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Obsessive Compulsive Disorder in Children

Obsessive-Compulsive Disorder (OCD) is characterized by intense obsessions and/or compulsions that significantly interfere with daily functioning. Obsessions are recurrent and persistent unwanted thoughts, impulses, or images that are usually irrational and cause the child to have negative feelings such as anxiety, doubt, or feelings of incompleteness. Compulsions are intentional and repetitive behaviors that serve to quiet these thoughts and the negative emotions that accompany them.

Some examples of obsessions and the accompanying compulsions are listed below. It is important to note that for a diagnosis of OCD, the pattern of obsessions and/or compulsions must cause significant impairment to the person's life. Having the thought "Did I lock the door?" and going back to check once is not a sign of OCD. But going back to check it several times may be indicative of an anxiety disorder.

 

Obsessions Compulsions

 

  • Constant, irrational worry about dirt, germs, or contamination
  • Cleaning (e.g., repeatedly washing one's hands, bathing, or cleaning household items
  • Excessive concern with order, arrangement, or symmetry
  • Checking (e.g., doors are locked, the stove is turned off, the hairdryer is unplugged)
  • Fear that negative or aggressive thoughts or impulses will cause personal harm or harm to a loved one
  • Repeating (e.g., inability to stop repeating a name, phrase, or simple activity
  • Preoccupation with losing or throwing away objects with little or no value
  • Hoarding (difficulty throwing away useless items such as old newspapers or magazines, bottle caps, or rubber bands)

 

Obsessions and compulsions may vary with age. For example, a younger child may worry that he or his family will be harmed by an intruder breaking into the house (Obsession). So he will check all the doors and windows to make sure they’re locked. But he may then fear that he accidentally unlocked a door while checking, and will go back through the ritual a second, third, fourth time (Compulsion). An older child or a teenager with OCD may fear that she will become ill with germs, so she may cope through excessive hand washing, refusing to touch door knobs with her bare hand, or refusing to use restrooms away from home.

One important factor with OCD is that the person continues to have the obsessions or compulsions despite realizing that they are unreasonable. This can lead to feelings of shame or embarrassment for children who suffer from OCD, and they may be hesitant to disclose what is happening for them. Good communication between parents and children can increase understanding of the problem and help the parents appropriately support their child.

Research shows that OCD is a neurological disorder and that it tends to run in families, but this is not a direct correlation meaning that parents with OCD will not definitely pass it down to their children. Likewise, children may develop OCD even if there is no history of OCD in the family. As it is a neurological disorder and tends to run in the family, the most effective intervention is a combination of medication, individual therapy, and family therapy.

 

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