Perfectionism and intolerance for uncertainty as early signs of OCD symptoms: a one-year prospective cohort study in children and early adolescents

Purpose: Cognitive models of Obsessive–Compulsive Disorder (OCD) identified four types of beliefs, which would develop during childhood and play a role in the etiology and maintenance of OCD: Inflated sense of responsibility, Threat overestimation, Importance of control of thoughts, Perfectionism and intolerance for uncertainty. Whereas research has produced consistent evidence in adult OCD, no study examined whether obsessive beliefs predict OCD over time in youth. The current study investigated the role of obsessive beliefs as predictors of OCD symptoms after one year in a large cohort sample of community children and early adolescents. Materials and methods: Seven hundred and seventy-four children and early adolescents recruited from the community (mean age= 10.87 years, range = 8–14, 51.30% females) completed the Obsessive Beliefs Questionnaire-Child Version as a measure of obsessive beliefs, Spence’s Children Anxiety Scale OCD subscale as a measure of OCD symptoms, Children’s Depression Inventory for depression at t0 and at one-year follow-up (t1). Results: More severe Perfectionism and intolerance for uncertainty at t0 predicted more severe OCD symptoms at t1 (β= 0.14, t= 3.84, p<.001) controlling for the effects of OCD symptoms (β= 0.22, t= 5.76, p<.001) and depression at t0 (β= 0.13, t= 3.64, p<.001). Evidence of the effects of the other beliefs was not found. Conclusion: Perfectionism and intolerance for uncertainty could be predictors of early signs of OCD symptoms in youth. Implications for early detection and prevention of OCD in children and adolescents are addressed. Future studies with clinical samples are required.