Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations

D. R.M.A. Højgaard; E. L. Mortensen; T. Ivarsson; K. Hybel; G. Skarphedinsson; J. B. Nissen; R. Valderhaug; K. Dahl; B. Weidle; N. C. Torp; M. Grados; A. B. Lewin; K. H. Melin; E. A. Storch; L. H. Wolters; T. K. Murphy; E. J.S. Sonuga-Barke; P. H. Thomsen

doi:10.1007/s00787-016-0887-5

Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations

D. R.M.A. Højgaard, E. L. Mortensen, T. Ivarsson, K. Hybel, G. Skarphedinsson, J. B. Nissen, R. Valderhaug, K. Dahl, B. Weidle, N. C. Torp, M. Grados, A. B. Lewin, K. H. Melin, E. A. Storch, L. H. Wolters, T. K. Murphy, E. J.S. Sonuga-Barke, P. H. Thomsen

Faculty of Psychology

University of Iceland

Research output: Contribution to journal › Article › peer-review

Abstract

The underlying structure of obsessive–compulsive disorder (OCD) remains to be confirmed in child and adolescent populations. In this paper we report the first factor analytic study of individual OCD items from Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). OCD symptoms were assessed using the CY-BOCS symptom checklist in a sample of 854 patients with OCD (7–18 years of age) recruited from clinics in five countries. Pooled data were subjected to exploratory and confirmatory factor analysis (CFA) to identify the optimal factor structure. Various models were tested for age and gender subgroups. Also, the invariance of the solution across age and gender was tested and associations with demographic and clinical factors were explored. A three-factor model provided the best-fit solution. It consisted of the following factors: (1) harm/sexual, (2) symmetry/hoarding, (3) contamination/cleaning. The factor structure was invariant for age and gender across subgroups. Factor one was significantly correlated with anxiety, and factor two with depression and anxiety. Factor three was negatively correlated with tic disorder and attention-deficit/hyperactivity disorder (ADHD). Females had higher scores on factor two than males. The OCD symptom structure in children and adolescents is consistent across age and gender and similar to results from recent child and adolescents although hoarding may not be a separate factor. Our three-factor structure is almost identical to that seen in early studies on adults. Common mental disorders had specific patterns of associations with the different factors.

Original language	English
Pages (from-to)	281-291
Number of pages	11
Journal	European Child and Adolescent Psychiatry
Volume	26
Issue number	3
DOIs	https://doi.org/10.1007/s00787-016-0887-5
Publication status	Published - 1 Mar 2017

Bibliographical note

Funding Information: The authors would like to thank TrygFonden, Lundbeck Foundation and Central Region Denmark’s Research Fund for supporting the research presented in this article through project grants. They would also like to thank the participants and staff from the contributing clinics. Funding Information: Edmund Sonuga-Barke: Speaker fees, consultancy, research funding and conference support from Shire Pharma. Speaker fees from Janssen Cilag, Consultancy from Neurotech solutions, Aarhus University, University of Copenhagen and Berhanderling, Skolerne, Copenhagen, KU Leuven. Book royalties from OUP and Jessica Kingsley. Grants awarded from MRC, ESRC, Wellcome Trust, Solent NHS Trust, European Union, Child Health Research Foundation New Zealand, NIHR, Nuffield Foundation, Fonds Wetenschappelijk Onderzoek-Vlaanderen (FWO), MQ—Transforming Mental Health. Eric A. Storch: Research Funding: National Institutes of Health, All Children’s Hospital Research Foundation Agency for Healthcare Research and Quality. Book Royalties: Wiley, Springer, American Psychological Association, Lawrence Erlbaum. Consultant: Prophase, INC, Rogers Memorial Hospital. Tord Ivarsson: Speakers bureau of Shire. Per Hove Thomsen: Speakers bureau of Shire and MEDICE. Tanya Murphy has received research funding from the Florida Agency for Healthcare Administration, AstraZeneca Research &Development, Brain and Behavior Research Foundation, the Centers for Disease Control and Prevention (CDCP), F. Hoffmann-La Roche Ltd., Indevus Pharmaceuticals, IOCDF, NIMH, Otsuka Pharmaceuticals, Pfizer, Inc., Psyadon Pharmaceuticals, Inc, and Shire Pharmaceuticals. She is on the Scientific and Clinical Advisory Board for the IOCDF. She has received travel support from the TSA and honoraria from grand rounds/CME lectures. Adam Lewin has received research funding from All Children’s Hospital, Florida Agency for Healthcare Administration, the International OCD Foundation (IOCDF), and the Centers for Disease Control and Prevention (CDC). He is on the Scientific and Clinical Advisory Board for the IOCDF and is on the Board of Directors for the Society for Clinical Child and Adolescent Psychology (SCCAP) and the American Board of Clinical Child and Adolescent Psychology (ABCCAP). He has received honorarium and/or travel support from the Tourette Association of America (TAA), American Psychological Association, Springer, Oxford Press, University of Central Oklahoma, Rogers Memorial Hospital, and James Cook University. He is on the speaker’s bureau for IOCDF and TAA. Consultant for Prophase, LLC and Bracket. Remaining authors: No conflict of interest. Publisher Copyright: © 2016, Springer-Verlag Berlin Heidelberg.

Other keywords

CY-BOCS
Children and adolescents
Comorbidity
Factor analysis
OCD symptom patterns
Obsessive–compulsive disorder

Access to Document

10.1007/s00787-016-0887-5

Cite this

Højgaard, D. R. M. A., Mortensen, E. L., Ivarsson, T., Hybel, K., Skarphedinsson, G., Nissen, J. B., Valderhaug, R., Dahl, K., Weidle, B., Torp, N. C., Grados, M., Lewin, A. B., Melin, K. H., Storch, E. A., Wolters, L. H., Murphy, T. K., Sonuga-Barke, E. J. S., & Thomsen, P. H. (2017). Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations. European Child and Adolescent Psychiatry, 26(3), 281-291. https://doi.org/10.1007/s00787-016-0887-5

@article{8a7941be77a34f15b72716d8496222db,

title = "Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations",

abstract = "The underlying structure of obsessive–compulsive disorder (OCD) remains to be confirmed in child and adolescent populations. In this paper we report the first factor analytic study of individual OCD items from Children{\textquoteright}s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). OCD symptoms were assessed using the CY-BOCS symptom checklist in a sample of 854 patients with OCD (7–18 years of age) recruited from clinics in five countries. Pooled data were subjected to exploratory and confirmatory factor analysis (CFA) to identify the optimal factor structure. Various models were tested for age and gender subgroups. Also, the invariance of the solution across age and gender was tested and associations with demographic and clinical factors were explored. A three-factor model provided the best-fit solution. It consisted of the following factors: (1) harm/sexual, (2) symmetry/hoarding, (3) contamination/cleaning. The factor structure was invariant for age and gender across subgroups. Factor one was significantly correlated with anxiety, and factor two with depression and anxiety. Factor three was negatively correlated with tic disorder and attention-deficit/hyperactivity disorder (ADHD). Females had higher scores on factor two than males. The OCD symptom structure in children and adolescents is consistent across age and gender and similar to results from recent child and adolescents although hoarding may not be a separate factor. Our three-factor structure is almost identical to that seen in early studies on adults. Common mental disorders had specific patterns of associations with the different factors.",

keywords = "CY-BOCS, Children and adolescents, Comorbidity, Factor analysis, OCD symptom patterns, Obsessive–compulsive disorder",

author = "H{\o}jgaard, \{D. R.M.A.\} and Mortensen, \{E. L.\} and T. Ivarsson and K. Hybel and G. Skarphedinsson and Nissen, \{J. B.\} and R. Valderhaug and K. Dahl and B. Weidle and Torp, \{N. C.\} and M. Grados and Lewin, \{A. B.\} and Melin, \{K. H.\} and Storch, \{E. A.\} and Wolters, \{L. H.\} and Murphy, \{T. K.\} and Sonuga-Barke, \{E. J.S.\} and Thomsen, \{P. H.\}",

note = "Funding Information: The authors would like to thank TrygFonden, Lundbeck Foundation and Central Region Denmark{\textquoteright}s Research Fund for supporting the research presented in this article through project grants. They would also like to thank the participants and staff from the contributing clinics. Funding Information: Edmund Sonuga-Barke: Speaker fees, consultancy, research funding and conference support from Shire Pharma. Speaker fees from Janssen Cilag, Consultancy from Neurotech solutions, Aarhus University, University of Copenhagen and Berhanderling, Skolerne, Copenhagen, KU Leuven. Book royalties from OUP and Jessica Kingsley. Grants awarded from MRC, ESRC, Wellcome Trust, Solent NHS Trust, European Union, Child Health Research Foundation New Zealand, NIHR, Nuffield Foundation, Fonds Wetenschappelijk Onderzoek-Vlaanderen (FWO), MQ—Transforming Mental Health. Eric A. Storch: Research Funding: National Institutes of Health, All Children{\textquoteright}s Hospital Research Foundation Agency for Healthcare Research and Quality. Book Royalties: Wiley, Springer, American Psychological Association, Lawrence Erlbaum. Consultant: Prophase, INC, Rogers Memorial Hospital. Tord Ivarsson: Speakers bureau of Shire. Per Hove Thomsen: Speakers bureau of Shire and MEDICE. Tanya Murphy has received research funding from the Florida Agency for Healthcare Administration, AstraZeneca Research \&Development, Brain and Behavior Research Foundation, the Centers for Disease Control and Prevention (CDCP), F. Hoffmann-La Roche Ltd., Indevus Pharmaceuticals, IOCDF, NIMH, Otsuka Pharmaceuticals, Pfizer, Inc., Psyadon Pharmaceuticals, Inc, and Shire Pharmaceuticals. She is on the Scientific and Clinical Advisory Board for the IOCDF. She has received travel support from the TSA and honoraria from grand rounds/CME lectures. Adam Lewin has received research funding from All Children{\textquoteright}s Hospital, Florida Agency for Healthcare Administration, the International OCD Foundation (IOCDF), and the Centers for Disease Control and Prevention (CDC). He is on the Scientific and Clinical Advisory Board for the IOCDF and is on the Board of Directors for the Society for Clinical Child and Adolescent Psychology (SCCAP) and the American Board of Clinical Child and Adolescent Psychology (ABCCAP). He has received honorarium and/or travel support from the Tourette Association of America (TAA), American Psychological Association, Springer, Oxford Press, University of Central Oklahoma, Rogers Memorial Hospital, and James Cook University. He is on the speaker{\textquoteright}s bureau for IOCDF and TAA. Consultant for Prophase, LLC and Bracket. Remaining authors: No conflict of interest. Publisher Copyright: {\textcopyright} 2016, Springer-Verlag Berlin Heidelberg.",

year = "2017",

month = mar,

day = "1",

doi = "10.1007/s00787-016-0887-5",

language = "English",

volume = "26",

pages = "281--291",

journal = "European Child and Adolescent Psychiatry",

issn = "1018-8827",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "3",

}

Højgaard, DRMA, Mortensen, EL, Ivarsson, T, Hybel, K, Skarphedinsson, G, Nissen, JB, Valderhaug, R, Dahl, K, Weidle, B, Torp, NC, Grados, M, Lewin, AB, Melin, KH, Storch, EA, Wolters, LH, Murphy, TK, Sonuga-Barke, EJS & Thomsen, PH 2017, 'Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations', European Child and Adolescent Psychiatry, vol. 26, no. 3, pp. 281-291. https://doi.org/10.1007/s00787-016-0887-5

Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations. / Højgaard, D. R.M.A.; Mortensen, E. L.; Ivarsson, T. et al.
In: European Child and Adolescent Psychiatry, Vol. 26, No. 3, 01.03.2017, p. 281-291.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents

T2 - a factor analytic study across five nations

AU - Højgaard, D. R.M.A.

AU - Mortensen, E. L.

AU - Ivarsson, T.

AU - Hybel, K.

AU - Skarphedinsson, G.

AU - Nissen, J. B.

AU - Valderhaug, R.

AU - Dahl, K.

AU - Weidle, B.

AU - Torp, N. C.

AU - Grados, M.

AU - Lewin, A. B.

AU - Melin, K. H.

AU - Storch, E. A.

AU - Wolters, L. H.

AU - Murphy, T. K.

AU - Sonuga-Barke, E. J.S.

AU - Thomsen, P. H.

N1 - Funding Information: The authors would like to thank TrygFonden, Lundbeck Foundation and Central Region Denmark’s Research Fund for supporting the research presented in this article through project grants. They would also like to thank the participants and staff from the contributing clinics. Funding Information: Edmund Sonuga-Barke: Speaker fees, consultancy, research funding and conference support from Shire Pharma. Speaker fees from Janssen Cilag, Consultancy from Neurotech solutions, Aarhus University, University of Copenhagen and Berhanderling, Skolerne, Copenhagen, KU Leuven. Book royalties from OUP and Jessica Kingsley. Grants awarded from MRC, ESRC, Wellcome Trust, Solent NHS Trust, European Union, Child Health Research Foundation New Zealand, NIHR, Nuffield Foundation, Fonds Wetenschappelijk Onderzoek-Vlaanderen (FWO), MQ—Transforming Mental Health. Eric A. Storch: Research Funding: National Institutes of Health, All Children’s Hospital Research Foundation Agency for Healthcare Research and Quality. Book Royalties: Wiley, Springer, American Psychological Association, Lawrence Erlbaum. Consultant: Prophase, INC, Rogers Memorial Hospital. Tord Ivarsson: Speakers bureau of Shire. Per Hove Thomsen: Speakers bureau of Shire and MEDICE. Tanya Murphy has received research funding from the Florida Agency for Healthcare Administration, AstraZeneca Research &Development, Brain and Behavior Research Foundation, the Centers for Disease Control and Prevention (CDCP), F. Hoffmann-La Roche Ltd., Indevus Pharmaceuticals, IOCDF, NIMH, Otsuka Pharmaceuticals, Pfizer, Inc., Psyadon Pharmaceuticals, Inc, and Shire Pharmaceuticals. She is on the Scientific and Clinical Advisory Board for the IOCDF. She has received travel support from the TSA and honoraria from grand rounds/CME lectures. Adam Lewin has received research funding from All Children’s Hospital, Florida Agency for Healthcare Administration, the International OCD Foundation (IOCDF), and the Centers for Disease Control and Prevention (CDC). He is on the Scientific and Clinical Advisory Board for the IOCDF and is on the Board of Directors for the Society for Clinical Child and Adolescent Psychology (SCCAP) and the American Board of Clinical Child and Adolescent Psychology (ABCCAP). He has received honorarium and/or travel support from the Tourette Association of America (TAA), American Psychological Association, Springer, Oxford Press, University of Central Oklahoma, Rogers Memorial Hospital, and James Cook University. He is on the speaker’s bureau for IOCDF and TAA. Consultant for Prophase, LLC and Bracket. Remaining authors: No conflict of interest. Publisher Copyright: © 2016, Springer-Verlag Berlin Heidelberg.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - The underlying structure of obsessive–compulsive disorder (OCD) remains to be confirmed in child and adolescent populations. In this paper we report the first factor analytic study of individual OCD items from Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). OCD symptoms were assessed using the CY-BOCS symptom checklist in a sample of 854 patients with OCD (7–18 years of age) recruited from clinics in five countries. Pooled data were subjected to exploratory and confirmatory factor analysis (CFA) to identify the optimal factor structure. Various models were tested for age and gender subgroups. Also, the invariance of the solution across age and gender was tested and associations with demographic and clinical factors were explored. A three-factor model provided the best-fit solution. It consisted of the following factors: (1) harm/sexual, (2) symmetry/hoarding, (3) contamination/cleaning. The factor structure was invariant for age and gender across subgroups. Factor one was significantly correlated with anxiety, and factor two with depression and anxiety. Factor three was negatively correlated with tic disorder and attention-deficit/hyperactivity disorder (ADHD). Females had higher scores on factor two than males. The OCD symptom structure in children and adolescents is consistent across age and gender and similar to results from recent child and adolescents although hoarding may not be a separate factor. Our three-factor structure is almost identical to that seen in early studies on adults. Common mental disorders had specific patterns of associations with the different factors.

AB - The underlying structure of obsessive–compulsive disorder (OCD) remains to be confirmed in child and adolescent populations. In this paper we report the first factor analytic study of individual OCD items from Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). OCD symptoms were assessed using the CY-BOCS symptom checklist in a sample of 854 patients with OCD (7–18 years of age) recruited from clinics in five countries. Pooled data were subjected to exploratory and confirmatory factor analysis (CFA) to identify the optimal factor structure. Various models were tested for age and gender subgroups. Also, the invariance of the solution across age and gender was tested and associations with demographic and clinical factors were explored. A three-factor model provided the best-fit solution. It consisted of the following factors: (1) harm/sexual, (2) symmetry/hoarding, (3) contamination/cleaning. The factor structure was invariant for age and gender across subgroups. Factor one was significantly correlated with anxiety, and factor two with depression and anxiety. Factor three was negatively correlated with tic disorder and attention-deficit/hyperactivity disorder (ADHD). Females had higher scores on factor two than males. The OCD symptom structure in children and adolescents is consistent across age and gender and similar to results from recent child and adolescents although hoarding may not be a separate factor. Our three-factor structure is almost identical to that seen in early studies on adults. Common mental disorders had specific patterns of associations with the different factors.

KW - CY-BOCS

KW - Children and adolescents

KW - Comorbidity

KW - Factor analysis

KW - OCD symptom patterns

KW - Obsessive–compulsive disorder

UR - https://www.scopus.com/pages/publications/84978148924

U2 - 10.1007/s00787-016-0887-5

DO - 10.1007/s00787-016-0887-5

M3 - Article

C2 - 27388606

SN - 1018-8827

VL - 26

SP - 281

EP - 291

JO - European Child and Adolescent Psychiatry

JF - European Child and Adolescent Psychiatry

IS - 3

ER -

Structure and clinical correlates of obsessive–compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations

Abstract

Bibliographical note

Other keywords

Access to Document

Fingerprint

Cite this