Overview:

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).

Symptoms:

  • 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

Causes:

  • 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)

Treatment:

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.

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