Skip to main content
SpringerLink
Log in

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

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • 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.

    Article  PubMed  Google Scholar 

  • American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn., text rev.) (Vol. 4). Washington, DC: Author.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • First, M., Spitzer, R., Gibbon, M., & et al. (1996). Structured clinical interview for DSM_IV Axis I disorder, Patient Edition (SCID-P).

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Geller, D. A. (2006). Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatric Clinics of North America, 29(2), 353–370.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Kovacs, M. (1992). Children’s depression inventory. New York: Multi-Health Systems.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    PubMed  PubMed Central  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Maina, G., Saracco, P., Albert, U., & Bogetto, F. (2006). Family-focused treatments for obsessive-compulsive disorder. Clinical Neuropsychiatry, 3(6), 382–390.

    Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Steketee, G., & Van Noppen, B. (2003). Family approaches to treatment for obsessive compulsive disorder. Revista Brasileira Psiquiatria, 25(1), 43–50.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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  Google Scholar 

Download references

Acknowledgments

This study was funded by a Grant awarded to Dr. Rasmussen from the National Institutes of Health, Bethesda, MD (Grant Number: R01-MH-060218).

Author information

Authors and Affiliations

  1. Department of Psychology, Kent State University, 600 Hilltop Drive, Kent, OH, 44242, USA

    Sarah K. Francazio & Christopher A. Flessner

  2. Butler Hospital, Providence, RI, USA

    Christina L. Boisseau, Nicholas J. Sibrava & Maria C. Mancebo

  3. Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA

    Christina L. Boisseau, Nicholas J. Sibrava, Maria C. Mancebo, Jane L. Eisen & Steven A. Rasmussen

Authors
  1. Sarah K. Francazio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher A. Flessner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christina L. Boisseau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicholas J. Sibrava
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria C. Mancebo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jane L. Eisen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Steven A. Rasmussen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah K. Francazio.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Francazio, S.K., Flessner, C.A., Boisseau, C.L. et al. Parental Accommodation Predicts Symptom Severity at Long-Term Follow-Up in Children with Obsessive–Compulsive Disorder: A Preliminary Investigation. J Child Fam Stud 25, 2562–2570 (2016). https://doi.org/10.1007/s10826-016-0408-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-016-0408-7

Keywords

Search

Navigation