Pediatric OCD. Joe Edwards, Psy.D. Stephanie Eken, M.D. David Causey, Ph.D. Prevalence of OCD in children. OCD is considerably more common than once thought 1 in 200 are thought to suffer from OCD 3 or 4 in each elementary school have it
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Joe Edwards, Psy.D.
Stephanie Eken, M.D.
David Causey, Ph.D.
OCD is characterized by recurrent obsessions and/or compulsions that cause marked distress and interference with social or role functioning
Children may present with either obsessions or compulsions (most have both)
In youth, the types of symptoms, can change rapidlyDSM-IV criteria for OCD
Harm to self or others
Need to tell, ask, confess
Washing or cleaning
PrayingCommon OCD symptoms in children
(Storch et al., 2005)
Neuropsychology has identified the following symptoms:
(which place kids at risk for dysgraphia, dyscalculia, poor written language skills, & reduced processing speed & efficiency)
Group A antigens may cross react with basal
ganglia neural tissue resulting in OCD or tic symptoms
a) discuss your goals openly with helper
b) accept encouragement for even partial
c) ask any reasonable question (not for
reassurance, and trust their opinion)
d) do not argue or get angry with your
Assessment of OCD:
Individualized diagnostic assessment:
Treatment of choice for OCD in children: is a combined treatment (CT) approach-- CBT & SSRI’s
Expert consensus treatment guidelines for 1st line treatments
CBT & SRI (or SRI alone) for severe OCD
CBT is a remarkably effective & durable TX for OCD(Dar & Greist, 1992)
While “booster” sessions may be necessary, those who are successfully treated with CBT alone tend to stay well
Relapse is more common following the discontinuance of medications
March (1994) found that improvement persisted in 6 of 9 CT responders following withdrawal from medication (CBT helps inhibit relapse)Treatment of OCD in children
1) additional assessment (psychological or medical)
4) academic and/or other behavioral interventions
10 - No Way!
8 - Really Hard
6- I’m not sure
4 - Hard
2- I’m unease
0 - No problem
Symptom List (Stimulus Hierarchy)
& Response Prevention (E/RP)
they can encourage the child to “boss back” OCD and not engage in behavior that helps reinforce OCD symptoms.
(Simons et al., 2006)
(Storch et al., 2007)