Obsessive-Compulsive Disorder (OCD) in childhood is characterized by recurrent and persistent obsessions and/or compulsions that cause distress or interfere with everyday life.
Obsessions are involuntary thoughts or feelings that arise repeatedly in the child's mind and which are frightening, disgusting, or bothersome. Obsessions are not simply excess worries about real-life problems. Examples of obsessions include thoughts that something bad will happen to a loved one if the child does not engage in a compulsion and fears of contamination or getting sick.
Compulsions are repeated behaviors or rituals that are done rigidly and in response to an obsession and which are usually aimed at preventing some dreaded event or situation. Examples of compulsions in children include repeated washing or dressing in a certain way; repeatedly checking things like doors, windows, light switches, or homework; erasing or rewriting; or repeating certain words/phrases or numbers over and over. Often children will ask family members for reassurance and will involve them in rituals. OCD can result in a lot of avoidance (e.g., not touching doorknobs) and distress.
Cognitive behavior therapy (CBT) and certain types of medication have been shown to be helpful in the treatment of OCD. Cognitive-behavior therapy for OCD is based on the techniques of exposure plus response prevention (ERP). In ERP, children are systematically exposed to the feared situations (exposure) while being instructed not to engage in their ritualistic behaviors (response prevention). Children are taught to challenge distorted thoughts and use other coping skills.