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Unread October 24th, 2005, 08:41 AM
Joop Meijers Joop Meijers is offline
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Location: Jerusalem Israel
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Default Intrusive thoughts in children

One of the major theories on the development of OCD states that catastrophic misrepresentations of the meaning of intrusive thoughts ( experienced by most people) is a major causal link in the chain that leads to the disorder.
Since approximately 50% of all cases of OCD begin in chiildhood or ealy adolescence, one would expect to find this phenomenon in children and adolescents as well.
I am interested in research into the development of intrusive thoughts in children ( I know the relevant recent litterature and books of the same phenomenon in adults) .
I would appreciate to hear from my CBT colleagues what relevant studies, theoretical contributions, papers, articles you can suggest as one of the sources of information to start investigating the development of intrusive thoughts in children as precursor to OCD. In this area too I am familiar with the studies by John March and his colleagues, and others like him but all those studies pertain mainly to intervention and do not specifically deal with the development of intrusive thoughts in children.
Of course I take into consideration that- given the specifics of cognitive development ( cf. Piaget). and considering the lack of meta-cognition in younger children, the pathway to OCD may be different then posited by the catastrophic misrepresentation hypothesis.
Any suggestion is welcome
Joop Meijers
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Unread October 31st, 2005, 08:57 PM
James Pretzer James Pretzer is offline
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Default Re: Intrusive thoughts in children

I don't know about research or theoretical papers but I have a few thoughts based on clinical; experience and what I remember of developmental psychology...

My sense is that "catastrophic" misinterpretations often play an important role in OCD in children and adolescents. However, the catastrophic misinterpretations of children can be quite different from the catastrophic misinterpretations of adults. Adults with OCD often are afraid that certain intrusive thoughts mean that they will "go crazy", roast in Hell, cause harm to others, act on unacceptable impulses, "lose control", etc.

Older adolescents may have exactly the same misinterpretations but younger children are likely to have less sophisticated, less differentiated misinterpretations. For example, the child may simply believe that certain thoughts are "bad" and therefore unacceptable without having a clear sense of why those thoughts are bad and without having a clear sense of what will happen if they continue to experience those thoughts. Likewise, they may conclude that "something bad" will happen to them or to family members without having a clear idea of exactly what will happen or exactly how their intrusive thoughts relate to the disaster they anticipate. Remember that, to an anxious child, the prospect of being embarassed in front of peers, offending an adult, being left home alone, or getting sick can seem catastrophic.

I remember one of my adult clients describing the event that he saw as his first episode of OCD. As a boy of 10 or 12 he was playing on a little league baseball team. While on the bench during his team's "at bat" he noticed an ant climbing up a friend's soda can. Then the final batter struck out and he had to go onto the field before he had a chance to point the ant out to his friend. While playing outfield a few minutes later it occurred to him that his friend might have accidentally swallowed the ant and he was horrified by the thought. He quickly became obsessed with the idea that some unspecified harm would befall his friend and that it would be his fault because he had not warned his friend. Over the years his OCD shifted from concern to concern but consistently centered around the idea that he had to be alert for any danger to others and warn them or else he would be responsible for any harm that resulted.

Any way, that's my two cents worth.
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