Parental Accommodation Predicts Symptom Severity at Long-term Follow-Up in Children with Obsessive-Compulsive Disorder.

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.

Cognitive flexibility differentiates young adults exhibiting obsessive-compulsive behaviors from controls.

The National Institute of Mental Health has proposed a shift toward classifying clusters of disorders on the basis of underlying biomarkers and neurological correlates. The present study sought to determine whether cognitive flexibility represents one such construct underlying obsessive-compulsive behaviors (OCBs), a cluster of behaviors characteristic of OCD and other body-focused repetitive behaviors (BFRBs), including trichotillomania, pathological skin picking, nail biting, and tic disorders. One-hundred and twenty-four undergraduate students completed the Depression Anxiety and Stress Scales, Padua Inventory-Washington State University Revision, Massachusetts General Hospital-Hairpulling Scale, Skin Picking Scale, and an Intradimensional/Extradimensional Shift (IDED) Test. Analyses were performed using a subsample of participants who met criteria for inclusion in the OCB group and a control group (N=56). Results indicated that young adults in the OCB group demonstrated significantly poorer performance on the IDED compared to controls. However, hierarchical regression analyses revealed that increased deficits in cognitive flexibility failed to predict worsened OCB severity-as assessed via a composite score. These results suggest that while cognitive flexibility differentiates those exhibiting OCBs from controls, it does not appear to be related to OCB severity. Future research is needed to replicate these results in larger clinical samples.

Parent psychopathology as a mediator of the relationship between anxiety and sleep problems in children.

INTRODUCTION: Sleep problems exert a negative impact on youths and their families. Parent and child mental health represent 2 posited, yet understudied, risk factors for sleep problems in youths. As such, this study sought to examine the role that parental psychopathology may play in mediating the relationship between child anxiety and sleep problems utilizing Internet sampling procedures. METHOD: Parents (n = 83; 90.4% female) answered questions about their own mental health, and about their child's (n = 83; 77.1% female) anxiety and sleep. RESULTS: Analyses found that parent anxiety and stress mediated the relationship between child anxiety and sleep problems. DISCUSSION: This is the first study to examine the joint roles of parent psychopathology and child anxiety in explaining sleep problems in youths. Limitations notwithstanding, these results suggest that both parent- and child-level variables are important for developing a more comprehensive understanding of child sleep problems. Future areas of research are discussed.