Child Psychiatry & Human Development

, Volume 41, Issue 6, pp 675–691 | Cite as

Understudied Clinical Dimensions in Pediatric Obsessive Compulsive Disorder

  • Adam B. Lewin
  • Nicole Caporino
  • Tanya K. Murphy
  • Gary R. Geffken
  • Eric A. Storch
Original Article


The present study aimed to assess the phenomenology and treatment sensitivity of insight, avoidance, indecisiveness, overvalued responsibility, pervasive slowness, and pathological doubting among youth with Obsessive-compulsive disorder (OCD) using the ancillary items on the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). These factors are believed to be relevant to the clinical presentation of youth with OCD but remain understudied. Eighty-nine youth with OCD were administered the CY-BOCS, including six subsidiary items aimed at the constructs of interest in this research. Participants also completed measures of OCD symptom clusters, depressive and anxious symptoms, externalizing/internalizing behavioral problems, and functional impairment. Associations between OCD symptom clusters and insight, avoidance, indecisiveness, overvalued responsibility, pervasive slowness, and pathological doubting are presented. Low insight, significant avoidance, indecisiveness, pervasive slowness and excessive sense of responsibility were all related to elevations in functional impairment. Clinical improvement in OCD severity was related to reductions in avoidance, doubting, and sense of responsibility. The six ancillary items of the CY-BOCS appear to be a practical and valid assessment of several constructs that are prognostically linked to cognitive-behavioral therapy outcomes in youth with OCD. Implications for clinicians are discussed.


Obsessive-compulsive disorder (OCD) Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) Children Insight Cognitive-behavioral therapy (CBT) 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Adam B. Lewin
    • 1
  • Nicole Caporino
    • 1
  • Tanya K. Murphy
    • 1
  • Gary R. Geffken
    • 2
  • Eric A. Storch
    • 1
  1. 1.Department of Pediatrics, Rothman Center for NeuropsychiatryUniversity of South Florida College of MedicineSaint PetersburgUSA
  2. 2.Department of PsychiatryUniversity of Florida College of MedicineGainesvilleUSA

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