title: A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder.
abstract: OBJECTIVE
  Familial aspects of pediatric obsessive-compulsive disorder (OCD), including accommodation and treatment, have received notable and warranted attention. However, individual perspectives of its repercussions on family functioning, including emotional and occupational parental burden, have not been closely examined. The present study details this topic using a large multicenter sample.
  
  
  METHODS
  Participants included 354 youth affected with OCD and their mothers and fathers ascertained through OCD programs in Boston, Massachusetts (n = 180) and Vancouver, British Columbia (n = 174). The validated OCD Family Functioning Scale and standard OCD measurements were completed. Descriptive, between-site, and cross-perspective comparative analyses were followed by regression model testing to predict family impairment.
  
  
  RESULTS
  Family functioning was negatively affected from youth, mother, and father perspectives. Impairment was reportedly more extensive at the time of worst OCD severity and was greater from maternal versus paternal viewpoints. Most frequently affected family tasks and implicated OCD symptoms included morning and bedtime routines and intrusive thoughts. Emotional repercussions in all members included stress and anxiety, followed by frustration or anger in youth and sadness in parents. Nearly half of mothers and one third of fathers reported daily occupational impairment. Compared with youth self-report, parents perceived fewer social and academic effects on their child. Family accommodation most consistently predicted family impairment, especially from parent perspectives. OCD and compulsion severity, contamination and religious obsessions, and comorbidities also predicted various perspectives of family subdomain impairment.
  
  
  CONCLUSIONS
  This study quantitatively details the pervasive burden that pediatric OCD places on families, as reported from complementary relative perspectives. Further attention to this topic is warranted in clinical and research realms.
authors.affiliation: University of British Columbia (UBC), Vancouver, Canada; British Columbia Children's Hospital, Vancouver; the Provincial Health Services Administration, British Columbia; Massachusetts General Hospital, Boston; and Harvard University, Boston. Electronic address: evelyn.stewart@ubc.ca.
authors.forename: S Evelyn
authors.initials: SE
authors.lastname: Stewart
authors.affiliation: Duke University Medical Center, Durham, NC.
authors.forename: Yu-Pei
authors.initials: YP
authors.lastname: Hu
authors.affiliation: UBC.
authors.forename: Aldrich
authors.initials: A
authors.lastname: Leung
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Elaine
authors.initials: E
authors.lastname: Chan
authors.affiliation: Harvard University.
authors.forename: Dianne M
authors.initials: DM
authors.lastname: Hezel
authors.affiliation: UBC and the Child and Family Research Institute, Vancouver.
authors.forename: Sarah Yao
authors.initials: SY
authors.lastname: Lin
authors.affiliation: UBC and the Child and Family Research Institute, Vancouver.
authors.forename: Laura
authors.initials: L
authors.lastname: Belschner
authors.affiliation: University of Texas, Austin.
authors.forename: Casey
authors.initials: C
authors.lastname: Walsh
authors.affiliation: Massachusetts General Hospital and Harvard University.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Geller
authors.affiliation: Massachusetts General Hospital and Harvard University.
authors.forename: David L
authors.initials: DL
authors.lastname: Pauls
mesh_terms: D000293:Adolescent; D000328:Adult; D001900:Boston; D001955:British Columbia; D002648:Child; D017281:Cost of Illness; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000451:nursing / Q000503:physiopathology / Q000523:psychology*; D010290:Parents / Q000523:psychology
keywords: emotional; family; obsessive-compulsive disorder; occupational; parents