Development of OCD in Children

Anxiety and Obsessive-Compulsive Disorders
1) Describe your first experience with obsessive-compulsive disorder (OCD) (Experiences you had with the first person you diagnosed/first time you heard your child had obsessive-compulsive disorder/first time you remember your obsessive-compulsive disorder being a problem).
According to Mash and Wolfe (2015) obsessive-compulsive disorder involves disturbing and unwanted images, thoughts, or urges that will interfere with a child's mind causing a great deal of discomfort. Mark was having issues with dirt, which forced him to constantly keep washing his hands and cleaning his surroundings. This was quite strange for a child who was only 7 years old. When Mark visited a new place, he had trouble settling down as he feared there was too much dirt and germs. This would at time result in him starting to clean some spots.
2) How did you have to alter your everyday routine/routine of your child/suggestions you gave your patient and their family to help cope with _________________?
Mark's obsession was contamination and his compulsion involved cleaning. While most people would recommend that the child is kept away from his OCD triggers it is never the best strategy. Exposing Mark to his OCD triggers and encouraging him to resist the urge to clean will work wonders. For Mark this was slightly difficult since he would get traumatized. Therefore, we opted to expose him to his triggers in a less obvious manner and we conditioned him slowly. This allowed us to reduce his compulsion to clean. We also recommended that the family pays close attention to the child to ensure that he does not suppress his urges too much as this might have a rebound effect with increased symptoms.
3) What were some of the initial symptoms you noticed/your family noticed that your child/your patient/you may have had with ______________________, or some kind of issue?
The Symptoms that Mark showed were that he constantly kept wiping door handles, washing hands constantly, and brushing teeth with too much force. The constant washing rituals had to do with his fear of germs or coming into contact with dirt. When Mark's fear was triggered, he would become restless to a point of trying to clean the dirt himself. This made it hard for him to socialize with other children or even visit their homes.
4) How did your child/your patients/you act compared to their peers that did not have _____________________?
When compared to other children his age, Mark would get anxious and restless whenever his fears were triggered. It is clear that Mark is distressed as he loses his focus, and he cannot rest till he has done something about the area he considered to have dirt. Mark had a routine that involved him cleaning his hands, wiping surfaces, and brushing teeth in a certain way for a specified period of time. This was quite different from his peers who did not have the disorder. They would not be concerned with dirt and most of them found Mark to be weird.
5) What was used to treat or what was recommended to alleviate some of the effects of your child’s/your patient’s/your ______________________?
Cognitive-behavioral therapy was recommended for treating Mark's OCD. This had two components the first one being exposure and response prevention and the second being cognitive therapy. Exposure and response require the child to be repeatedly exposed to their triggers and they are refrained from their compulsive behavior. Cognitive therapy will focus on thought and exaggerated sense of responsibility that Mark feels. Mark will be taught a healthy and effective way for responding to his obsessive thoughts without him resorting to his compulsive behavior.
6) Were non-medication alternatives suggested? Why or why not?
Cognitive-behavioral therapy is what was used initially. This was to determine the impact of Mark’s OCD before any medication was prescribed to the child. While medication can be effective, if not properly monitored the child could become dependent on medicines. It is for this reason that non-medication alternatives are sought first.
7) How did the medication affect your child/your patients/you? (If no medication was prescribed or taken, why?)
Antidepressants were prescribed for Mark. The medications were to be used in conjunction with the cognitive-behavioral therapy. However, it was discovered that the medications were not effective and it was recommended that they are stopped.
8) What are some of the causes of ______________________?
Although there is no specific gene that has been found, experts believe that OCD does run in families, which points to the likelihood of genetics playing a part in its development. Compulsions can also be learned behaviors that will become habitual and repetitive especially when they are associated with the relief of anxiety. Others believe that there are chemical, functional, and structural abnormalities that occur in the brain, which lead to the development of OCD.
9) Was the school helpful in accommodating your child/your patient/you with your __________________________?
Initially, the school administrators did not understand Mark’s behavior. This resulted in his isolation and constant reprimanding in an attempt to rectify his behavior. However, once the disorder was diagnosed, the school was more accommodative. Teachers were educated on strategies that they could use to reinforce Mark’s behavior that were in line with his cognitive-behavior therapy.
10) How has your child’s/your patient’s/your ____________________ affected adulthood?
The chances of the disorder affecting Mark's adulthood is reduced if he does maintain his therapy. Cognitive-behavior therapy has been found to be effective in improving the symptoms of OCD and the improvement is maintained in the long term (Riva, Berger, & Anholt, 2016). Since treatment has begun early Mark will be able to lead a normal adulthood without the obsession creeping up in his life.
11) Additional information/questions. Note: What you ask will be determined by the course of the interview. Blank is not sufficient.
Parents should be aware of the obsessions and compulsions. This is because there is a likelihood of them passing on these obsessions and compulsions to their children. Since OCD is a learned, if parents pay close attention to the development of their children it is possible for them to discover and correct the behaviors before they become too serious. Dealing with the disorder early will ensure that the child will change their thinking patterns and behaviors, which will assist in reducing their compulsions.
Critical Thinking Reflection Summary
Obsessive-compulsive disorder (OCD) is defined as an anxiety disorder that affects about 2 to 3% of the population. While it is normal for a person to double check something to ensure that they have done the correct thing. For people with OCD, it becomes an obsession that might affect their performance. Children with OCD will suffer greatly since they are having disturbing and unwanted images, thoughts, or urges that they do not properly understand (Mash & Wolfe, 2015). This will interfere with the child's mind and it causes a great deal of discomfort. This disorder has to do with obsessions and compulsions. Obsessions are the fears that the child will have and compulsions are their way of coping with the obsessions. Compulsions are the repetitive, intentional, and purposeful behaviors that a child performs in response to their obsession. Compulsions are done in an attempt to suppress or neutralize the obsessions. A child who has OCD will experience recurrent, time consuming, and disturbing obsessions. In order for a person to be diagnosed with OCD, the presence of an obsession and a compulsion that is time-consuming (taking more than an hour a day) is required. OCD will cause a major impairment at school for the child as they will not be able to focus due to the fears. The lack of focus could be misdiagnosed by the teachers as a lack of interest and the child would be forced to undertake remedial classes.
Genetics has been established to be a risk factor for OCD. Therefore, parents need to be aware of their own obsessions and compulsions. This will ensure that they are alert to the behaviors of their children and corrective action can be taken if they discover any OCD traits in their children. Early interventions have been found to be effective in the treatment of the disorder. However, in order for treatment to be effective, it is vital that the child's specific OCD is established and their obsessions and compulsions clearly identified. This way therapy will be effective as it will be targeted towards the particular obsessions and compulsions for the child (Hirschtritt, Bloch, & Mathews, 2017). Cognitive-behavioral therapy has been established to be quite effective in treating and preventing remission of OCD. If the child is taken for treatment early, the chances of them having the disorder when they are adults is reduced. Cognitive-behavioral therapy aims to modify the child's patterns of thinking, behaviors, and beliefs that trigger their anxiety and obsessive-compulsive symptoms. Therapy will make use of education in order to promote the child's control over their symptoms. The chosen education will assist in exposing the myths that cause the child's OCD.
Medication therapies can also be prescribed for the child. However, medications alone are not effective in the treatment of OCD. Snyder, Kaiser, Warren, and Heller (2015) posits that antidepressants have been found to reduce the symptoms of OCD, which could be vital especially if the child is undergoing behavior therapy. Combining medications with therapy will be effective in modifying the child’s behavior and thoughts. With the aim of therapy being to expose the child to their fears, when the child is given the medication, they can easily be exposed to their fears without them becoming too anxious (Snyder et al., 2015). However, there might be instances that would require the child to be exposed to their fears without any medications. Cognitive-behavioral therapy aims to slowly and progressively expose the child to their obsessions and encourage them not to undertake their compulsion behavior. This way the child will slowly reduce their anxiety to the obsessions and they can rebuild their trust in a more manageable and functional level.
References
Hirschtritt, M. E., Bloch, M. H., & Mathews, C. A. (2017). Obsessive-compulsive disorder: advances in diagnosis and treatment. JAMA, 317(13), 1358-1367.
Mash, E. J., & Wolfe, D. A. (2015). Abnormal Child Psychology. Boston, MA: Cengage Learning.
Riva, A. D., Berger, A., & Anholt, G. (2016). Actions speak louder than words: Enhanced action tendencies in obsessive-compulsive disorder: An ERP study. European Psychiatry, 33, S90-S91.
Snyder, H. R., Kaiser, R. H., Warren, S. L., & Heller, W. (2015). Obsessive-compulsive disorder is associated with broad impairments in executive function: A meta-analysis. Clinical Psychological Science, 3(2), 301-330.