Clinical significance of family accommodation and parental psychological distress in a sample of children and adolescents with obsessive-compulsive disorder aged 8-17 years old

Abstract

Background Family Accommodation (FA) refers to the involvement of family members (especially parents) in the compulsive behaviors of children and adolescents with Obsessive-Compulsive Disorder (e.g. modifying family routines or facilitating avoidance of obsessive-compulsive triggers). Many studies have examined the high prevalence of FA in this clinical population; however, less is known about its clinical significance and relationship to the individual psychological distress of parents. In our study, we investigated the clinical significance of FA examining its relationship with obsessive-compulsive symptomatology, functioning, anxiety and depressive symptoms in a clinical sample (n = 51) of children and adolescents with Obsessive-Compulsive Disorder (OCD) aged 8–17 years old and their parents, included to examine their individual psychological distress. Methods The sample was divided into two groups: the High Accommodation group (n = 36) and the Low Accommodation group (n = 15). Results Results demonstrated that children and adolescents in the OCD High Accommodation group reported major functional impairment in global (p = .001313), social (p = .000334) and role (p = .000334) domains, and higher depressive symptoms than the Low Accommodation group. Both fathers and mothers from the High Accommodation group reported a higher level of individual psychological distress compared to mothers and fathers from the Low Accommodation group (p = .040365). Conclusions The findings of this study show that FA is common in children and adolescents with OCD and it could cause not only an impairment of the patient’s global, social and role functioning but also a high level of individual psychological distress in the single parent. The presence of FA should therefore be carefully investigated and considered in planning assessment and treatment of OCD in children and adolescents.

Parental perception matters: Reciprocal relations between adolescents’ depressive symptoms and parental perceptions.

“…When cognitive behavioral therapy that is designed to decrease anxiety symptoms is applied to adolescents, the intervention can also ameliorate depressive symptoms (e.g., Ishikawa et al, 2019). Some studies have also shown that adolescents with high accommodation tend to have greater depressive symptoms than those with low accommodation (e.g., Kobayashi et al, 2017; Pontillo et al, 2020).…”

Anxiety in Autism Spectrum Disorder: Clinical Characteristics and the Role of the Family

“…Additionally, the role of Parental Psychological Distress (PPD) in families of children and adolescents with ASD and AD should not be underestimated. PPD is defined as family members’ distress, resulting in high levels of family conflict and increased expressed emotions, defined as criticism, hostility, and emotional over-involvement [ 10 , 11 ]. Parents of children with ASD have higher parental stress levels and lower quality of life than parents of normotypical children [ 12 , 13 , 14 , 15 ], similar to parents with disabled children (e.g., Down syndrome, cerebral palsy, and intellectual disability) [ 16 , 17 , 18 ].…”

Predictors of Parental Accommodation and Response Treatment in Young Children With Obsessive-Compulsive Disorder

“…Mainly, high rates of accommodation among families of children with OCD suggest that up to 60-96% of relatives modify their family routines and even perform the child's rituals (22,(26)(27)(28)(29)(30)(31)(32). Second, the absence of or little introspection of minors can hinder involvement in treatment; also, the parents can participate as co-therapists and carry out exposure tasks at home, allowing us to come closer to ideal treatment as this contributes both to generalizing and maintaining achievements, and so on (5,14,(33)(34)(35)(36).…”