Family accommodation in obsessive–compulsive disorder

Lebowitz, Eli R.; Panza, Kaitlyn E.; Su, Jessica; Bloch, Michael H.

doi:10.1586/ern.11.200

Cited by 206 publications

(174 citation statements)

References 60 publications

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“…Family accommodation has been a frequently studied construct among patients with OCD [18], with recent investigations extending into anxious youth [19,20]; however, despite commonly observing this phenomenon in families of youth with TS, no data have directly examined family accommodation among youth with TS. Across pediatric OCD and anxiety, accommodation is ubiquitous, occurring to some degree in virtually all families [14,[21][22][23][24][25][26][27].…”

mentioning

confidence: 99%

An initial study of family accommodation in children and adolescents with chronic tic disorders

Storch

Johnco

McGuire

et al. 2016

Eur Child Adolesc Psychiatry

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This initial study examined the nature, incidence, and clinical correlates of family accommodation in youth with tic disorders, and validated a brief self-report measure of tic-related family accommodation, the Tic Family Accommodation Scale (TFAS). Seventy-five youth aged 6-18 who were diagnosed with a tic disorder and their parent completed a diagnostic clinical interview, and clinician and parent-report measures of tic severity, depressive symptoms, anxiety symptoms, behavioral problems, family accommodation and impairment. An exploratory factor analysis of the TFAS showed a two-factor structure, with good internal consistency for the Total score, Modification of Child Environment and Modification of Parent Environment subscales (α = 0.88, 0.86, and 0.81, respectively). Family accommodation was not associated with tic severity. Family accommodation was associated with increased anxiety and depressive symptoms, higher externalizing, rule breaking, aggressive behaviors and social problems, and with greater tic-related functional impairment. Anxiety and externalizing problems (but not depressive symptoms) predicted family accommodation when controlling for tic severity. Family accommodation predicted high levels of functional impairment over and above the effect of tic severity, anxiety, depression and externalizing problems. Family accommodation is a common phenomenon for youth with tic disorders, with modifications typically encompassing changes to the child and/or parent environments. Accommodation was not associated with tic severity, but was related to higher levels of anxiety, depressive symptoms, externalizing symptoms, aggression, and rule breaking behaviors. Results suggest that other emotional symptoms are more likely to drive accommodation practices than the tic symptoms per se.

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mentioning

confidence: 99%

An initial study of family accommodation in children and adolescents with chronic tic disorders

Storch

Johnco

McGuire

et al. 2016

Eur Child Adolesc Psychiatry

View full text Add to dashboard Cite

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“…Further, and crucially, it is clear that while some coping strategies may facilitate adaptation, others -in this context, accommodating or ignoring a child's symptoms for example -may obstruct the process. (Albert et al, 2010;Lebowitz et al, 2012;Peay, Rosenstein, & Biesecker, 2013) It is important that interventions for supporting the long-term adaptation process of parents of children with OCD are developed, refined, and implemented, both for parental well-being and to improve outcomes for affected children via optimized family functioning. (Peris et al, 2012) Genetic counseling, which involves comprehensive discussion of, and supportive counseling around, genetic and environmental contributions to conditions in families(National Society of Genetic Counselors' Definition Task Force et al, 2006), is ideally placed to support parents in their journey of adapting to their child's OCD, and indeed directly addresses several of the important concepts that emerged from our data, in particular family history of mental illness, conceptualizing the meaning of OCD, stigma, and navigating the impact of OCD on family dynamics.…”

Section: Discussionmentioning

confidence: 99%

“…At one end of the spectrum were parents' day-to-day decisions, such as with whom to socialize or whether to go on vacation, which were related to accommodating their child's OCD (Albert et al, 2010;Lebowitz et al, 2012). More specifically, parents described changing their behavior to appease their child.…”

Section: Processes Of Parental Adaptationmentioning

confidence: 99%

“…OCD has well-documented and unique impacts on family functioning, primarily related to parental accommodation of symptoms. Accommodation represents a counter-therapeutic process that involves parents enabling children's avoidance of triggers and assisting in their rituals (Albert et al, 2010;Lebowitz, Panza, Su, & Bloch, 2012). Individuals with OCD and their relatives experience significant stigmatization associated with the disorder, and fear of this stigma often results in concealment of the illness and delayed help-seeking (Hansson, Jormfeldt, Svedberg, & Svensson, 2013;Simonds & Thorpe, 2003;Stengler-Wenzke, Trosbach, Dietrich, & Angermeyer, 2004b).…”

Section: Introductionmentioning

confidence: 99%

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Obsessive‐Compulsive Disorder: The Process of Parental Adaptation and Implications for Genetic Counseling

Andrighetti

Semaka

Stewart

et al. 2015

Journal of Genetic Counseling

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Obsessive-compulsive disorder (OCD) has primarily pediatric onset and well-documented unique impacts on family functioning. Limited research has assessed the understanding that parents of children with OCD have of the etiology of the condition, and there are no data regarding potential applications of genetic counseling for this population. We recruited 13 parents of 13 children diagnosed with OCD from the OCD Registry at British Columbia Children's Hospital, and conducted qualitative semi-structured telephone interviews to explore participants' experiences with their child's OCD, causal attributions of OCD, and perceptions of two genetic counseling vignettes. Interviews were audio-recorded, transcribed, and analyzed using elements of grounded theory qualitative methodology. Analysis revealed key components and contextual elements of the process through which parents adapt to their child's OCD. This adaptation process involved conceptualizing the meaning of OCD, navigating its impact on family dynamics, and developing effective illness management strategies. Adaptation took place against a backdrop of stigmatization and was shaped by participants' family history of mental illness and their child's specific manifestations of OCD. Parents perceived genetic counseling, as described in the vignettes, as being empowering, alleviating guilt and blame, and positively impacting treatment orientation. These data provide insight into the process of parental adaptation to pediatric OCD, and suggest that genetic counseling services for families affected by OCD may help facilitate adaptation to this illness.

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“…These behaviours are often conceptualised as a requirement to maintain the balance in family (family system theory), a rewarding behaviour (social exchange theory) and a change in the caregiver's role and identity in relation to the care recipient (caregiver identity theory) (5). It inadvertently validates irrational thoughts, and reinforces the patient behaviour (6). The level of compliance (proxy compulsion or accommodation) depends upon the quality of interpersonal relationship, the personality of the person who carries out the proxy acts, the severity of OCD, the role of the person suffering from OCD and knowledge about the illness (3, 7).…”

Section: Discussionmentioning

confidence: 99%