How Children's Understanding of OCD is Affected by Different Explanations

What you need to know

• Children’s understanding of OCD can be influenced by the explanations they are given
• Biomedical explanations led children to have a more pessimistic view of OCD prognosis
• Cognitive-behavioral explanations aligned better with children’s intuitive understanding of OCD
• Even brief explanations can impact how children view OCD and its treatability

Children’s initial understanding of OCD

The study first looked at how children naturally understand OCD before being given any explanation. The researchers found that children were most likely to view OCD as being caused by cognitive and behavioral factors, followed by biomedical (brain-based) factors. This suggests that cognitive-behavioral explanations of OCD may align better with how children intuitively understand the disorder.

Interestingly, children who reported having prior exposure to OCD (either personally or through someone they knew) were more likely to endorse biomedical explanations. The researchers suggest this may be because biomedical explanations are common in healthcare settings and media portrayals of OCD.

Impact of different explanations

A key finding was that even brief explanations about OCD could change children’s understanding of the disorder. When given a biomedical explanation focusing on brain factors, children became more likely to view OCD as having a biomedical cause. Similarly, when given a cognitive-behavioral explanation focusing on thoughts and behaviors, children shifted toward that understanding.

Importantly, the type of explanation given impacted how children viewed the prognosis and treatability of OCD:

• Children given biomedical explanations predicted that OCD would last longer and be less curable
• Children given cognitive-behavioral explanations maintained a more optimistic view of OCD prognosis

The researchers suggest biomedical explanations may promote pessimism by locating the problem in genetics or brain functioning - factors seen as outside of an individual’s control.

Children’s understanding differs from adults

The study found that children’s concepts of OCD were less sophisticated and inter-related compared to typical adult understanding. For example, adults often link the perceived severity of an illness to predictions about its duration and curability. Children in this study did not make these connections between different aspects of OCD.

This highlights the need for clinicians to carefully assess children’s understanding of OCD and help them form a more integrated view of the disorder and its treatment.

Conclusions

• Children’s understanding of OCD is malleable and can be influenced by the explanations they are given
• Biomedical explanations may promote an overly pessimistic view of OCD prognosis in children
• Cognitive-behavioral explanations align better with children’s intuitive understanding and maintain a more optimistic outlook
• Clinicians should assess children’s concepts of OCD and consider the impacts of different explanatory models