Obsessive Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) in Children

Obsessive-Compulsive Disorder (OCD) in childhood is characterized by recurrent and persistent obsessions and/or compulsions that cause distress or interfere with daily life.

Obsessions are involuntary thoughts or feelings that repeatedly arise in the child’s mind and are often frightening, disgusting, or bothersome. These are not simply excessive worries about real-life problems. Examples of obsessions include fears that something bad will happen to a loved one if a compulsion is not performed, or fears of contamination or illness.

Compulsions are repeated behaviors or rituals performed rigidly in response to an obsession, usually aimed at preventing some dreaded event or situation. Examples of compulsions in children include repeated hand washing, dressing in a specific way, checking things like doors, windows, light switches, or homework, excessive erasing or rewriting, or repeating certain words, phrases, or numbers. Children often ask family members for reassurance and may involve them in rituals.

OCD can lead to significant avoidance (e.g., not touching doorknobs) and emotional distress. Cognitive-behavioral therapy (CBT) and certain medications have been shown to be effective treatments for OCD. CBT for OCD is based on the technique of exposure with response prevention (ERP). In ERP, children are gradually exposed to feared situations (exposure) while being guided to refrain from engaging in their ritualistic behaviors (response prevention). They are also taught to challenge distorted thoughts and use alternative coping skills.