What are Obsessions and Compulsions in Children?
Obsessions are thoughts that the child cannot get out of his/her head like “I am going to get very sick if I touch that dirty handle” or “Something terrible is going to happen if my books aren’t all in order”. Compulsions are behaviours or rituals that the child feels they HAVE to do over and over such as washing hands repeatedly in a particular pattern or organising toys in a very specific way. These obsessions and compulsions can also be a normal experience, but for some children it takes over their life.
Obsessive-compulsive disorder (OCD) is likely present when these obsessions and compulsions are repeated for long periods. Children with OCD will perform these rituals even if it gets them in trouble. Each compulsion is performed after an obsession to prevent a feared outcome from occurring (e.g., if I tap my fingers seven times then nothing bad will happen to Mum). After the compulsion, the child usually feels less anxious for a short time however, the anxiety peaks again the next time the obsessive thought comes into their mind. Other types of obsessions and compulsions include hoarding (not being able to throw anything away), thoughts about hurting someone (accidentally or intentionally), religious concerns or satanic images, horrific images, counting or tapping.
Prevalence
Between 0.2-1.2% of children and 3% of adolescents, develop OCD (Schniering, Hudson & Rapee, 2000). If obsessions or compulsions are interfering with daily activities then professional help is needed.