Obsessive Compulsive Disorder (OCD)

Introduction

Obsessive Compulsive Disorder (OCD) is a unbearable disorder characterised by recurrent obsessions and compulsions that root major impairment in an individual's every day functioning (Kendall, 27). Adults diagnosed with OCD often realise that their obsessions or compulsions are excessive or unreasonable; however, children with OCD may not be able make this determination. The individual's obsessions and/or compulsions cause significant distress and can significantly interfere with social, school, and occupational activities, and relationships. Given the intrusive nature of OCD's symptomatology and the distress that the disorder causes, it is imperative that school psychologists are aware of the nature of the disorder and how to accurately diagnose and treat children with OCD.

Discussion

OCD can occur in children as young as 4 years old (Chansky, 115), with a mean age of onset occurring between 6 and 11 years of age and bimodal peaks in early childhood and early adolescence (Kendall, 26). More than a million children in the United States suffer from OCD (Silverman, 71), and OCD has a lifelong prevalence estimated at 1% (Chansky, 116). Pauls found that 80% of adults with OCD identify the onset of symptoms before the age of 18 years. Rates of OCD in individuals vary from study to study; however, it is generally accepted in the literature (Kendall, 27) that OCD affects 2% to 3% of the total population. It is estimated that 1 in 200 youngsters experience diagnosable OCD (Chansky, 117). However, many researchers conclude that OCD is underreported in children and youth because of an inability to properly recognise and diagnose the disorder. OCD is more common in boys than girls; however, by adulthood, OCD occurs equally across the sexes. Developmentally, most children experience minor obsessive-compulsive symptoms as part of the normal process of achieving mastery and control over their environment. However, the difference between normative obsessions or compulsions and pathological symptoms is that OCD symptoms produce “dysfunction rather than mastery” (Silverman, 70).

OCD is best conceptualised as a neurobehavioural disorder (March, 82). The etiology of OCD is complex, with evidence supporting a genetic component (Swedo, 338), faulty circuitry between the basal ganglia to the cortex, and neurotransmitter and neuroendocrine abnormalities (Kendall, 27). Additionally, in a subgroup of children with OCD, symptoms may develop or be exacerbated by the presence of group A ß-hemolytic streptococcus (GABHS) infection. This onset is known as “pediatric autoimmune neuropsychiatric disorder associated with streptococcus” (PANDAS) (Chansky, 117). Research supports ...