Perfectionism and Intolerance of Uncertainty are Predictors of OCD Symptoms in Children and Early Adolescents: A Prospective, Cohort, One-Year, Follow-Up Study.

objectiveCognitive models of Obsessive-Compulsive Disorder (OCD) identified four types of beliefs, which would develop during childhood and play a role in the aetiology and maintenance of OCD: Inflated Responsibility, Threat Overestimation, Importance/Control of Thoughts, Perfectionism/Intolerance of Uncertainty. Whereas research produced consistent evidence in adults that these beliefs constitute vulnerability factors for OCD, no study examined whether the obsessive beliefs prospectively predict OCD symptoms over time in youth. The current study investigated the role of the obsessive beliefs as predictors of OCD symptoms after one year in a large cohort sample of community children and early adolescents prospectively followed-up.

methodSeven hundred and fifty-four children and early adolescents recruited from the community (mean age= 10.87 years, 51.46% females) completed the Obsessive Belief Questionnaire-Child Version (OBQ-CV) as a measure of obsessive beliefs, the Obsessive-Compulsive Inventory-Child Version (OCI-CV) as a measure of OCD symptoms, the Children's Depression Inventory for depression (CDI) at baseline (t0) and at one-year follow-up (t1). A multiple linear regression analysis was run entering the scores on the OBQ-CV and the CDI as predictors and the scores on the OCI-CV at t1 as dimensional outcome.

resultsMore intense Perfectionism/Intolerance of Uncertainty at t0 (β= 0.17, t= 4.33, p<0.001) and to a lesser extent more intense Threat Overestimation at t0 (β= 0.08, t= 1.97, p<0.05) predicted more severe OCD symptoms at t1 controlling for the effects of depression at t0 (β= 0.19, t= 5.53, p<0.001). Evidence of the predictive effects of the other cognitions at t0 on OCD symptoms at t1 was not found.

conclusionsPerfectionism/Intolerance for Uncertainty and to a lesser Threat Overestimation may be early predictors of OCD symptoms in youth. Early detection and prevention of OCD in children and adolescents could focus on these cognitive vulnerability factors. The current findings appear to raise some doubts about the role of Inflated Responsibility and Importance/Control of Thoughts as cognitive vulnerability factors specific to OCD among youth. Future studies should use clinical interviews to assess the presence of an OCD diagnosis.