Children and Adolescents With Obsessive-Compulsive Disorder.A Primer for Teachers
Although prevalence rates in the OCD OCD obsessive-compulsive disorder.
Obsessive-compulsive disorder (OCD) literature vary, it has been estimated that 1 in 200 young persons suffers from obsessive-compulsive disorder obsessive-compulsive disorder
Mental disorder in which an individual experiences obsessions or compulsions, either singly or together. An obsession is a persistent disturbing preoccupation with an unreasonable idea or feeling (such as of being contaminated through shaking - 3 or 4 students in an average-size elementary school elementary school: see school. .
In the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , it is estimated that one in every 40 persons suffers from obsessive-compulsive disorder (OCD) (Penzel, 1995), an anxiety disorder anxiety disorder
Any of various psychiatric disorders in which anxiety is either the primary disturbance or is the result of confronting a feared situation or object. characterized by the presence of obsessions or compulsions (American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential world-wide. Its some 148,000 members are mainly American but some are international. [APA (All Points Addressable) Refers to an array (bitmapped screen, matrix, etc.) in which all bits or cells can be individually manipulated.
APA - Application Portability Architecture ], 1994). Once regarded as rare and untreatable Un`treat´a`ble
a. 1. Incapable of being treated; not practicable. , OCD is now considered to be the fourth most common psychiatric disorder among Americans (Rasmussen & Eisen, 1992). Indeed, OCD is so prevalent, yet so secretive, that it has been referred to as a "hidden epidemic" (Jenike, 1989).
OCD is also far more common among children than previously thought. Research indicates that one third to one half of adults with OCD report onset of the disorder during childhood (March & Leonard, 1996). When OCD begins in childhood, it frequently appears between 5 and 8 years of age or during adolescence (Swedo, Leonard, & Rapoport, 1990). Although prevalence rates in the OCD literature vary, it has been estimated that 1 in 200 young persons suffers from obsessive-compulsive disorder - 3 or 4 students in an average-size elementary school, or up to 20 in a large urban high school (March, Leonard, & Swedo, 1995). Prevalence rates may be even higher, however, since childhood OCD is frequently unrecognized or misdiagnosed (Clarizio, 1991; Rasmussen & Eisen, 1992). Thus, teachers have a critical role to play in the identification, treatment, and management of OCD (Adams & Torchia, 1998).
Over the past decade, a flurry of research in the psychological and medical communities has resulted in rapid and dramatic advances in understanding and treating childhood OCD. This article is essentially a "primer" for classroom practitioners, designed to promote an understanding of OCD and to better equip teachers to assist children who struggle daily with their "OCD monster."
What Is OCD?
The clinical definition of "obsession" refers specifically to thoughts, impulses, urges, or images that seem to force their way into a person's thinking (APA, 1994). Young children may try to explain obsessions in particular ways. They may say, for example, that someone on the outside (e.g., "Jiminy Cricket," "friendly martians") is telling them to do things or is putting thoughts in their heads (Swedo, Rapoport, Leonard, Lenane, & Cheslow,
1989). Most people with OCD, however, are aware that the source of these thoughts is their own minds. Nevertheless, they experience great discomfort, anxiety, and/or fear, because the content of the obsessions often is distressing (APA, 1994).
Common childhood obsessions include fear of contamination; fear of harm, illness, or death; fear of making mistakes that will have disastrous results; magical thinking magical thinking Psychology Dereitic thinking, similar to a normal stage of childhood development, in which thoughts, words or actions assume a magical power, and are able to prevent or cause events to happen without a physical action occurring; a conviction that (i.e., that engaging in certain behavior can prevent something bad from happening); fear of thinking or acting in a way that breaches morality or offends God (commonly called "scrupulosity"); and obsessive thinking related to numbers, symmetry, or sex (Francis & Gragg, 1996; Hanna, 1995; Swedo, Rapoport et al., 1989). Thus, a child may be overwhelmed by worries about germ-infested door handles at school, a house fire that may harm family members, or going to hell because of a sacrilegious sac·ri·le·gious
1. Grossly irreverent toward what is or is held to be sacred.
2. Having committed sacrilege.
sac thought. Obsessions also may take the form of pathological doubting. Indeed, doubting among OCD sufferers can be so strong that the French have called it "the doubting disease"; individuals doubt their memories or senses to the point that they do not trust their perceptions (Rapoport, 1991).
Most children attempt to ignore or suppress obsessions (March & Leonard, 1996). Without treatment, however, youngsters may be powerless to stop these intrusive thoughts Intrusive thoughts are unwelcome, involuntary thoughts, images or unpleasant ideas that may become obsessions, are upsetting or distressing, and can be difficult to be free of and manage. . Having such uncontrollable, disturbing thoughts leads many sufferers to fear that they are going crazy. Individuals with OCD are not crazy, however. In fact, most children have insight into their disorder: They realize that what they are thinking is irrational or, in children's terms, "silly" or "stupid" (Johnston & March, 1992; March & Leonard, 1996).
Whereas obsessions occur only in the mind, compulsions manifest as ritualized behavior that can be either covert (internal, or mental) or overt (outward, or physical). Compulsions are behaviors that are performed intentionally to reduce the anxiety or discomfort brought on by obsessions (APA, 1994). Although a small percentage of sufferers experience only obsessions or only compulsions, the large majority of people with OCD have both obsessions and compulsions (March & Leonard, 1996). Indeed, children frequently experience multiple obsessions and compulsions concurrently. Furthermore, the specific content of their obsessions and compulsions tends to change over time (American Academy The American Academy in Berlin is a non-partisan academic institution in Berlin. It was founded in September 1994 by a group of prominent Americans and Germans, among them Richard Holbrooke, Henry Kissinger, Richard von Weizsäcker, Fritz Stern and Otto Graf Lambsdorff and opened in of Child and Adolescent Psychiatry A branch of psychiatry that specialises in work with children, teenagers, and their families. History
An important antecedent to the specialty of child psychiatry was the social recognition of childhood as a special phase of life with its own developmental stages, starting with [AACAP AACAP American Academy of Child and Adolescent Psychiatry
AACAP ATSIC/Army Community Assistance Program
AACAP Area Agency on Aging of the Capital Area (Texas) ], 1998).
Compulsions frequently are shaped by the content of the obsession. For children who obsess ob·sess
v. ob·sessed, ob·sess·ing, ob·sess·es
To preoccupy the mind of excessively.
v.intr. about germs on a door handle, for example, the corresponding compulsion may take the form of covering their hands before touching the handle, washing their hands immediately after contact with it, or avoiding touching it entirely (Adams & Torchia, 1998). In some cases, however, obsessions and compulsions are paired in a way that cannot be explained. For example, a child may read and reread Verb 1. reread - read anew; read again; "He re-read her letters to him"
read - interpret something that is written or printed; "read the advertisement"; "Have you read Salman Rushdie?" a sentence over and over again because he believes that doing so will somehow prevent his parents' deaths. The child may not understand his own behavior and may be embarrassed if asked to explain how his repeated actions can influence events (Johnston & March, 1992). It is important to note that some children, particularly younger children, are not aware of, or have difficulty verbalizing, obsessions. In these cases, ritualistic rit·u·al·is·tic
1. Relating to ritual or ritualism.
2. Advocating or practicing ritual.
rit or compulsive behavior Compulsive behavior is behavior which a person does "compulsively", i.e., not because he enjoys it but because he feels he "has to". The two most common forms are:
1. An apartment house or office building with no elevator.
2. An apartment or office in a building with no elevator. , 1997).
Common childhood compulsions include excessive handwashing, showering, or cleaning; checking doors, windows, locks, or other objects; repeating actions over and over again; counting; touching or tapping objects; and excessive collecting or hoarding. Mental rituals include saying prayers, words, poems, or songs over and over in one's mind (Hanna, 1995; March & Leonard, 1996; Swedo, Rapoport et al., 1989). Compulsive behavior, then, may manifest in a child's washing his or her hands until they are chapped, cracked, or even bleeding; checking one's body for indications of an illness; or mentally reciting the Lord's Prayer 10 times in a row.
It is important to note that behaviors such as doubting, checking, and repeating represent a normal part of daily functioning. Think for a moment about leaving your home in the morning. You turn the key in the lock. You may think, "Is the door really locked?" Just to be sure, you turn the handle and push on the door. Satisfied that the door is secure, you leave for work. In a similar vein, teachers and children routinely wash their hands at school to promote personal hygiene personal hygiene person n → Körperhygiene f and prevent the spread of germs and illness. It is only when these actions are carried out to excess - checking the door 20 times or washing one's hands for two hours at a time, for example - that concerns about OCD should be raised. In fact, by definition, an individual has OCD only if the behaviors are distressing and time-consuming, or if they significantly interfere with daily functioning (APA, 1994).
It also is important for teachers to remember that most, if not all, children exhibit developmentally appropriate, normal obsessive-compulsive behaviors. These behaviors occur early in childhood, and actually enhance socialization socialization /so·cial·iza·tion/ (so?shal-i-za´shun) the process by which society integrates the individual and the individual learns to behave in socially acceptable ways.
n. and advance development. Mastery of separation anxiety, for example, is promoted by bedtime rituals and childhood games such as "step on a crack step on a crack
and break your mother’s back; advice to avoid walking on cracks in pavement. [Am. Folklore: Misc.]
See : Luck, Bad and you'll break your mother's back." By contrast, OCD occurs somewhat later in development, appears bizarre to adults and other children (if not to the affected child), and produces dysfunction, rather than mastery (Leonard, 1989).
Causes of OCD
While the exact cause or causes of OCD are unclear, substantial evidence suggests that the illness is linked to a disturbance in brain functioning. Much of the research points to a complication in the transmission of serotonin, one of the major chemicals (neurotransmitters Neurotransmitters
Chemicals within the nervous system that transmit information from or between nerve cells.
Mentioned in: Bulimia Nervosa, Impotence, Pain, Withdrawal Syndromes ) found in the brain (Barr, Goodman, Price, McDougle, & Charney, 1992; Winslow & Insel, 1990). Furthermore, there is evidence to suggest that a particular circuit in the brain is involved in OCD (Swedo, Schapiro et al., 1989). Other research has indicated that the volume of certain structures within the brain may be greater in individuals with OCD than in those without the disorder (Rauch, Bates Bates , Katherine Lee 1859-1929.
American educator and writer best known for her poem "America the Beautiful," written in 1893 and revised in 1904 and 1911. , & Grachev, 1997).
Other factors that appear to play a role in OCD are genetics, infection, and life events (Lenane et al., 1990). Psychiatric disorders such as depression, Tourette Syndrome Tourette syndrome
Rare neurological disease that causes repetitive motor and vocal tics. Named for Georges Gilles de la Tourette, who first described it in 1885, it occurs worldwide, is usually inherited, generally begins at ages 2–15, and is three times more common , and anxiety disorders Anxiety disorders
A group of distinct psychiatric disorders characterized by marked emotional distress and social impairment, including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. other than OCD are common among family members of children with OCD (Lenane et al., 1990). Moreover, research suggests that approximately 25 to 30 percent of children and adolescents with OCD have a parent or sibling with the disorder (Swedo, Leonard, & Rapoport, 1990). Hence, in some cases, there appears to be a genetic predisposition genetic predisposition Molecular medicine The tendency to suffer from certain genetic diseases–eg, Huntington's disease, or inherit certain skills–eg, musical talent for obsessive-compulsive disorder. Recent research also suggests that for a small percentage of children, sudden-onset OCD or sudden worsening of existing OCD symptoms may result from bacterial or viral infections. According to this theory, antibodies produced to ward off the infections are believed to cause an inflammation in certain areas of the brain, which may result in OCD symptoms (Allen, Leonard, & Swedo, 1995). In addition, the onset of childhood OCD frequently can be linked to a specific, often traumatic, life event such as the death of a loved one, a divorce, a change in schools (e.g., going from elementary school to middle school), a move to a new location, or unhappiness at school (Allsopp & Verduyn, 1990; Rapoport, 1991).
In sum, it is crucial for teachers to realize that neither psychological conflicts nor problems in early childhood, such as inappropriate toilet training, appear to be the root cause of OCD (Greist, 1997; Rapoport, 1991). Thus, although stress from family conflict certainly can affect OCD symptoms, parents do not cause OCD.
Treatment of OCD
Several different treatments have been shown to be beneficial in managing OCD symptoms. A specific form of cognitive behavior therapy behavior therapy or behavior modification, in psychology, treatment of human behavioral disorders through the reinforcement of acceptable behavior and suppression of undesirable behavior. known as exposure and response prevention Exposure and response prevention (ERP) is a treatment method available from behavioral psychologists and cognitive-behavioral therapists for a variety of anxiety disorders, especially Obsessive Compulsive Disorder. (ERP (Enterprise Resource Planning) An integrated information system that serves all departments within an enterprise. Evolving out of the manufacturing industry, ERP implies the use of packaged software rather than proprietary software written by or for one customer. ) has been very effective for many children with OCD (March & Mulle, 1998). Medications that alter the transmission of serotonin in the brain also are used widely to treat OCD, including Anafranil, Prozac, Luvox, Paxil, and Zoloft. Like all medications, such drugs may produce side effects Side effects
Effects of a proposed project on other parts of the firm. including sedation Sedation Definition
Sedation is the act of calming by administration of a sedative. A sedative is a medication that commonly induces the nervous system to calm.
The process of sedation has two primary intentions. , insomnia, stomach and intestinal upsets, increased or decreased appetite, and restlessness (Johnston & Fruehling, 1997). Although rare, more serious side effects may occur, including elevated heart rate, dizziness, blackouts, psychiatric symptoms, and seizures. Teachers should notify parents immediately if any of the latter symptoms are observed at school (A. J. Allen, personal communication, June 3, 1997).
Although behavior therapy and medications, alone or in combination, are effective for large numbers of children with OCD, additional treatment components are essential in many cases. Included among these are cognitive therapy cognitive therapy
Any of a variety of techniques in psychotherapy that utilize guided self-discovery, imaging, self-instruction, and related forms of elicited cognitions as the principal mode of treatment. , social skills training, support groups, and individual and family therapy (Rapoport, Leonard, Swedo, & Lenane, 1993). For children who struggle with OCD at school, it is very important that educational interventions be a fundamental part of treatment (Adams & Torchia, 1998).
Conditions Associated With OCD
OCD frequently co-exists with other disorders and conditions such as Tourette Syndrome (TS), Attention Deficit/Hyperactivity Disorder Attention deficit/hyperactivity disorder
A persistent pattern of inattention, hyperactivity and/or impulsiveness; the pattern is more frequent and severe than is typically observed in people at a similar level of development. (AD/HD), depression, disruptive behavior disorders, and anxiety disorders other than OCD (e.g., panic disorder Panic Disorder Definition
A panic attack is a sudden, intense experience of fear coupled with an overwhelming feeling of danger, accompanied by physical symptoms of anxiety, such as a pounding heart, sweating, and rapid breathing. and separation anxiety) (Hanna, 1995; Swedo, Rapoport et al., 1989). Children with OCD also commonly exhibit a type of learning disability known as a nonverbal learning disability (NVLD NVLD Non Verbal Learning Disorder ). Language and reading skills are intact in children with NVLDs, but they may experience difficulties in nonverbal areas that tap visual-spatial areas. Such difficulties can lead to problems with math, handwriting, and processing social-emotional information (March & Mulle, 1998).
It is essential that teachers recognize another potentially debilitating de·bil·i·tat·ing
Causing a loss of strength or energy.
Weakening, or reducing the strength of.
Mentioned in: Stress Reduction condition that usually occurs with OCD: family stress. Parents may experience stress as a result of many different factors, including feeling guilty that they may have caused or passed on the disorder; taking a child to numerous physicians, only to receive incorrect diagnoses; and witnessing or feeling pressure to participate in a child's rituals (e.g., the child may insist that a parent repeatedly check a door or wash clothing). In addition, parents frequently have difficulty distinguishing voluntary behavior (behavior that is within the child's control) from involuntary behavior (OCD-related behavior that is outside the child's control) (Adams & Torchia, 1998; A. J. Allen, personal communication, August 22, 1997).
Siblings of children with OCD also may experience significant stress. In some cases, they are ridiculed because of the afflicted af·flict
tr.v. af·flict·ed, af·flict·ing, af·flicts
To inflict grievous physical or mental suffering on.
[Middle English afflighten, from afflight, sibling's bizarre behavior. They may even be reluctant to invite friends into their homes. Siblings sometimes feel neglected by their parents because it seems as though the affected child "gets all the attention." And indeed, caring for a child with OCD frequently requires an inordinate amount of parents' time and energy. Siblings secretly may be concerned that they, too, will become a victim of OCD. Therefore, when a child suffers from OCD, it is important to attend to the needs of any siblings (Adams & Torchia, 1998; Rapoport, Leonard, Swedo, & Lenane, 1993).
OCD in the School Context
Teachers should be aware that there is a range in the severity level of OCD symptons. For example, a child may have relatively mild symptoms that only minimally interfere with functioning at home or at school. Some children experience symptoms that hinder performance in both settings. Others are adept at keeping their symptoms under control at school. Once at home, however, they frequently "let loose" and begin a frenzy of ritualized, compulsive behavior. This situation may set the stage for conflict between the home and the school: Family members are drained by the child's OCD symptoms, yet school personnel are not observing problems at school. It may even be difficult for school professionals to believe that parents are accurately describing conditions at home. In these circumstances, it is important for teachers to take parents at their word and to provide as much support as possible (Adams & Torchia, 1998).
Symptoms of OCD
Despite differences in the ways OCD manifests at school, some patterns of OCD behavior are recognizable. First and foremost, the teacher must realize that the obsessions that bombard bom·bard
tr.v. bom·bard·ed, bom·bard·ing, bom·bards
1. To attack with bombs, shells, or missiles.
2. To assail persistently, as with requests. See Synonyms at attack, barrage2.
3. the child will reduce his or her ability to pay attention to instruction (Adams, Waas, March, & Smith, 1994). Thus, the child who frequently has such thoughts as "If I do this wrong, will God be mad at me?" or "If I touch that object, I may get really sick and die" will have difficulty disengaging dis·en·gage
v. dis·en·gaged, dis·en·gag·ing, dis·en·gag·es
1. To release from something that holds fast, connects, or entangles. See Synonyms at extricate.
2. attention from those thoughts in order to pay attention to the ongoing lesson. The child also may be engaging in mental rituals in response to obsessions. For example, a child may feel compelled to count mentally to 12, 12 times in succession, to prevent her dog from dying. A teacher may observe these children gazing out the window or staring blankly at a worksheet and believe them to be inattentive in·at·ten·tive
Exhibiting a lack of attention; not attentive.
inat·ten , lazy, or even defiant, when in fact, the children are trapped in the clutches of OCD. This drain of mental energy may leave little, if any, attention for the task at hand, and frequently diminishes the child's ability to learn. Therefore, work production and grades may suffer (Adams, Waas, March, & Smith, 1994). Children with OCD may become frustrated and embarrassed by their failure to meet teacher and/or parental expectations. If the classroom is an especially threatening environment, they may even take extreme measures to avoid attending school (Clarizio, 1991).
Rituals may remain undetected because many children are skilled at keeping them hidden. The alert teacher, however, may notice one or more of the following warning signs:
* Using a shirt, jacket, glove, paper towel, tissue, etc. to cover hands while touching a door knob or handle
* Making excessive requests to use the bathroom (where the student may be carrying out cleaning rituals)
* Repeatedly checking doors, windows, electrical outlets, classroom media aids, computers, lockers, school supplies, backpacks
* Excessively checking answers on written assignments or tests (parents may report excessive checking of homework assignments)
* Engaging in repetitive movements such as walking in and out of a doorway, getting up and down from a desk, walking up and down the hallway, sharpening a pencil
* Reading and rereading words, sentences, paragraphs, or pages in a book
* Crossing out and rewriting (or erasing and re-erasing) letters, words, numbers, etc. on written assignments (i.e., "perfectionistic" behavior)
* Meticulously filling in circles/boxes on computer-scored answer sheets
* Repeatedly tying shoes so that the bow on each shoe is perfectly balanced
* Arranging items on a desk, shell or worksheet so that they appear symmetrical
* Repeatedly touching an object, such as a tree on the playground
* Avoiding contact with objects such as glue, paste, paint, clay, chalk, or scissors scissors
Cutting instrument or tool consisting of a pair of opposed metal blades that meet and cut when the handles at their ends are brought together. Modern scissors are of two types: the more usual pivoted blades have a rivet or screw connection between the cutting ends
* Repeatedly asking questions to secure reassurance (e.g., about safety concerns)
* Showing signs of fatigue (the child may be staying up late completing rituals)
* Being habitually tardy tar·dy
adj. tar·di·er, tar·di·est
1. Occurring, arriving, acting, or done after the scheduled, expected, or usual time; late.
2. Moving slowly; sluggish. (the child may be engaging in morning rituals). (Adams & Torchia, 1998)
OCD also may have a significant effect on social functioning social functioning,
n the ability of the individual to interact in the normal or usual way in society; can be used as a measure of quality of care. . Children with OCD frequently have difficulty making and maintaining friendships. Aware that their thoughts and behaviors are odd and socially unacceptable, these young people may go to great lengths to hide the disorder from their peers, resulting in social isolation. Furthermore, preoccupation with unending obsessions and rituals frequently leaves little time or energy for friends or family. When OCD symptoms are observable to peers, the child may become the target of teasing and cruel remarks, encouraging further social ostracism ostracism (ŏs`trəsĭz'əm), ancient Athenian method of banishing a public figure. It was introduced after the fall of the family of Pisistratus. (Clarizio, 1991; Rapoport, Leonard, Swedo, & Lenane, 1993).
How Teachers Can Help
P-8 teachers can play a pivotal role in the life of a child with OCD in several ways. First, they must become educated about the disorder and its various manifestations in the school setting. Adams, Waas, March, and Smith (1994) stress that,
Classroom teachers represent a crucial resource in the identification process due to their extensive interaction with, and opportunities to observe, students. Teachers are also in a position to receive verbal reports from other students concerning a child exhibiting OCD-related behaviors. For these reasons, the initial identification of children at risk for OCD often will be made by classroom teachers. (p. 280, italics added)
Second, the teacher can collaborate with student services personnel (e.g., school psychologist, counselor, social worker) to explore options for an outside mental health evaluation. Third, once a diagnosis of OCD has been made, the teacher can play an important role in school-based academic and behavioral interventions. Teachers also can monitor and document the effects of medication and share their observations with health care providers (Adams & Torchia, 1998).
Educational Services for Youth With OCD
Most students with OCD can succeed in the general education classroom setting (Johnston & Fruehling, 1997). In some cases, teachers will need to make specific accommodations or modifications. For example, a student with OCD who has trouble with written assignments due to writing compulsions (e.g., the child endlessly writes and rewrites words) may need to do assignments orally or put responses on tape. (The interested reader is referred to Adams & Torchia, 1998, for a more complete discussion of accommodations.) Such accommodations may be provided within the context of a "504 plan" (Adams & Torchia, 1998). Section 504 of the Rehabilitation Act of 1973, a civil rights law, states that a child qualifies for special services For Special Services, first published in 1982, was the second novel by John Gardner featuring Ian Fleming's secret agent, James Bond. Carrying the Glidrose Publications copyright, it was first published in the United Kingdom by Jonathan Cape and in the United States by if he or she exhibits a physical or mental impairment that substantially limits one or more major life activities, such as caring for oneself, learning, or working. Students with more serious cases of OCD may require special education and related services under the Individuals With Disabilities Education Act
Some statements may be disputed, incorrect, , biased or otherwise objectionable.
Obsessive-compulsive disorder is a serious and potentially debilitating illness. You can make a profound difference in the lives of these students by taking a deeper look at their behavior and, if you suspect OCD, taking appropriate steps. Darren Fleeger (1995) wishes that a teacher had done that for him:
As a child with OCD, I was very sensitive, moody, depressed, and introverted in·tro·vert·ed
Marked by interest in or preoccupation with oneself or one's own thoughts as opposed to others or the environment. . Much of my time was spent seeking refuge in some solitary activity.... Teachers saw me as a bright, though emotional, student. Now I wish that my character was more problematic in school. OCD is such a secretive and embarrassing disease. It would have been nice if someone had picked up on my strange behavior and suggested something. Maybe that would have saved [me] years of suffering. (pp. 27-28)
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Adams, G. B., Waas, G. A., March, J. S., & Smith, M. C. (1994). Obsessive compulsive disorder Obsessive compulsive disorder (OCD)
Disorder characterized by persistent, intrusive, and senseless thoughts (obsessions) or compulsions to perform repetitive behaviors that interfere with normal functioning.
Mentioned in: Tourette Syndrome in children and adolescents: The role of the school psychologist in identification, assessment, and treatment. School Psychology Quarterly, 9(4), 274-294.
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Of or relating to pediatrics. OCD and Tourette's Syndrome Tou·rette's syndrome or Tou·rette syndrome
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Study of the development and function of the nervous system, with emphasis on how nerve cells generate and control behavior. The major goal of neurobiology is to explain at the molecular level how nerve cells differentiate and develop their of obsessive compulsive disorder: A possible role for serotonin. Journal of Clinical Psychiatry, 51 (8) (supplement), 27-31.
For information on OCD, contact the Obsessive-Compulsive Foundation, P.O. Box 70, Milford, CT 06460; 203-878-5669; http://www.ocfoundation.org.
Gail B. Adams is Educational Psychologist, Department of Pediatrics, University of Illinois University of Illinois may refer to:
Robert W. Burke is Assistant Professor, Department of Elementary Education, Ball State University, Muncie, indiana.