Researchers have discovered that mothers tend to be more critical of children with obsessive-compulsive disorder than they are of other children in the family. The parental criticism is linked to poorer outcomes for the child even after they receive treatment for the condition.
Case Western Reserve University researchers said while parental criticism has been associated with child anxiety in the past, they wanted to find out if this is a characteristic of the parent or something specific to the relationship between the anxious child and the parent.
“This suggests that mothers of anxious children are not overly critical parents in general. Instead they seem to be more critical of a child with OCD than they are of other children in the home,” said Amy Przeworski, Ph.D., lead author of the study.
Her observations have been published in the journal, Child Psychiatry & Human Development.
The American Academy of Child and Adolescent Psychiatry says that OCD is found in one in 200 children. The psychological disorder often becomes debilitating as individuals are plagued with repetitive thoughts that lead to anxiety.
The anxiety then is acted out in exacting routines or behaviors that can range from foot-tapping to eating rituals to school or bedtime preparations.
Researchers said their study is an outgrowth of prior investigations that have discovered parental criticism is associated with less success in therapy and a relapse of behavior.
“Parents’ criticism may be a reaction to the child’s anxiety. This research is not blaming the parent for the child’s OCD. But it does suggest that the relationship between parents and children with OCD is important and should be a focus of treatment. This means that parents can help children with OCD to get better,” Przeworski said.
“OCD sneaks up on the kids and parents,” she said.
Przeworski said some parents become concerned when their children show some early warning signs for OCD:
- Rigidity in a child, with things routinely done or said in exactly the same way or order;
- Asking for reassurance many times in the day;
- Repetition of a task from tapping the foot, checking on the stove, washing hands that the child cannot stop when asked;
- Routines that have prescribed patterns or are excessive lengthy: An example is a two-hour shower or raw and chapped hands that look like the child is wearing red gloves;
- Bedtime or dinner rituals, where there is a prescribed order for eating food, placement of food on the plate, etc.;
- Temper tantrums where the child goes beyond being stubborn but has anxiety associated with them;
- Children want symmetry in appearance or things around them.
Parents often initially think it is a phase, a habit or stubbornness. Over time, the behaviors become so exacting that the child and family members have to act in prescribed ways. Parents may end up criticizing the child in an effort to get them to drop obsessive-compulsive behaviors.
The researchers videotaped interviews with 62 mother-child pairs just before the child’s OCD treatment began. Children either had medication, therapy, a combination of the two, or a placebo. The children were between the ages of 7 and 17.
Because most mothers bring their children for treatment appointments, the researchers focused on the mother’s view of their children.
Mothers were asked to give a five-minute description of their relationship with the child with OCD and the mother’s relationship with the sibling closest in age to the child with OCD. The researchers asked the children to describe their relationships with their mothers and fathers.
Researchers took this qualitative feedback and examined the presence of criticism and emotional over-involvement (over-protection or excessive self-sacrificing). The tone of the OCD child and parent tended toward criticism, they said.
Investigators detected that the other sibling received more loving expressions. Parental criticism was also associated with poorer child functioning after treatment.
Source: Case Western Reserve University