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Distinguishing Fear Versus Distress Symptomatology in Pediatric OCD

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Abstract

Prior research has identified OCD subtypes or “clusters” of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7–17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment.

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Notes

  1. It should be noted that the MASC harm avoidance subscale and use of the phrase “harm avoidance” in this paper refers to perfectionism and anxious coping. This is distinct from use of the term “harm avoidance” to describe intrusive aggressive/harm thoughts in OCD. In this paper, we use “harm avoidance” to describe the MASC subscale, and the term “aggression” to describe OCD symptoms related to harm to self or others.

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Acknowledgments

This work was supported by the NIH/NCATS UCLA CTSI UL1TR000124 (Rozenman), NIMH K23 MH085058 (Peris), NIMH R01 081864 (O’Neill, Piacentini), and NIMH R01MH58549 (Piacentini). The authors would like to acknowledge and thank the children and their parents who participated in this research.

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  1. Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA

    Michelle Rozenman, Tara Peris, R. Lindsey Bergman, Susanna Chang, Joseph O’Neill, James T. McCracken & John Piacentini

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  1. Michelle Rozenman
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Correspondence to Michelle Rozenman.

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Rozenman, M., Peris, T., Bergman, R.L. et al. Distinguishing Fear Versus Distress Symptomatology in Pediatric OCD. Child Psychiatry Hum Dev 48, 63–72 (2017). https://doi.org/10.1007/s10578-016-0653-4

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