BACKGROUND:

Obsessive-compulsive disorder (OCD) commonly has its onset in childhood, affecting 1-4% of young people under the age of 18 (Douglass et al, 1995; Flament et al., 1988; Heyman et al, 2001) . The disorder is highly disabling across domains (Piacentini et al, 2003) and is predictive of a range of negative outcomes (Wewetzer et al., 2001; Micali et al, 2010). Furthermore, if left untreated the disorder typically follows a chronic course (Skoog & Skoog, 1999) and is major source of economic burden, ranking among the top 10 most disabling illnesses recognized by the World Health Organization (Murray & Lopez, 1996). There is a pressing need to further understand the mechanisms underlying the development and maintenance of pediatric OCD, in order to facilitate effective prevention and intervention.

OCD results from a complex interplay between genetic and environmental factors. Twin studies have shown that genetic factors explain 45-65% of the variance in OCD symptoms in children, with the remainder being accounted for by shared and non-shared environment (Pauls, 2008). The specific environmental risk factors remain unknown, but it has been proposed that aspects of family environment contribute to OCD (Van Noppen et al, 2009). Consistent with this, previous studies have demonstrated that parents of young people with OCD show elevated rates of critical and over-intrusive parenting styles (Barrett et al, 2002; Hibbs et al, 1991) and psychiatric disorders (Lenane et al, 1990). However, a major limitation of the research in this field to date is the reliance on cross-sectional designs, meaning that the direction of effects between childhood OCD and parenting style/parental psychopathology remain unclear. To date, no prospective studies have been conducted to test whether such family factors predict the onset of OCD in children.

AIMS:

This primary aim of this study is to test whether maternal parenting style and maternal psychopathology in early childhood predict the subsequent development of OCD symptoms in youth. A secondary aim is to test whether the persistence of OCD symptoms in young people is mediated by maternal parenting style and maternal pscyhopathology.