Phenomenology and correlates of insight in pediatric obsessive-compulsive disorder.
Obsessive-compulsive disorder (OCD) is marked by the presence of obsessions and/or compulsions that cause significant interference in an individual's life. Insight regarding symptoms in youth with OCD may affect accurate assessment, acceptance and motivation for treatment, tolerance of negative valence states (i.e., fear) and treatment outcome, so assessment of this construct and associated clinical characteristics is important. Accordingly, the current study sought to expand the literature on symptom insight by examining multi-informant ratings of insight from children, parents, and clinicians simultaneously and its relationship to varied clinical characteristics. One-hundred and ten treatment-seeking youth with a primary diagnosis of OCD, aged 6-17, participated in the study along with a parent/guardian. The nature of symptom conviction, fixity of ideas, and perceptions about the cause of the problems were important indicators in assessing child insight and resulted in a comprehensive, psychometrically-sound measure of insight. Insight was generally not strongly associated with clinical characteristics. Poor insight was moderately associated with less resistance of obsessive-compulsive symptoms, increased externalizing symptoms, and ordering symptoms. Overall, this study contributes further information into the nature and correlates of insight in youth with OCD, and provides a psychometrically sound approach for its assessment.
Department of Pediatrics, University of South Florida, St. Petersburg, FL; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL; Department of Psychology, University of South Florida, St. Petersburg, FL. Electronic address: estorch@health.usf.edu.
Eric A
EA
Storch
Department of Pediatrics, University of South Florida, St. Petersburg, FL; Department of Psychology, University of South Florida, St. Petersburg, FL.
Alessandro S
AS
De Nadai
Department of Pediatrics, University of South Florida, St. Petersburg, FL.
Marni L
ML
Jacob
Department of Pediatrics, University of South Florida, St. Petersburg, FL; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL.
Adam B
AB
Lewin
Department of Social Work, Boston University, Boston, MA.
Jordana
J
Muroff
Department of Psychiatry and Human Behavior, Brown University, Providence, RI.
Jane
J
Eisen
Department of Psychology, University of North Carolina, Chapel Hill, NC.
Jonathan S
JS
Abramowitz
Department of Psychiatry, Massachusetts General Hospital Boston, MA.
Daniel A
DA
Geller
Department of Pediatrics, University of South Florida, St. Petersburg, FL; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL.
Tanya K
TK
Murphy
D000293:Adolescent; D001364:Awareness; D002648:Child; D003192:Compulsive Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009770:Obsessive Behavior / Q000523:psychology*; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index