The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth

Matti Cervin, Sean Perrin, Elin Olsson, Kristina Aspvall, Daniel A. Geller, Sabine Wilhelm, Joseph McGuire, Luisa Lázaro, Agustin E. Martínez-González, Barbara Barcaccia, Andrea Pozza, Wayne K. Goodman, Tanya K. Murphy, İsmail Seçer, José A. Piqueras, Tiscar Rodríguez-Jiménez, Antonio Godoy, Ana I. Rosa-Alcázar, Ángel Rosa-Alcázar, Beatriz M. Ruiz-GarcíaEric A. Storch, David Mataix-Cols

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well-established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure of these dimensions in unselected schoolchildren and in children with OCD. Method: We estimated the network structure of OCD symptom dimensions in 6,991 schoolchildren and 704 children diagnosed with OCD from 18 sites across 6 countries. All participants completed the Obsessive-Compulsive Inventory−Child Version. Results: In both the school-based and clinic-based samples, the OCD dimensions formed an interconnected network with doubting/checking emerging as a highly central node, that is, having strong connections to other symptom dimensions in the network. The centrality of the doubting/checking dimension was consistent across countries, sexes, age groups, clinical status, and tic disorder comorbidity. Network differences were observed for age and sex in the school-based but not the clinic-based samples. Conclusion: The centrality of doubting/checking in the network structure of childhood OCD adds to classic and recent conceptualizations of the disorder in which the important role of doubt in disorder severity and maintenance is highlighted. The present results suggest that doubting/checking is a potentially important target for further research into the etiology and treatment of childhood OCD.

Original languageEnglish (US)
Pages (from-to)880-889
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number7
StatePublished - Jul 2020


  • Obsessive-Compulsive Inventory
  • dimensions
  • network analysis
  • obsessive-compulsive disorder

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth'. Together they form a unique fingerprint.

Cite this