TY - JOUR
T1 - The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth
AU - Cervin, Matti
AU - Perrin, Sean
AU - Olsson, Elin
AU - Aspvall, Kristina
AU - Geller, Daniel A.
AU - Wilhelm, Sabine
AU - McGuire, Joseph
AU - Lázaro, Luisa
AU - Martínez-González, Agustin E.
AU - Barcaccia, Barbara
AU - Pozza, Andrea
AU - Goodman, Wayne K.
AU - Murphy, Tanya K.
AU - Seçer, İsmail
AU - Piqueras, José A.
AU - Rodríguez-Jiménez, Tiscar
AU - Godoy, Antonio
AU - Rosa-Alcázar, Ana I.
AU - Rosa-Alcázar, Ángel
AU - Ruiz-García, Beatriz M.
AU - Storch, Eric A.
AU - Mataix-Cols, David
N1 - Funding Information:
Mr. Cervin has received funding from L.J. Boëthius Foundation, Lindhaga Foundation, The Sven Jerring Foundation, and Region Skåne that made possible the preparation of the present manuscript. Original data was collected in part by support from grants from the National Institute of Mental Health (NIMH) to Drs. Storch (1R01MH093381) and Geller (5R01MH093402). None of the funding organizations were involved in the design or conduct of the study; collection, management, analysis, and interpretation of the data or preparation, review, and approval of the manuscript.Disclosure: Dr. Geller has received grant or research support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development subcontract with Duke Clinical Research Center Pediatric Trials Network, Biohaven Pharmaceuticals, Boehringer Ingelheim, Eli Lilly and Co., Forest Pharmaceuticals, GlaxoSmithKline, the International OCD Foundation, Neurocrine Biosciences, Nuvelution Pharma, Peace of Mind Foundation, Pfizer, Solvay, Syneos Health, Teva Pharmaceutical Industries, and the Tourette Association of America. He has served as a consultant to the Arlington Youth Counseling Center. He has served on the editorial board of Annals of Clinical Psychiatry. He has received honoraria from the Massachusetts Psychiatry Academy and the American Academy of Child and Adolescent Psychiatry. He has held stock options/ownership in Assurex Health and Revolutionary Road. Dr. Wilhelm has received research support in the form of free medication and matching placebo from Forest Laboratories for clinical trials funded by the NIH. She is a presenter for the Massachusetts General Hospital Psychiatry Academy in educational programs supported through independent medical education grants from pharmaceutical companies; she has received royalties from Elsevier Publications, Guilford Publications, New Harbinger Publications, Springer, and Oxford University Press. She has also received speaking honorarium from various academic institutions and foundations, including the International OCD Foundation, the Tourette Association of America, and Brattleboro Retreat. She has received payment from the Association for Behavioral and Cognitive Therapies for her role as Associate Editor of Behavior Therapy, as well as from John Wiley and Sons, Inc. for her role as Associate Editor of Depression and Anxiety. She has received honorarium from One-Mind for her role on the PsyberGuide Scientific Advisory and has received salary support from Novartis and Telefonica Alpha, Inc. Dr. McGuire has received support from the Tourette Association of America, the American Academy of Neurology, the Brain Research Foundation, the American Psychological Foundation, and the Hilda and Preston Davis Family Foundation. He has received royalties from Elsevier and has served as a consultant for Bracket, Syneos Health, and Luminopia. Dr. Lázaro has received funding from Marató-TV3 Foundation. Dr. Goodman has received research funding from NIH, the Simons Foundation, and Biohaven Pharmaceuticals. He was paid a consultant training fee by Biohaven. Dr. Storch has received grant funding from NIH, the Texas Higher Education Coordinating Board, ReBuild Texas, the Red Cross, and the Greater Houston Community Foundation. He has received book royalties from Elsevier, American Psychological Association, Springer, Oxford Press, Jessica Kingsley, and Wiley. He has served as a consultant for Levo Therapeutics. Dr. Mataix-Cols has received personal fees from Elsevier and royalties from UpToDate, Inc., all outside the submitted work. Mr. Cervin has received funding from Lions Research Foundation Skåne and Bror Gadelius Foundation. Drs. Perrin, Martínez-González, Barcaccia, Pozza, Murphy, Seçer, Piqueras, Rodríguez-Jiménez, Godoy, Ana I. Rosa-Alcázar, Ángel Rosa-Alcázar, and Ruiz-García and Mss. Olsson and Aspvall have reported no biomedical financial interests or potential conflicts of interest.
Publisher Copyright:
© 2019 American Academy of Child and Adolescent Psychiatry
PY - 2020/7
Y1 - 2020/7
N2 - 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.
AB - 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.
KW - Obsessive-Compulsive Inventory
KW - dimensions
KW - network analysis
KW - obsessive-compulsive disorder
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U2 - 10.1016/j.jaac.2019.06.018
DO - 10.1016/j.jaac.2019.06.018
M3 - Article
C2 - 31421234
AN - SCOPUS:85077150788
SN - 0890-8567
VL - 59
SP - 880
EP - 889
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 7
ER -