How Do Mothers and Fathers Differ in Supporting Their Child's OCD Behaviors?

What you need to know

• Both mothers and fathers frequently accommodate their child’s OCD symptoms, but mothers tend to do so more often.
• The severity of a child’s OCD symptoms and parents’ own mental health issues are linked to higher levels of accommodation.
• When parents accommodate OCD symptoms more, children tend to have worse outcomes after treatment.

Understanding OCD and Family Accommodation

Obsessive-Compulsive Disorder (OCD) is a mental health condition that affects 1-4% of children and teens. People with OCD experience unwanted, intrusive thoughts (obsessions) and feel compelled to perform repetitive behaviors or mental acts (compulsions) to reduce anxiety.

Family accommodation refers to ways that family members participate in or help facilitate a person’s OCD rituals. This can include providing reassurance, helping with compulsions, or changing family routines to avoid triggering the person’s anxiety. While family members often do this with good intentions to reduce their loved one’s distress, research suggests it may actually maintain or worsen OCD symptoms over time.

How the Study Was Conducted

This study looked at 209 children and teens with OCD (average age 14) and both of their parents. The researchers had parents complete questionnaires about how much they accommodated their child’s OCD symptoms. They also collected information on the severity of the child’s OCD, the child’s overall functioning, and parents’ own mental health symptoms. For 124 of the youth who received cognitive-behavioral therapy (CBT) treatment for OCD, the researchers examined how family accommodation related to treatment outcomes.

Key Findings on Parental Accommodation

The study found that both mothers and fathers frequently engage in accommodating their child’s OCD symptoms:

• 80% of mothers and 57% of fathers reported accommodating OCD symptoms daily in at least one way
• The most common forms of accommodation for both parents were providing reassurance, participating in rituals, and helping the child avoid anxiety triggers
• Mothers reported higher overall levels of accommodation compared to fathers
• For 55% of the youth, both parents accommodated OCD symptoms daily

Interestingly, when one parent accommodated symptoms frequently, the other parent was also more likely to do so. This suggests parents may take similar approaches in responding to their child’s OCD.

Factors Related to Higher Accommodation

Several factors were associated with greater family accommodation by both mothers and fathers:

• More severe OCD symptoms in the child
• More emotional and behavioral difficulties in the child
• Higher levels of mental health symptoms (like anxiety and depression) in the parents themselves

These findings highlight that accommodation tends to increase when children are struggling more and when parents are experiencing their own mental health challenges.

Impact on Treatment Outcomes

An important finding was that higher levels of accommodation by both mothers and fathers predicted worse outcomes after CBT treatment for OCD. Specifically:

• Youth whose parents accommodated symptoms more had higher OCD severity scores after treatment
• Higher accommodation was linked to lower chances of the child being classified as a “treatment responder”
• When both parents accommodated daily, only 60% of youth responded well to treatment, compared to 84% when one parent accommodated daily and 96% when neither parent accommodated daily

This suggests that family accommodation may interfere with the effectiveness of OCD treatment for youth.

Conclusions

• Both mothers and fathers frequently accommodate their child’s OCD symptoms, though mothers tend to do so more often
• Higher child symptom severity and parent mental health issues are linked to greater accommodation
• When parents accommodate more, children tend to have worse outcomes after OCD treatment
• Involving both parents in OCD treatment and teaching them to reduce accommodation may lead to better results

The findings emphasize the importance of considering both parents’ roles when assessing and treating childhood OCD. Teaching parents about the potential negative effects of accommodation and helping them learn alternative ways to support their child could improve treatment outcomes. Future research should continue to examine how mothers and fathers may differ in their responses to childhood OCD and explore the benefits of involving both parents in family-based treatments.