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. 2020 Jul;59(7):880-889.
doi: 10.1016/j.jaac.2019.06.018. Epub 2019 Aug 14.

The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth

Matti Cervin  1 , Sean Perrin  2 , Elin Olsson  3 , Kristina Aspvall  4 , Daniel A Geller  5 , Sabine Wilhelm  5 , Joseph McGuire  6 , Luisa Lázaro  7 , Agustin E Martínez-González  8 , Barbara Barcaccia  9 , Andrea Pozza  10 , Wayne K Goodman  11 , Tanya K Murphy  12 , İsmail Seçer  13 , José A Piqueras  14 , Tiscar Rodríguez-Jiménez  15 , Antonio Godoy  16 , Ana I Rosa-Alcázar  17 , Ángel Rosa-Alcázar  18 , Beatriz M Ruiz-García  17 , Eric A Storch  11 , David Mataix-Cols  4
Affiliations

The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth

Matti Cervin et al. J Am Acad Child Adolesc Psychiatry. 2020 Jul.

Abstract

Objective: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well-established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure of these dimensions in unselected schoolchildren and in children with OCD.

Method: We estimated the network structure of OCD symptom dimensions in 6,991 schoolchildren and 704 children diagnosed with OCD from 18 sites across 6 countries. All participants completed the Obsessive-Compulsive Inventory-Child Version.

Results: In both the school-based and clinic-based samples, the OCD dimensions formed an interconnected network with doubting/checking emerging as a highly central node, that is, having strong connections to other symptom dimensions in the network. The centrality of the doubting/checking dimension was consistent across countries, sexes, age groups, clinical status, and tic disorder comorbidity. Network differences were observed for age and sex in the school-based but not the clinic-based samples.

Conclusion: The centrality of doubting/checking in the network structure of childhood OCD adds to classic and recent conceptualizations of the disorder in which the important role of doubt in disorder severity and maintenance is highlighted. The present results suggest that doubting/checking is a potentially important target for further research into the etiology and treatment of childhood OCD.

Keywords: Obsessive-Compulsive Inventory; dimensions; network analysis; obsessive-compulsive disorder.

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Figures

FIGURE 1
FIGURE 1. Network Structure for School-Based and Clinic-Based Samples
Note: Individual (a) and factor-analysis—derived (c) symptom network of schoolchildren and of children with obsessive-compulsive disorder (OCD) (b) and (d). Solid edges represent a positive interconnection; dashed edges represent a negative interconnection. Widths of edges represent strength of an edge. Node circle depicts predictability of that specific node.
FIGURE 2
FIGURE 2. Centrality Estimates for School-Based and Clinic-Based Dimension Networks
Note: Centrality estimates for the symptom dimension network of schoolchildren (a) and of children with obsessive-compulsive disorder (b).
See this image and copyright information in PMC

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References

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