To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Teens With Obsessive-Compulsive Disorder Dismissive of Attachment, Making Personal Support Difficult: Presented at AACAP URL: http://www.pslgroup.com/dg/216912.htm Doctor's Guide November 1, 2007
By Maria Bishop BOSTON, MA -- November 1, 2007 -- Teens with obsessive compulsive disorder (OCD) frequently have formed negative concepts about attachment to others, while depressed teens are more often dealing with unresolved trauma and loss. Awareness of these distinctions may help psychiatrists to provide more effective support, and prevent worsening of the disorder's course, according to research presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP). Tord Ivarsson, MD, Researcher, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway, and colleagues from the University of Goteborg, Goteborg, Sweden, assessed the internal working models of adolescents with OCD, depressive disorder (DD), and OCD plus DD, comparing them with control subjects chosen randomly from the general school population. The researchers enrolled 75 adolescents (OCD = 25; DD = 25; OCD + DD = 25) who were being treated at the Child and Adolescent Psychiatry Clinic at the University of Goteborg. Diagnostic assessments involved semi-structured interviews using the Adult Attachment Interview Scoring and Classification System (AAI-SCS). The internal working models concept is the foundation for understanding how attachment operates in relationships. The researchers used five attachment models as classifiers: 1) Free/Secure -- positive model of the self and others, comfortable with closeness and intimacy; 2) Dismissing of Attachment -- positive model of the self but negative model of others, uncomfortable with closeness, overly self-reliant; 3) Enmeshed/Preoccupied -- negative model of the self and positive model of others, high level of closeness, fear of abandonment; 4) Unresolved Trauma or Loss -- negative models of the self and others, fear of and desire for closeness due to an unresolved event; 5) Cannot Classify -- does not fit one model well. While controls were classified as Secure, a large majority of the clinical cases in this study were found to have insecure internal working models, although the kinds of insecurity differed. Teens with OCD (with or without depression) had mostly Dismissing (60%) internal working models, while those with DD were mostly Unresolved (44%). Somewhat less than a third of DD cases' interviews were Cannot Classify (P =.0001 for all). It seems probable, the researchers noted, that subjects with Dismissing and Cannot Classify internal working models have limited competence for emotional and behavioural regulation. "We hypothesise that a lack of such competence will... increase the likelihood of clinical OCD, once subclinical OCD symptoms have emerged," stated Dr. Ivarsson. The Dismissing stance may also interfere with enlisting support from parents when OCD phenomena become troublesome, increasing susceptibility to a worsening OCD course. While the subject and control groups in this study did not differ with regard to gender, it must be noted that the 25 OCD subjects were significantly younger than the teens in the other three groups (1.2 to 1.8 years younger). Most adolescents in this study, subjects or controls, had experienced loss of some kind (90%), but Dr. Ivarsson noted that pathways with unresolved loss or trauma or anomalous attachment relationships might differ in important ways from those with organised attachment patterns where depressive disorder is concerned. [Presentation title: Attachment Internal Working Models in Adolescents With Obsessive-Compulsive Disorder (OCD), Depressive Disorder (DD), OCD Plus DD and in Adolescents From the General Population. Abstract A49] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.