Obsessive Compulsive Behavior in Children: An Insight

Obsessive Compulsive Behavior in Children: An Insight
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Obsessions are the recurrence of unwanted thoughts, and compulsions are behaviors performed repeatedly in the hope of relieving the anxiety or fear caused by such thoughts.

Most people experience some amount of unreasonable fear, worry and anxiety, and perform actions in response to such worries. For instance, people usually worry about intruders and check the lock on the door many times. Such normal worries and resultant actions can turn into obsessive-compulsive disorder when they become frequent or intense to the extent that they linger for more than an hour a day, make the person miserable, and disrupt normal life and developmental activities.

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Obsessive Compulsive Behavior in Children

Children suffering from obsessive-compulsive disorder (OCD) develop unreasonable fears or worries about something bad happening, such as a death or illness in the family or a sudden drop in test grades. They then develop compulsions as a reaction to those fears. For instance, they worry about touching dirty objects, and develop compulsive rituals such as excessive hand washing to control their fears.

Such a fear-ritual or obsession-compulsion relation need not always be logical. For instance, a child suffering from OCD may fear the death of a parent, and develop an image of that parent in a car accident. The child may then take a totally unrelated and illogical action of avoiding sidewalk cracks when walking, as an attempt to remove the lingering image of the car accident from the mind. Over time, the child makes another unreasonable association that identifies the specific number of sidewalk cracks sidestepped as a “magical” number to ‘keep their parent safe’.

Obsessive Compulsive Behavior in Children: Symptoms

Obsessive Compulsive Behavior in Children

OCD symptoms in children can change with age and each child experiences symptoms differently. The most common symptoms and behaviors nevertheless are:

  • extreme preoccupation with dirt, germs, or contamination, and frequent washing of hands, excessive use of soaps, towels, or spending too much time showering or brushing teeth
  • obsession with perfection and symmetry, and repeating homework over and over to make it perfect/ordering and or arranging articles repeatedly for perfection
  • hoarding and collecting things, including items discarded by others out of fear that something bad will happen if they are thrown away
  • checking drawers and locks many times, counting and recounting everything from tiles and windowpanes to money, and repeating sounds, words, numbers, and or music to oneself

It is difficult to identify the symptoms of OCD in children, for unlike adults, children do not have the required skills or experience to recognize obsessions or compulsions as such.

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Research has not yet pinned down the exact cause of obsessive compulsive disorder (OCD), but genetics appears to play an important role. Children of parents or first cousins who have obsessive-compulsive behaviors are at a 9 percent risk of displaying obsessive-compulsive behavior compared to a 2 percent risk among the general population.

Another possible cause of obsessive compulsive behavior in children could be neurological problems, or improper communication between nerve cells in the brain. Studies have established that people with OCD tend to have lower amounts of the chemical serotonin in the brain. This hampers nerve cell communications and contributes to the formation of obsessions and compulsions.

The brain structure could also contribute to obsessive compulsive disorder. Basal ganglia is a collection of nuclei on both sides of the thalamus in the brain, and the interactions that go on inside them supposedly play a role in inclining the brain towards certain habits and fixed routines. A 1998 study established that children with obsessive compulsive disorder have a smaller basal ganglia than normal, and that the smaller the basal ganglia, the greater the symptoms.

A larger or normal sized basal ganglia enable the brain to process information better. The interactions in a small basal ganglia fail to protect the cortex of the brain from receiving irrelevant information. The brain, on receiving such irrelevant information acts upon it, leading to obsessions and compulsions. The smaller the basal ganglia, the greater the amount of such irrelevant information fed into the brain, and thereby the greater the symptoms of OCD.

Accompanying Disorders

Very often anxiety and other disorders accompany obsessive compulsive behavior in children, which can sometimes make diagnosis difficult.

  • About two-thirds of all children suffering from obsessive-compulsive disorder (OCD) experience depression simultaneously.
  • Many children with OCD also have ADHD, along with its manifest symptoms such as hyperactivity, distractibility, and impulsiveness.
  • About 10 percent of OCD children have Tourette’s disorder, which manifests as vocal tics such as blinking, head jerking, throat clearing, grunts, obscene gestures, and exclamations.

Other disorders that may accompany obsessive compulsive behavior in children include body dysmorphic disorder or delusions of being ugly or physically repulsive, and trichotillomania or pathological hair-pulling disorder.

Children suffering from such behaviors and symptoms require a visit to a mental health specialist to confirm or rule out OCD. One of the most effective treatment and coping mechanisms comes with early diagnosis.


  1. NYU Child Study Center. “Obsessive Compulsive Disorder.” https://www.aboutourkids.org/families/disorders_treatments/az_disorder_guide/obsessive_compulsive_disorder. Retrieved 21 January 2011.
  2. Children’s Hospital of Pittsburgh of UPMC. “Obsessive-Compulsive Disorder.” https://www.chp.edu/CHP/P02572. Retrieved 21 January 2011.
  3. Harvard Health Publications. “Obsessions and Compulsions in Children.” https://www.health.harvard.edu/newsweek/Obsessions_and_Compulsions_in_Children.htm. Retrieved 21 January 2011.
  4. Dear, Anna. “Obsessive Compulsive Disorder: Is there a biological cause?” https://serendip.brynmawr.edu/bb/neuro/neuro06/web1/adejdar.html. Retrieved 23 January 2011.
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