Comparing Family Accommodation in Pediatric Obsessive-Compulsive Disorder, Anxiety Disorders, and Nonanxious Children

Abstract

Findings highlight family accommodation as a phenomenon that applies broadly and in a similar manner to children with AD and OCD. Evaluating accommodation provides useful information for clinical care and is an important part of the assessment of children with AD and OCD.

An initial study of family accommodation in children and adolescents with chronic tic disorders

“…These incidence rates are consistent with some of the previously reported rates of family accommodation in childhood anxiety and OCD [19], but are comparatively lower than other reports within pediatric OCD [22]. Overall, the accommodating behaviors appeared to fit within family modifications to the child's environment as well as to the parental environment, indicating that these alterations not only affect the child, but also the family routine as a whole.…”

“…The initial family accommodation scale (FAS) was developed as a semistructured clinician-administered interview to assess family accommodation among patients with OCD [47,48]. Subsequently, this instrument was adapted to serve as a parentreport measure in both OCD [19,24] and anxiety disorder samples [23] and found to have acceptable psychometric properties. The 13 items on these scales were reworded to reflect and assess family accommodation due to tics.…”

“…Family accommodation has been a frequently studied construct among patients with OCD [18], with recent investigations extending into anxious youth [19,20]; however, despite commonly observing this phenomenon in families of youth with TS, no data have directly examined family accommodation among youth with TS. Across pediatric OCD and anxiety, accommodation is ubiquitous, occurring to some degree in virtually all families [14,[21][22][23][24][25][26][27].…”

Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: Incidence, clinical correlates, and behavioral treatment response

“…As in youth with OCD, family accommodation is common in children with anxiety disorders, with incidence rates reaching 97% (Lebowitz et al, 2013;Thompson-Hollands, Kerns, Pincus, & Comer, 2014). Frequently endorsed accommodating behaviors include providing reassurance, participating in symptoms, and modifying routines and schedules (Lebowitz, Scharfstein, & Jones, 2014). Parents reported experiencing distress related to accommodation and negative consequences, such as exacerbation of the child's distress/anxiety and anger outbursts when accommodation was not provided (Lebowitz et al, 2014(Lebowitz et al, , 2013.…”

Treatment Concerns and Functional Impairment in Pediatric Anxiety

“…Specifically, youth may experience impaired academic performance due to anxiety, as well as negative impacts on peer relationships related to anxiety-related withdrawal [3]. Family life can be particularly impacted as well, as family members often become involved and accommodate the child [4], consequently maintaining and possibly exacerbating anxiety. Furthermore, relative to healthy controls without psychiatric disorders, youth with anxiety disorders experience lower quality of life [5] and exhibit poorer emotional functioning [6].…”