Predictors of Family Accommodation in Obsessive-Compulsive Disorder

S. Evelyn Stewart · Caitlin Beresin · Stephen A. Haddad · Denise Egan Stack · Jeanne M. Fama · Michael A. Jenike

128 citations0/0 files storedAnnals of Clinical Psychiatry

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Obsessive-Compulsive Spectrum Disorders Psychoanalysis and Psychopathology Research Family Caregiving in Mental Illness

Abstract

BACKGROUND: Obsessive-compulsive disorder (OCD) is a serious, disabling illness. Family members are frequently involved by attempting to stop rituals or by performing rituals for their relative. Factors associated with family accommodation of OCD have been largely overlooked in the literature. This study aims to identify the frequency and clinical predictors of OCD family accommodation behaviors. METHODS: Participants include those with a first admission to the McLean/Massachusetts General Hospital OCD Institute (N = 110). The Family Accommodation Scale was completed independently by family members. Univariate relationships between factors and family accommodation were assessed via graphs, parametric and non-parametric testing. Multiple regression analyses modeled relationships between family accommodation and predictor variables. RESULTS: Family accommodation was reported in 96.9% of cases, and predominantly occurred at least daily (59.1% of cases). Most common behaviors included providing reassurance and waiting for ritual completion. Two of 13 potential predictors were significantly correlated with family accommodation both in univariate regression analysis and in the final regression model (F = 10.15; p < 0.0001; R-square = 0.17; adjusted R-Square = 0.15). These include OCD severity (p = 0.0007) and the cleaning/contamination symptom dimension (p = 0.03). CONCLUSIONS: Family accommodation is ubiquitous in OCD. Psychoeducation regarding potential deleterious effects of accommodation must not be overlooked in management of this illness.

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References

1961An Inventory for Measuring Depression 1989The Yale-Brown Obsessive Compulsive Scale 1989The Yale-Brown Obsessive Compulsive Scale 2004Distinct Neural Correlates of Washing, Checking, and Hoarding SymptomDimensions in Obsessive-compulsive Disorder 1997Symptoms of obsessive-compulsive disorder 1999Use of Factor-Analyzed Symptom Dimensions to Predict Outcome With Serotonin Reuptake Inhibitors and Placebo in the Treatment of Obsessive-Compulsive Disorder 1995Family accommodation in obsessive-compulsive disorder 1999Family Accommodation of Obsessive-Compulsive Symptoms

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2012Development and preliminary psychometric evaluation of a self-rated version of the Family Accommodation Scale for Obsessive-Compulsive Disorder 2014Development of the pediatric accommodation scale: Reliability and validity of clinician- and parent-report measures 2017Family accommodation in adult obsessive–compulsive disorder: clinical perspectives 2019Family accommodation in psychopathology: A synthesized review 2016A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder

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