christian counseling today
Vol. 20 no. 2
71
child sample that had been diagnosed
with obsessive-compulsive disorder
(OCD). Participants in the study
were 24 female children ranging in
age between 10 and 12 years. The 24
children were then randomly assigned
to receive either attachment-based
interventions or be in a wait-list control
group (to receive intervention later).
Twelve youth received the attachment-
based treatment over an eight-week
period of time (eight, 60-minute ses-
sions with their mothers). There were
no differences on various measures of
symptom severity between the treat-
ment and control groups at the start of
therapy.
The attachment-based intervention
focused on a number of areas, includ-
ing discussing the link between attach-
ment needs and behavioral expression;
how mothers respond to their children’s
attachment needs; role play of emo-
tional needs and responses; and so on.
A great deal of emphasis was placed on
identifying areas of conflict and training
mothers to respond based on attach-
ment needs rather than the mother’s
own emotional state.
The results were that symptoms of
OCD decreased significantly by the end
of the eight weeks of attachment-based
therapy. These gains were maintained at
the four-week follow-up. There was no
such improvement among children in
the control group.
This study supports other studies
that have been conducted that emphasize
the importance of family-based inter-
ventions. At the same time, it may be
the first to examine attachment-based
interventions. The researchers argue that
future research should consider whether
improving the parent-child relationship
could “contribute to the prevention of
OCD in children” (p. 85).
Whether or not preventative strate-
gies are developed, this study affirms
attachment-based interventions with
children diagnosed with OCD. Perhaps
others will be able to replicate these
findings with a larger sample.
Children with Very Early
Onset OCD
Nakatani, E., Krebs, G., Micali, N., Turner, C.,
Heyman, I. & Mataix-Cols, D. (2011). Children
with Very Early Onset Obsessive Compulsive
Disorder: Clinical Features and Treatment
Outcome.
The Journal of Child Psychology
and Psychiatry
, 52 (12), 1261-1268. DOI:
10.1111/j.1469-7610.2011.02434.x.
Eriko Nakatani and his colleagues
examined early onset obsessive-com-
pulsive disorder (OCD). Literature
suggests that those who report early
onset OCD tend to have greater symp-
tom severity, greater persistence of
symptoms, and are less responsive to
intervention. Three hundred sixty-five
young people were a part of the study.
They were divided into two groups:
very early onset of OCD, which refers
to before the age of 10, and late onset,
which refers to age 10 or later. The
researchers also conducted an analysis
of a subgroup of those who participated
in cognitive-behavioral therapy (CBT)
alone or CBT with medication.
The very early onset group was
younger at the time of assessment and
reported a longer history of OCD.
More frequently reported among the
very early onset group were comorbid
chronic tic disorders (sudden, rapid
and nonrhythmic movements) and
scores (reported by parents) indicat-
ing more total difficulties. The very
early onset group was also more likely
to have higher levels of repeating and
