Date of Award

6-1-2015

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Clinical Psychology

First Advisor

Alice S. Carter

Second Advisor

Laurel Wainwright

Third Advisor

Abbe Garcia

Abstract

As a result of the behaviors that are characteristic of OCD, families are often profoundly impacted by the disorder. In transactional models, which have received less attention in the literature, children with OCD may be affected by parenting styles and family processes, and the course of a child's OCD may be impacted by parent behaviors or responses to obsessive compulsive symptoms. The present study involved the development of a reliable coding system, and use of this system, to measure parent behaviors across clinical and non-clinical groups when engaged in problem-solving discussions with children diagnosed with OCD or anxiety. It further sought to determine a) whether parents of children with OCD or anxiety differ from parents of non-diagnosed children in their behavior when discussing family and anxiety-related problems, and b) whether parent behaviors during these discussions predict child outcome on an anxiety-inducing task. A sample of 165 parent-child pairs (assigned to OCD, Anxiety, and Non-diagnosed groups), engaged in discussions of both family and anxiety-related problems, were coded for 12 parent behaviors related to negativity, positivity, validation of emotions, engagement in discussion, dominance within discussion, and effective problem solving. Analyses were focused on: 1) comparison of group means between discussion type, 2) multivariate analysis of variance of parent behavior within discussion type, 3) repeated measures analysis to assess the impact of discussion type on parenting behaviors across groups, 4) regression analysis to determine the impact of symptom duration on parent discussion behaviors, and 5) regression analysis of the impact on child outcome of parent behaviors during discussions. Findings indicated that, regardless of group membership, parents showed lower negativity, higher positivity, more validation of emotions, more avoidance, and less effective problem solving when engaged in discussions of anxiety, and that parents of children with OCD were more negative and used less effective problem solving than other groups. Hierarchical regression analysis revealed that less effective problem solving and more avoidance in the general discussion, as well as negativity toward the child in the anxiety discussion, predicted children's performance on an anxiety-inducing task. These results suggest that parents' ability to engage in general problem solving discussions, and to refrain from sharing negative appraisals of their children, are critical factors in children's ability to successfully cope with anxiety. Implications for treatment are discussed, as well as the utility of the present coding system as a clinical tool to measure family functioning and problem solving across OCD and anxiety.

Comments

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