A multilevel longitudinal study of obsessive compulsive symptoms in adolescence: male gender and emotional stability as protective factors

Annals of General Psychiatry, Dec 2017

The severity of obsessive compulsive symptoms (OCS) is suggested to be normally distributed in the general population, and they appear to have an impact on a range of aspects of adolescent development. Importantly, there are individual differences regarding susceptibility to OCS. In the present repeated measures study, OCS were studied in relation to gender and emotional stability (as a personality trait) using a normative sample of 515 adolescents at ages 16 and 18 years. OCS were assessed with the relevant subscale of the SCL-90-R and emotional stability with the Five Factor Questionnaire. A three-level hierarchical linear model was calculated to longitudinally assess the over time variations of OCS and their over time links to gender and emotional stability, while controlling for random effects due to the nesting of the data. Experiencing OCS increased with age (between 16 and 18 years). Additionally, male gender and higher emotional stability were associated with lower OCS at 16 years and these remained stable over time. Results indicate age-related and between individual differences on reported OCS that need to be considered for prevention and intervention planning.

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A multilevel longitudinal study of obsessive compulsive symptoms in adolescence: male gender and emotional stability as protective factors

Stavropoulos et al. Ann Gen Psychiatry A multilevel longitudinal study of obsessive compulsive symptoms in adolescence: male gender and emotional stability as protective factors Vasilis Stavropoulos 0 1 Kathleen A. Moore 1 Helen Lazaratou 0 Dimitris Dikaios 0 Rapson Gomez 1 0 National and Kapodistrian University of Athens , Vas Sofias 72, 11528 Athens , Greece 1 Federation University Australia , Mount Helen, Ballarat, VIC , Australia The severity of obsessive compulsive symptoms (OCS) is suggested to be normally distributed in the general population, and they appear to have an impact on a range of aspects of adolescent development. Importantly, there are individual differences regarding susceptibility to OCS. In the present repeated measures study, OCS were studied in relation to gender and emotional stability (as a personality trait) using a normative sample of 515 adolescents at ages 16 and 18 years. OCS were assessed with the relevant subscale of the SCL-90-R and emotional stability with the Five Factor Questionnaire. A three-level hierarchical linear model was calculated to longitudinally assess the over time variations of OCS and their over time links to gender and emotional stability, while controlling for random effects due to the nesting of the data. Experiencing OCS increased with age (between 16 and 18 years). Additionally, male gender and higher emotional stability were associated with lower OCS at 16 years and these remained stable over time. Results indicate age-related and between individual differences on reported OCS that need to be considered for prevention and intervention planning. Obsessive compulsive symptoms; Adolescence; Gender; Development; Emotional stability Background Over the past two decades, significant emphasis has been placed on understanding the etiology of obsessive compulsive symptoms (OCS) [ 1, 2 ]. OCS entail recurrent and persistent thoughts that are experienced as intrusive, but which cannot be ignored (obsessions). Individuals often engage in repetitive physical or mental acts (compulsions) aimed at reducing or removing the stress induced by the obsessions. The severity of OCS is suggested to be normally distributed in the general population and often constitutes a transient part of normal development (e.g., commonplace childhood rituals such as not walking on pavement lines) [ 3, 4 ]. However, OCS over a specific threshold may result in obsessive compulsive disorder (OCD), which is a chronic psychiatric condition, with potentially serious repercussions [ 5 ] OCD includes either obsessions or compulsions or a combination of both. It tends to compromise the quality of life and the well-being of the individual in significant ways by causing distress and interfering with everyday functioning [ 1, 3 ]. Research has advanced knowledge regarding the nature and the etiology of OCS [ 6 ]. In particular, OCS have been described as heterogeneous, varying across several different dimensions (i.e., cleaning/contamination, forbidden thoughts, symmetry/ordering-counting, hoarding/ acquiring and retaining objects) [ 3, 7, 8 ]. The broader OCS dimensions (content of OCS) experienced by individuals remain relatively stable over time (i.e., propensity to experience forbidden thoughts is likely to shift from thoughts of violence to thoughts of religion, but is less likely to shift from forbidden thoughts to hoarding [ 1, 9 ]; however, the severity/intensity of OCS may vary over developmental phases [1]. For instance, obsessions related to fear and loss of others are typically higher in childhood and sexual obsessions tend to present more during adolescence [ 10 ]. Although there is consensus that levels of OCS fluctuate over developmental phases, there is a dearth of longitudinal studies that focus specifically on factors associated with particular developmental trajectories [ 1 ]. As it is considered a high-risk period for the onset of OCS and the diagnosis of OCD, explaining variations in the severity of OCS during adolescence appears particularly important [ 2 ]. Also, identifying factors that may contribute to higher OCS severity in adolescents could provide useful clinical guidelines for more effective prevention and treatment interventions. Conceptual framework To address these needs an integrative, multilevel approach that blends elements and concepts from the OCS literature and from the risk and resilience framework was used [ 4, 11, 12 ]. Specifically, Abramowitz et al. [ 4 ] contended that OCS may often constitute a part of normal development that may be better approached dimensionally, that is on a continuum from minimum to maximum OCS, rather than categorically (presence vs absence of OCS). In that context, pathological aspects of OCS have been defined as extreme versions of normative cognitive and emotional processes [ 11 ]. There is evidence supporting a multidimensional model of OCD/OCS, where the complex clinical presentation of OCD has (...truncated)


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Vasilis Stavropoulos, Kathleen A. Moore, Helen Lazaratou, Dimitris Dikaios, Rapson Gomez. A multilevel longitudinal study of obsessive compulsive symptoms in adolescence: male gender and emotional stability as protective factors, Annals of General Psychiatry, pp. 42,