Incompleteness and disgust predict treatment outcome in pediatric obsessive compulsive disorder

Increasing evidence suggests that pediatric obsessive-compulsive disorder (OCD) is underpinned not only by fear but by feelings of incompleteness and disgust, but it is currently unclear whether emotion-involvement in OCD symptoms is associated with treatment response in youth with OCD. The present study investigates whether treatment outcome for youth with OCD was predicted by the degree to which fear, disgust, and incompleteness underpinned baseline OCD symptoms. Children and adolescents with OCD entering treatment for this condition (n = 111) were administered standardized OCD symptom measures and an interview designed to assess the degree of fear, incompleteness, and disgust experienced during current OCD symptoms. Follow-up assessments occurred on average 13 months after baseline with each participant coded for outcome according to internationally acknowledged change criteria for pediatric OCD. Participants who reported higher levels of incompleteness and disgust as part of their baseline OCD symptoms had poorer outcomes. Fear did not predict outcome. If replicated under controlled conditions, these results suggest that incompleteness and disgust may act as barriers to improvement in pediatric OCD and that treatment modifications that target these emotions may improve outcome for a subset of youth.