Although long recognized in the clinical literature, obsessive-compulsive disorder in children has not received the attention given to the disorder in adults. There have been few reports of behavioral treatments with children, and the existing literature is composed largely of case studies employing one or more behavioral techniques as part of a treatment package. Most reports demonstrate a positive effect, but no treatment has demonstrated superiority, and the general outcome effect is much less than optimistic. The role of etiology, of epidemiology, of families in treatment, and of associated conditions are reviewed, and considerations for future investigations are offered.
Get full access to this article
View all access options for this article.
References
1.
Alban, L. S. , & Nay, W. R. (1976). Reduction of ritual re-checking by a relaxation-delay treatment. Journal of Behavior and Experimental Psychiatry, 7, 151-154.
2.
Apter, R. , Bernhout, E., & Tynno, S. (1984).Severe OCD in adolescence: A report of eight cases. Journal of Adolescence, 7, 349-358.
3.
Bear, L. & Minichiello, W. E. (1986). Behaviortherapy for obsessive compulsive disorder. In M. Jenike, L. Bear, W. E. Minicheillo (Eds.), Obsessive compulsive disorder (pp. 45-75). Littletown, MA: PSG Publications.
4.
Berg, C. J. , Rapoport, J. L., & Flament, M. (1980). The Leyton Obsessional Inventory-Child version. Journal of the American Academy of Child Psychiatry, 25, 84-91.
5.
Boersma, K. , Hengst, S. D., Dekker, J., & Emmelkamp, P. M. C. (1976). Exposure and response prevention in the natural environment: A comparison with obsessive-compulsive patients. Journal of Behavioral Research and Therapy, 14, 19-24.
6.
Bolton, D. , Collins, S., & Steinberg, D. (1983). Treatment of OCD in Adolescence: A report of 15 cases. British Journal of Psychiatry, 142, 456-464.
7.
Campbell, L. M. (1973). A variation of thought-stopping in a 12-year-old boy: A case report. Journal of Behavior and Experimental Psychiatry, 4, 69-70.
8.
Clark, D. R. , & Bolton, D. (1985). An investigation of two self-report measures of obsessional phenomena: Obsessive-compulsive adolescents. Research note. Journal of Child Psychology and Psychiatry, 26, 429-437.
9.
Dalton, P. (1983). Family treatment of an obsessive compulsive child: A case report. Family Process, 22, 99-108.
10.
Emmelkamp, P. M. G. , Kuipert, A. C. M., & Eggeraat, J. B. (1978). Cognitive modification vs prolonged exposure in vivo: A comparison with agoraphobics as subjects. Behavior Research and Therapy, 16, 33-41.
11.
Fine, S. (1973). Family therapy and a behavioral approach to childhood obsessive-compulsive neurosis. Archives of General Psychiatry, 28, 695-697.
12.
Flament, M. F. , Rapoport, J. L., Berg, C. J., & Kilts, C. (1985). A controlled trial of Clomipramine in childhood OCD. Psychopharmacology Bulletin, 21, 150-152.
13.
Flament, M. F. , Rapoport, J. L., Berg, C. J., Sceery, W., Kilts, C., Mellstrom, B., & Linnoila, M. (1985). Clomipramine treatment of childhood OCD. Archives of General Psychiatry, 42, 977-983.
14.
Flament, M. , Rapoport, J., Whitaker, A., Berg, C., & Sceery, W. (1985). Obsessive-compulsive disorders in adolescents: An epidemiological study. Paper presented at the 32nd meeting of the American Academy of Child Psychiatry, San Antonio, TX.
15.
Foa, E. B. (1979). Failures in treating obsessive compulsives. Behavior Research and Therapy, 17, 169-176.
16.
Foa, E. B. , & Steketee, G. (1977). Emergent fears during treatment of three obsessive compulsives: Symptom substitutions or deconditioning?Journal of Behavior Therapy and Experimental Psychiatry, 8, 353-358.
17.
Foa, E. B. , Steketee, G., Grayson, J. B., Turner, R. M., & Latimer, B. R. (1984). Behavior Therapy, 15, 450-472.
18.
Freud, S. (1955a). Obsessions and phobias: Their psychical mechanisms and their etiology. In J. Strachey (Ed.) Collected papers (Vol. 1, standard ed., pp. 128-137). London: Hogarth Press.
19.
Freud, S. (1955b). The disposition of obsessional neurosis. In J. Strachey (Ed.) The standard edition of the collected works of Sigmund Freud. London: Hogarth Press.
20.
Freidmann, C. D. H. , & Silvers, F. M. (1977). A multimodality approach to inpatient treatment of obsessive compulsive disorder. American Journal of Psychotherapy, 31, 450-465.
21.
Grad, L. , Pelcovitz, D., Olsen, M., Matthews, M., & Grad, G. (in press). Presence of obsessive-compulsive symptoms in children with Tourettes disorder. Journal of the American Academy of Child Psychiatry.
22.
Hackman, A. , & McLean, C. (1975). A comparison of flooding and thought stopping in the treatment of obsessional neurosis. Behavioral Research and Therapy, 13, 263-269.
23.
Hafner, R. J. , Gilchrist, P., Bowling, J., & Kalucy, R. (1981). The treatment of obsessional neurosis in a family setting. Australia and New Zealand Journal of Psychiatry, 15145-151.
24.
Hall, M. (1935). Obsessive-compulsive states in childhood. Archives of Diseases of Children, 10, 49-59.
25.
Hay, W. M. , Hay, L. R., Nelson, R. 0. (1977). The adaptation of covert modeling procedures to the treatment of chronic alcoholism and obsessive compulsive behaviors. Behavior Therapy, 8, 70-76.
26.
Haynes, R. (1978). Treatment of an obsessive compulsive checker. Behavior Research and Therapy, 16, 136-137.
27.
Hoover, C. F. , & Insel, T. R. (1984). Families of origin in OCD. Journal of Nervous and Mental Disease, 172, 207-215.
28.
Janet, P. (1903). Les obsessions et la psychiastnenie (Vol. 1) Paris: Felix Alcan.
29.
Kasvikis, Y. , Tsakiris, F., Marks, I., Basough, M., & Noshirvani, N. (in press). Women with obsessive compulsive disorder frequently report a past history of anorexia nervosa. International Journal of Eating Disorders.
30.
Melamed, B. G. , & Siegel, L. G. (1975). Self-directed in vivo treatment of an obsessive compulsive checking ritual. Journal of Behavior Therapy and Experimental Psychiatry, 6, 31-35.
31.
O'Brien, J. S. , & Raynes, A. E. (1973). Treatment of compulsive verbal behavior with response contingent punishment and relaxation. Journal of Behavior Therapy and Experimental Psychiatry, 4, 347-352.
32.
Ong, S. B. , & Leng, V. K. (1979). The treatment of an obsessive compulsive girl in the context of Malaysian Chinese culture. Australia and New Zealand Journal of Psychiatry, 13, 255-259.
33.
Ownby, R. L. (1983). A cognitive behavioral intervention for compulsive handwashing with a thirteen-year-old boy. Psychology in the Schools, 20, 219-222.
34.
Phillips, D. , & Wolpe, S. (1981). Multiple behavioral techniques in severe separation anxiety of a 12 year old. Journal of Behavior Therapy and Experimental Psychiatry, 12, 329-332.
35.
Post, R. , Korin, J. V., & Goodwin, F. K. (1973). Tetrahyorocann Abinol (THC) in depressed patients. Archives of General Psychiatry, 28, 345-352.
36.
Queiroz, L. , Motta, M., Madi, M., Sossai, D., & Boren, J. J. (1981). A functional analysis of obsessive-compulsive problems with related therapeutic procedures. Behavior Research and Therapy, 18, 377-388.
37.
Rapoport, J. , Elkins, R., Mikkelson, E. (1980). Clinical controlled trial of Chlorimipramine in adolescents with obsessive compulsive disorder. Psychopharmacology Bulletin, 16, 61-63.
38.
Solyom, L. , & Kingstone, E. (1973). An obsessive neurosis following morning glory seed ingestion treated by aversion relief. Journal of Behavior Therapy and Experimental Psychiatry, 4, 293-295.
39.
Thoren, P. , Asberg, M., & Cronholm, B. (1980). Clomipramine treatment of obsessive-compulsive disorder: I. A controlled clinical trial. Archives of General Psychiatry, 37, 1281-1285.
40.
Warneke, L. B. (1985). Intravenous Cholorimipramine in the treatment of obsessional disorder: Case report. Journal of Clinical Psychiatry, 46, 100-103.
41.
Weiner, I. B. (1967). Behavior therapy in obsessive compulsive neurosis. Psychotherapy: Theory Research and Practice, 4, 27-29.
42.
Weiner, A. , Reich, T., & Robins, E. (1976). Obsessive compulsive neurosis: Record follow-up and family studies. Comprehensive Psychiatry, 17, 527-539.
43.
Zetzel, E. (1966). Additional notes upon a case of obsessional neurosis. International Journal of Psychoanalysis, 47, 123-129.
44.
Zikis, P. (1983). Treatments of an 11 year old ritualizer and tiquer girl with in vivo exposure and response prevention. Behavioral Psychotherapy, I1, 75-81.
