A Structural Equation Analysis of Family Accommodation in Pediatric Obsessive-Compulsive Disorder
Open accessAbstract
Family accommodation of symptoms is counter to the primary goals of cognitive-behavioral therapy for pediatric obsessive-compulsive disorder (OCD) and can pose an obstacle to positive treatment outcomes. Although increased attention has been given to family accommodation in pediatric OCD, relatively little is known about associated child and parent characteristics, and their mediating/moderating effects. This study examined a structural equation model of parent and child variables related to parent reports of family accommodation. Sixty-one children with OCD (ages 6-17 years, 39% female) and their parents were recruited from a university-based clinic. They were administered clinician- and parent-rated measures of child OCD symptom severity, OCD-specific impairment, internalizing problems, and externalizing problems as well as parent anxiety, depression, empathy, consideration of future consequences, and accommodation. Results generally supported the hypothesized model. Family accommodation mediated the relationship between OCD symptom severity and parent-rated functional impairment; child internalizing problems mediated the relationship between parent anxiety and family accommodation; and parent empathy and consideration of future consequences interacted to predict family accommodation. Child externalizing problems were significantly associated with family accommodation but neither of these two variables was associated with parent depression. Findings suggest that reductions in family accommodation might be maximized by routinely screening for comorbid psychopathology in children with OCD and their parents, and using prescriptive or modular approaches to intervention. Directions for future research are discussed.
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Accommodation may be negatively reinforcing for parents due to an immediate decrease in parental distress and aversive youth behaviors.
“accommodation also may be experienced as negatively reinforcing by the parent due to an immediate decrease in both parental distress [78] and aversive youth behaviors [63••]”
From Intolerance of Uncertainty and Parental Accommodation: Promising Targets for Personalized Intervention for Youth Anxiety. (2020) · cites this paper as [78]
In OCD, parental anxiety is associated with illness accommodation.
“For example, in obsessive-compulsive disorder, parental anxiety has been associated with illness accommodation (i.e., allowing the child to engage in checking compulsions; Caporino et al., 2012; Flessner et al., 2011).”
From A Pilot Study of an Acceptance-Based Separated Family Treatment for Adolescent Anorexia Nervosa (2013) · cites this paper as Caporino et al., 2012
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References 148 · Cited by 143
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- Authors
- Caporino, N. E., Morgan, J., Beckstead, J., Phares, V., Murphy, T. K., & Storch, E. A.
- Affiliations
- University of South Florida (US)
- Corresponding author
- Storch, Eric A.
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2011-08-04
- Volume
- 40
- Issue
- 1
- Pages
- 133-143
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- OpenAlex
- W1966068698
- Semantic Scholar
- 5b5ee3655e191d901ce3be3dc24b2d4119ad3004
- Cited by
- 143
- References
- 148
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 4 · 2023: 11 · 2022: 5 · 2021: 20 · 2020: 16 · 2019: 10 · 2018: 10 · 2017: 14 · 2016: 9 · 2015: 13 · 2014: 10 · 2013: 6 · 2012: 2
- FWCI
- 6.20
- Type
- journal article
- Language
- en
- Open access
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons - University of South Florida (University of South Florida) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- family accommodation, pediatric obsessive-compulsive disorder, parental anxiety, consideration of future consequences, internalizing problems, externalizing problems, functional disability, comorbid psychopathology, cognitive behavioral therapy, mediating and moderating effects
- MeSH terms
- Adolescent, Anxiety, Child, Depression, Empathy, Family, Family Relations, Female, Helping Behavior, Humans, Internal-External Control, Male, Obsessive-Compulsive Disorder, Parents, Psychiatric Status Rating Scales, Social Support, Cognitive Behavioral Therapy
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