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Family Accommodation in Pediatric Obsessive–Compulsive Disorder: Investigating Prevalence and Clinical Correlates in the NordLOTS Study

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Family accommodation (FA) involves the actions taken by family members, particularly parents, to accommodate a child´s obsessive–compulsive disorder (OCD) symptoms, reducing distress or impairment. This behavior may maintain compulsive and avoidant behavior, preventing corrective learning or habituation. This study aims to investigate the prevalence and factors influencing FA in a large Scandinavian sample of children with OCD. We assessed 238 children using standardized diagnostic interviews, OCD symptom severity assessments and questionnaires evaluating functional impairment and internalizing and externalizing symptoms. FA was measured using the Family Accommodation Scale, a 12-item clinician-rated interview. Our results confirmed a high frequency of accommodation, with approximately 70% of primary caregivers reporting some accommodation daily and 98% at least once per week. FA was associated with increased OCD symptom severity, contamination/cleaning symptoms, internalizing and externalizing behavior, and functional impairment. Linear regression analysis showed that high levels of FA are specifically associated with lower age, higher OCD symptom severity, parent-reported impairment, internalizing, and externalizing symptoms. A path analysis revealed that FA partially mediated the relationship between OCD severity, externalizing symptoms, and child’s age, highlighting the role of FA in the progression of OCD and related symptoms. The findings emphasize the importance of evaluating FA before initiating treatment and specifically addressing it during the therapeutic process.

TidsskriftChild Psychiatry and Human Development
StatusE-pub ahead of print - 8 nov. 2023

Bibliografisk note

Funding Information:
The Stiftelsen Clas Groschinskys Minnesfond Agreement concerning the research and education of doctors in Region Västra Götaland, TrygFonden, The Lundbeck Foundation, Central Region Denmark’s Research Fund, The Danish Council for Strategic Research, the Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), the Norwegian Research Council, and the Norwegian Extra Foundation supported the research presented in this article through project grants. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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