The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth
Open accessAbstract
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.
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Doubt and IU are core features of OCD.
“Doubt and IU are seen as core features of OCD (Gillett et al., 2018; Cervin et al., 2020).”
From Intolerance of Uncertainty and Health-Related Anxiety in Youth amid the COVID-19 Pandemic: Understanding and Weathering the Continuing Storm (2022) · cites this paper as Cervin et al., 2020
The Discussion describes doubt as central to OCD, and the study finds doubting/checking central in youth symptom networks. It mentions uncertainty alongside doubt but does not identify intolerance of uncertainty (IU) as a core feature. The source therefore supports the doubt portion, not the IU portion. (LLM, conf=0.85)
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Self-citationA biopsychosocial perspective on endometriosis: the importance of psychological inflexibility
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- Authors
- Cervin, M., Perrin, S., Olsson, E., Aspvall, K., Geller, D. A., Wilhelm, S., McGuire, J., Lázaro, L., Martínez-González, A. E., Barcaccia, B., Pozza, A., Goodman, W. K., Murphy, T. K., Seçer, İ., Piqueras, J. A., Rodríguez-Jiménez, T., Godoy, A., Rosa-Alcázar, A. I., Rosa-Alcázar, Á., Ruiz-García, B. M., Storch, E. A., & Mataix-Cols, D.
- Affiliations
- Lund University (SE)
- Karolinska Institutet (SE)
- Harvard University (US)
- Johns Hopkins University (US)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Sapienza University of Rome (IT)
- University of Florence (IT)
- Baylor College of Medicine (US)
- University of South Florida (US)
- Atatürk University (TR)
- Universidad de Málaga (ES)
- Universidad de Murcia (ES)
- Corresponding author
- Cervin, Matti
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 59
- Issue
- 7
- Pages
- 880-889
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC7219532
- OpenAlex
- W2966875637
- Cited by
- 37
- References
- 51
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 7
- FWCI
- 6.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Hispana (publishedVersion, cc-by-nc-nd)
- PubMed Central (acceptedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Iris (Roma Tre University) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- RUA, Repositorio Institucional de la Universidad de Alicante (Universidad de Alicante) (submittedVersion)
- Use Siena air (University of Siena) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute of Mental Health (1R01MH093381, 5R01MH093402)
- National Institute of Child Health and Human Development
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, childhood OCD, symptom dimensions, network centrality, symptom structure, elementary school students, age and sex differences
- MeSH terms
- Adolescent, Child, Emotions, Humans, Obsessive-Compulsive Disorder, Severity of Illness Index, Tic Disorders, Comorbidity
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