Obsessive-compulsive disorder in children and adolescents ~ Cognition and treatment

Excerpts from Zhang Hua Meiying

The Horn Voice Counseling Center held a lecture on obsessive-compulsive disorder on October 2th. The lecturer is Dr. Anne Su, a doctor of licensed psychologist, currently working at Mustard Seed Psychology, PLLC.She holds a bachelor's degree from the University of Pittsburg, majoring in neuroscience and psychology, and later received a doctorate in professional psychology from George Washington University, focusing on psychological problems in children and adolescents (18-XNUMX years old), such as autism and anxiety Disorders, depression, learning disabilities, ADHD, environmental adaptation and friction with parents.

What is obsessive-compulsive disorder?

  • Obsessive-compulsive thoughts – thoughts that recursively invade the patient’s mind
  • Compulsive behavior-In order to relieve the anxiety and pain caused by obsessive thoughts, the patient frequently repeats something
  • The vicious circle between the two

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to satisfy the diagnosis of obsessive-compulsive disorder, a person must have obsessive thoughts, compulsive behaviors, or both.  

In addition, in some cases, individuals with obsessive-compulsive disorder can realize that their obsessions or behaviors are overreactive and irrational.

Moreover, the obsession or behavior must be time-consuming (more than one hour per day) or damage the individual's social, professional, or academic functions.

General symptoms of children

  • Have obsessions and behaviors
  • Pay attention to cleanliness-wash your hands often for fear of infection
  • Focus on neatness and organization
  • Repeat actions, touch, tap
  • Check and check-excessively worry about safety, often check doors and windows
  • Fear of making mistakes and hoarding
  • Too obsessed with some religious and moral issues

Causes of obsessive-compulsive disorder

  • No one knows for sure
  • It may be related to the imbalance of the neurotransmitter serotonin and dopamine.

Who can get obsessive-compulsive disorder?

  • A five-year-old child may start to have fearful thoughts and hide his behavior
  • The average age in the United States is 19.5, and one-quarter of them have the disease before the age of 14
  • Boys get sick earlier than girls, and a quarter of boys get sick before the age of 10
  • There are patients with symptoms all over the world, and the cultural background of the patients also needs to be considered.

Disease risk factors?

  • Personal temperament-hide illness, negative emotions, behavior inhibition
  • Environmental factors-physical punishment or sexual abuse as a child, major stress or trauma
  • Genetic factors-patients with a family history are more likely to develop the disease in childhood or adolescence in the next generation
  • Suicidal thoughts-more than half of the patients, if depression is added, a quarter of the patients will try to commit suicide

What is not obsessive-compulsive disorder?

  • Tell stories or pray before going to bed, separate from your parents, or behave in a stressful situation
  • It hasn't happened since the age of eight
  • Superstition or prayer of normal culture and religion
  • Addictive behaviors make emotions better (obsessive-compulsive behavior is to relieve or release bad emotions)
  • Nervous habits, such as sucking thumbs, picking skin, biting nails, pulling hair, etc., which are natural reactions, are actually caused by insufficient self-control.
  • Depression or suicidal thoughts
  • Special fear
  • Panic Disorder
  • Excessive worry, anxiety
  • Obsessive-compulsive personality disorder
  • Tics
  • Eating disorders (anorexia or bulimia)
  • Self-harm

how to respond?

  • Consult with a pediatrician to rule out physiological causes
  • Referral to a child psychiatrist
  • Check that the insurance company may have a designated doctor
  • Make an appointment with your doctor
  • While waiting to see the doctor, collect and record the child's thinking and behavior

Treatment methods and results

With the treatment of the'first line of defense', XNUMX% will get better

  • Exposure and Response Prevention (ERP)-is the most effective cognitive behavioral treatment method. Patients learn to face fearful thinking without causing unexpected behavior.This needs to be done step by step, and it also takes time to improve.
  • Drug treatment-If the above treatments are ineffective or the patient's condition is more serious, antidepressant drugs can be used to make ERP more efficient and easy to implement.

If you have any questions about the above, please refer to Child Mind Institute http://childmind.org.Also welcome to email directly to Dr.Su@Mustardseedpsychology.com