Abstract
Family accommodation of symptoms is counter to the primary goals of cognitive-behavioral therapy for pediatric obsessive-compulsive
disorder (OCD) and can pose an obstacle to positive treatment outcomes. Although increased attention has been given to family
accommodation in pediatric OCD, relatively little is known about associated child and parent characteristics, and their mediating/moderating
effects. This study examined a structural equation model of parent and child variables related to parent reports of family
accommodation. Sixty-one children with OCD (ages 6–17 years, 39% female) and their parents were recruited from a university-based
clinic. They were administered clinician- and parent-rated measures of child OCD symptom severity, OCD-specific impairment,
internalizing problems, and externalizing problems as well as parent anxiety, depression, empathy, consideration of future
consequences, and accommodation. Results generally supported the hypothesized model. Family accommodation mediated the relationship
between OCD symptom severity and parent-rated functional impairment; child internalizing problems mediated the relationship
between parent anxiety and family accommodation; and parent empathy and consideration of future consequences interacted to
predict family accommodation. Child externalizing problems were significantly associated with family accommodation but neither
of these two variables was associated with parent depression. Findings suggest that reductions in family accommodation might
be maximized by routinely screening for comorbid psychopathology in children with OCD and their parents, and using prescriptive
or modular approaches to intervention. Directions for future research are discussed.
disorder (OCD) and can pose an obstacle to positive treatment outcomes. Although increased attention has been given to family
accommodation in pediatric OCD, relatively little is known about associated child and parent characteristics, and their mediating/moderating
effects. This study examined a structural equation model of parent and child variables related to parent reports of family
accommodation. Sixty-one children with OCD (ages 6–17 years, 39% female) and their parents were recruited from a university-based
clinic. They were administered clinician- and parent-rated measures of child OCD symptom severity, OCD-specific impairment,
internalizing problems, and externalizing problems as well as parent anxiety, depression, empathy, consideration of future
consequences, and accommodation. Results generally supported the hypothesized model. Family accommodation mediated the relationship
between OCD symptom severity and parent-rated functional impairment; child internalizing problems mediated the relationship
between parent anxiety and family accommodation; and parent empathy and consideration of future consequences interacted to
predict family accommodation. Child externalizing problems were significantly associated with family accommodation but neither
of these two variables was associated with parent depression. Findings suggest that reductions in family accommodation might
be maximized by routinely screening for comorbid psychopathology in children with OCD and their parents, and using prescriptive
or modular approaches to intervention. Directions for future research are discussed.
- Content Type Journal Article
- Pages 1-11
- DOI 10.1007/s10802-011-9549-8
- Authors
- Nicole E. Caporino, Department of Psychology, University of South Florida, Tampa, FL, USA
- Jessica Morgan, Department of Pediatrics, University of South Florida, Tampa, FL, USA
- Jason Beckstead, College of Nursing, University of South Florida, Tampa, FL, USA
- Vicky Phares, Department of Psychology, University of South Florida, Tampa, FL, USA
- Tanya K. Murphy, Department of Pediatrics, University of South Florida, Tampa, FL, USA
- Eric A. Storch, Department of Psychology, University of South Florida, Tampa, FL, USA
- Journal Journal of Abnormal Child Psychology
- Online ISSN 1573-2835
- Print ISSN 0091-0627