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

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 59; no. 7; pp. 880 - 889
• Main Authors: Cervin, Matti, Perrin, Sean, Olsson, Elin, Aspvall, Kristina, Geller, Daniel A., Wilhelm, Sabine, McGuire, Joseph, Lázaro, Luisa, Martínez-González, Agustin E., Barcaccia, Barbara, Pozza, Andrea, Goodman, Wayne K., Murphy, Tanya K., Seçer, İsmail, Piqueras, José A., Rodríguez-Jiménez, Tiscar, Godoy, Antonio, Rosa-Alcázar, Ana I., Rosa-Alcázar, Ángel, Ruiz-García, Beatriz M., Storch, Eric A., Mataix-Cols, David
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2020; Elsevier BV
• Subjects: Adolescent; Adolescents; Age differences; Anxiety; Anxiety Disorders; Autism; Behavior Patterns; Child; Childhood; Children; Children & youth; Children and Adolescents; Clinical Medicine; Comorbidity; dimensions; Emotions; Estimates; Etiology; Hoarding disorder; Humans; Interviews; Klinisk medicin; Life span; Medical and Health Sciences; Medicin och hälsovetenskap; Missing data; Network Analysis; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - epidemiology; Obsessive-Compulsive Inventory; Obssessive Compulsive Disorder; Post traumatic stress disorder; Psychiatry; Psychology; Psychology (excluding Applied Psychology); Psychopathology; Psykiatri; Psykologi; Psykologi (exklusive tillämpad psykologi); Samhällsvetenskap; Severity of Illness Index; Social Sciences; Standard deviation; Statistical methods; Teenagers; Tic Disorders; Tics; Italy; Spain; network analysis; Obsessive-Compulsive Inventory; obsessive-compulsive disorder; dimensions
• ISSN: 0890-8567; 1527-5418; 1527-5418
• DOI: 10.1016/j.jaac.2019.06.018

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. 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. 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. 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. [Display omitted]