Obsessive-compulsive disorder (OCD) is an anxiety condition in which a child is plagued by unwanted thoughts, images or impulses (called obsessions) that he attempts to fend off or neutralize by performing compulsions (ritualized or repeated behaviors).


  • Ritualized or compulsive behavior such as repeated hand washing, locking and relocking doors, or touching things in a certain order
  • Extreme or exaggerated fears of contamination, family members being hurt or harmed, or doing harm themselves.
  • Use of “magical thinking,” particularly in young children. (“If I touch everything in the room, Mom won’t be killed in a car accident.”)
  • Repeatedly seeking assurances about the future
  • Intolerance for certain words or sounds


  • Brain dysfunction (particularly in an area called the basal ganglia)
  • Genetics (the disorder appears to run in families)
  • Environmental factors (children who see adults consistently responding to stress with compulsive behavior can develop similar behaviors)


OCD is best treated with cognitive behavior therapy (CBT), specifically exposure and response prevention, which habituates a child to the objects of his obsession by exposing him to them in small increments, thereby reducing his anxiety.

If the OCD is severe, it is often treated with a combination of CBT and medication, which can reduce anxiety enough to allow the child to react better to exposure therapy.