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THE FAMILY & OCD THE INFLUENCE OF FAMILY FACTORS ON THE DEVELOPMENT, MAINTENANCE, AND TREATMENT OF PEDITRAIC OCD
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],II. Explore the Role of the Family in the : I.  Brief Introduction to OCD III. Summary & Clinical Recommendations IV. Future Directions
OCD Defined ,[object Object],[object Object],[object Object],[object Object]
“ Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t. When I set my alarm at night, I had to set it to a number that wouldn’t add up to a ’bad’ number. ” “ Getting dressed in the morning was tough, because if I didn’t follow my routine, I’d get anxious and would have to get dressed again. I always worried that if I didn’t do something, my parents were going to die. I’d have these terrible thoughts of harming them. It was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. B/c of the time I spent on rituals, I was unable to do a lot of things.”
II (A). Role of Family in the Development of OCD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
II (B). Role of Family in the Maintenance   of OCD   ,[object Object],[object Object],Member w/OCD Family
II (B). Role of Family in the Maintenance of OCD   (cont).   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Alternative hypothesis:  OCD is exaggerated +/or maintained through parental/sibling involvement and accommodation, and/or overly negative family interactions. *Emotional over-   involvement Accommodation Sp lit Antagonism Note : Accommodation is analogous to emotional over-involvement. Note : Antagonism is analogous to high EE in family interactions.
Family Distress, Accommodation, & Participation Renshaw et al., 2005
Family Accommodation (FA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Family Interaction Style ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],II (C). Role of Family in the Treatment of OCD
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Summary: Reasons for a Family-Based Tx Approach Summary Slide
[object Object],[object Object],[object Object],[object Object],A Primer for the Treatment of OCD
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Family-Based CBT for Children
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Preliminary Evidence of Effectiveness of FB-CBT
Summary & Clinical Recommendations   ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Some Future Directions
references Allsopp, M., & Verduyn, C. (1990). Adolescents with obsessive compulsive disorder: A case note review of consecutive patients referred to a provincial regional adolescent psychiatry unit.  Journal of Adolescence, 13 , 157-169. Amir, N., Freshman, M., & Foa, E. B. (2000). Family distress and involvement in relatives of obsessive-compulsive disorder patients.  Journal of Anxiety Disorders, 14(3),  209-217. Barrett, P. M., Shortt, A., & Healy, L. (2002). Do parent and child behaviours differentiate families whose children have obsessive-compulsive disorder from other clinic and non-clinic families?  Journal of Child Psychology and Psychiatry, 43 , 597–607. Black, D. W., Gaffney, G., Schlosser, S., & Gabel, J. (1998). The impact of obsessive-compulsive disorder on the family: Preliminary findings.  Journal of Nervous and Mental Disease, 186,  440-442. Calvocoressi, L., Mazure, C., Kasl, S. V., Skolnick, J., Fisk, D., Vegso, S. J., et al. (1999). Family accommodation of obsessive-compulsive symptoms: Instrument development and assessment of family behavior.  Journal of Nervous and Mental Disease, 187 , 636-642. Chambless, D. L., & Steketee, G. (1999). Expressed emotion and behavior therapy outcome: A prospective study with obsessive-compulsive and agoraphobic outpatients.  Journal of Consulting and Clinical Psychology, 67 (5), 658-665. Farrell, L. J., & Barrett, P. M. (2007). The function of the family in childhood obsessive-compulsive disorder: Family interactions and accommodation. Mahwah, NJ: Lawrence Erlbaum Associates. Ferrão, Y. A., Shavitt, R. G., Bedin, N. R., de Mathis, M. E., Carlos, L. A., Fontenelle, L. F., et al. (2006). Clinical features associated to refractory obsessive-compulsive disorder.  Journal of Affective Disorders, 94 (1-3), 199-209. Grunes, M. S., Neziroglu, F., & McKay, D. (2001).  Family involvement in the behavioral treatment of obsessive-compulsive disorder: A preliminary investigation.  Behavior Therapy, 32 , 803-820. Hibbs, E. D., Hamburger, S. D., Lenane, M., Rapoport, J. L., Kruesi, M. J. P., Keysor, C. S., et al.  (1991). Determinants of expressed emotion in families of disturbed and normal children.  Journal of Child Psychology and Psychiatry, 32 (5), 757-770. Knox, L. S., Albano, A. M., & Barlow, D. H. (1996). Parental involvement in the treatment of childhood compulsive disorder: A multiple baseline examination incorporating parents.  Behavior Therapy, 27 (1), 93-114. Renshaw, K. D., Steketee, G., & Chambless, D. L. (2005). Involving family members in the treatment of OCD.  Cognitive Behaviour Therapy, 34 (3), 164-175. Rufer, M., Grothusen, A., Mass, R., Peter, H., & Hand, I. (2005).  Temporal stability of symptom dimensions in adult patients with obsessive-compulsive disorder.  Journal of Affective Disorders, 88 , 99-102. Storch, E. A., Geffken, G. R., Merlo, L. J., Jacob, M. L., Murphy, T. K., Goodman, W. K., et al. (2007). Family accommodation in pediatric obsessive-compulsive disorder.  Journal of Clinical Child and Adolescent Psychology, 36 (2), 207-216. Storch, E. A., Merlo, L. J., Lehmkuhl, H., Geffken, G. R., Jacob, M., Ricketts, E., et al.  (2008). Cognitive-behavioral therapy for obsessive--compulsive disorder: A non-randomized comparison of intensive and weekly approaches.  Journal of Anxiety Disorders, 22 (7), 1146-1158. Van Noppen, B., & Steketee, G. (2003). Family approaches to treatment for obsessive compulsive disorder.  Revista brasileira de psiquiatria, 25  (1), 43-50. Waters, T. L., & Barrett, P. M. (2000). The role of the family in childhood obsessive-compulsive disorder.  Clinical Child and Family Psychology Review, 3 (3), 173-184. Zohar, A. H. The epidemiology of obsessive-compulsive disorder in children and adolescents.  Child and Adolescent Psychiatric Clinics of North America, 8 , 445-460.
 

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The Family & OCD

  • 1. THE FAMILY & OCD THE INFLUENCE OF FAMILY FACTORS ON THE DEVELOPMENT, MAINTENANCE, AND TREATMENT OF PEDITRAIC OCD
  • 2.
  • 3.
  • 4. “ Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t. When I set my alarm at night, I had to set it to a number that wouldn’t add up to a ’bad’ number. ” “ Getting dressed in the morning was tough, because if I didn’t follow my routine, I’d get anxious and would have to get dressed again. I always worried that if I didn’t do something, my parents were going to die. I’d have these terrible thoughts of harming them. It was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. B/c of the time I spent on rituals, I was unable to do a lot of things.”
  • 5.
  • 6.
  • 7.
  • 8. Family Distress, Accommodation, & Participation Renshaw et al., 2005
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18. references Allsopp, M., & Verduyn, C. (1990). Adolescents with obsessive compulsive disorder: A case note review of consecutive patients referred to a provincial regional adolescent psychiatry unit. Journal of Adolescence, 13 , 157-169. Amir, N., Freshman, M., & Foa, E. B. (2000). Family distress and involvement in relatives of obsessive-compulsive disorder patients. Journal of Anxiety Disorders, 14(3), 209-217. Barrett, P. M., Shortt, A., & Healy, L. (2002). Do parent and child behaviours differentiate families whose children have obsessive-compulsive disorder from other clinic and non-clinic families? Journal of Child Psychology and Psychiatry, 43 , 597–607. Black, D. W., Gaffney, G., Schlosser, S., & Gabel, J. (1998). The impact of obsessive-compulsive disorder on the family: Preliminary findings. Journal of Nervous and Mental Disease, 186, 440-442. Calvocoressi, L., Mazure, C., Kasl, S. V., Skolnick, J., Fisk, D., Vegso, S. J., et al. (1999). Family accommodation of obsessive-compulsive symptoms: Instrument development and assessment of family behavior. Journal of Nervous and Mental Disease, 187 , 636-642. Chambless, D. L., & Steketee, G. (1999). Expressed emotion and behavior therapy outcome: A prospective study with obsessive-compulsive and agoraphobic outpatients. Journal of Consulting and Clinical Psychology, 67 (5), 658-665. Farrell, L. J., & Barrett, P. M. (2007). The function of the family in childhood obsessive-compulsive disorder: Family interactions and accommodation. Mahwah, NJ: Lawrence Erlbaum Associates. Ferrão, Y. A., Shavitt, R. G., Bedin, N. R., de Mathis, M. E., Carlos, L. A., Fontenelle, L. F., et al. (2006). Clinical features associated to refractory obsessive-compulsive disorder. Journal of Affective Disorders, 94 (1-3), 199-209. Grunes, M. S., Neziroglu, F., & McKay, D. (2001). Family involvement in the behavioral treatment of obsessive-compulsive disorder: A preliminary investigation. Behavior Therapy, 32 , 803-820. Hibbs, E. D., Hamburger, S. D., Lenane, M., Rapoport, J. L., Kruesi, M. J. P., Keysor, C. S., et al. (1991). Determinants of expressed emotion in families of disturbed and normal children. Journal of Child Psychology and Psychiatry, 32 (5), 757-770. Knox, L. S., Albano, A. M., & Barlow, D. H. (1996). Parental involvement in the treatment of childhood compulsive disorder: A multiple baseline examination incorporating parents. Behavior Therapy, 27 (1), 93-114. Renshaw, K. D., Steketee, G., & Chambless, D. L. (2005). Involving family members in the treatment of OCD. Cognitive Behaviour Therapy, 34 (3), 164-175. Rufer, M., Grothusen, A., Mass, R., Peter, H., & Hand, I. (2005). Temporal stability of symptom dimensions in adult patients with obsessive-compulsive disorder. Journal of Affective Disorders, 88 , 99-102. Storch, E. A., Geffken, G. R., Merlo, L. J., Jacob, M. L., Murphy, T. K., Goodman, W. K., et al. (2007). Family accommodation in pediatric obsessive-compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 36 (2), 207-216. Storch, E. A., Merlo, L. J., Lehmkuhl, H., Geffken, G. R., Jacob, M., Ricketts, E., et al. (2008). Cognitive-behavioral therapy for obsessive--compulsive disorder: A non-randomized comparison of intensive and weekly approaches. Journal of Anxiety Disorders, 22 (7), 1146-1158. Van Noppen, B., & Steketee, G. (2003). Family approaches to treatment for obsessive compulsive disorder. Revista brasileira de psiquiatria, 25 (1), 43-50. Waters, T. L., & Barrett, P. M. (2000). The role of the family in childhood obsessive-compulsive disorder. Clinical Child and Family Psychology Review, 3 (3), 173-184. Zohar, A. H. The epidemiology of obsessive-compulsive disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 8 , 445-460.
  • 19.