impairment, internalizing problems, and externalizing problems as well as parent anxiety, depression, empathy, consideration of future consequences, and accommodation. Results generally supported the hypothesized model. Family accommodation mediated the relationship between OCD symptom severity and parent-rated functional impairment; child internalizing problems mediated the relationship between parent anxiety and family accommodation; and parent empathy and consideration of future consequences interacted to predict family accommodation. Child externalizing problems were significantly associated with family accommodation but neither of these two variables was associated with parent depression. Findings suggest that reductions in family accommodation might be maximized by routinely screening for comorbid psychopathology in children with OCD and their parents, and using prescriptive or modular approaches to intervention. Directions for future research are discussed.

Keywords

Obsessive-compulsive disorder Children Treatment Assessment Family accommodation