Obsessive compulsive disorder (OCD) is an anxiety disorder based on an individual having obsessions and compulsions, according to the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV-TR). Both children and adults can be diagnosed with OCD. The obsessions and compulsions are time-consuming and may cause impairment in the child, according to the DSM-IV-TR. Only about 1 percent of children have OCD, according to KidsHealth.
Obsessions
Obsessions are constant inappropriate thoughts that cause distress, according to the DSM-IV-TR. These thoughts are intrusive, which means they just appear in a child's mind. The thoughts are out of the child's control and are hard to get out of his mind, according to KidsHealth. The most common obsession is thoughts about contamination. For example, the child may be horrified by germs because he thinks he may get an illness and die. Another common obsession is to have things in a particular order, for example, by size or color. A child with OCD also may have repeated doubts and need constant reassurance of his performance, according to the DSM-IV-TR. Obsessions that occur less frequently are thoughts of horrific situations or sexual imagery. Children who have obsessions try to suppress the thoughts or neutralize them with actions, called compulsions, according to KidsHealth.
Compulsions
Compulsions are repetitive behaviors or mental acts that children do to get rid of the obsessive thoughts and reduce anxiety, according to KidsHealth. It is important to note that these compulsions do not provide pleasure, according to the DSM-IV-TR. Children feel they must engage in compulsive behavior in order to prevent a dreaded event from occurring, according to KidsHealth. For example, a child with the obsession of contamination will wash her hands until they become raw in order to not get sick and die. If the child does not do the compulsive act, anxiety continuously builds within her, according to the DSM-IV-TR. A child with obsessions about safety will recheck locks in the house several times throughout the day. When asked why, she might answer, "Just because," according to KidsHealth. Other compulsions include counting, cleaning or repeating things, according to the DSM-IV-TR. Children usually try to avoid situations that provoke obsessions or compulsions, according to the DSM-IV-TR.
Insight
Most adults are able to recognize that obsessions are products of their mind, according to the DSM-IV-TR. Adults with poor insight do not realize that their obsessions or compulsions are unreasonable or excessive, according to the DSM-IV-TR. Children may have poor insight, because they might not have the cognitive awareness to make this judgment, according to the DSM-IV-TR. Additionally, an individual's insight varies, depending on the situation. For example, if a person is talking to a therapist, he may admit his contamination obsession, but in real life will not go without washing his hands.
References
- "Diagnostic and Statistical Manual of Mental Disorders, Four Edition, Text Revision"; American Psychiatric Association; 2000
- KidsHealth: Obsessive Compulsive Disorder
