The role of parental experiential avoidance (PEA) in the accommodation of pediatric obsessive-compulsive disorder (POCD)

Parental accommodation of pediatric OCD (POCD) is a significant antagonist of symptom severity and family distress as well as a barrier to treatment remission that appears to be more common in parents experiencing their own symptoms of anxiety. Some theorists posit that children of anxious parents may be at greater risk for inflated severity and related effects on prognosis due to increased parental accommodation that may occur specifically in anxious parents attempting to avoid or control their own anxiety in the face of the stressful experience that is often POCD (i.e. parental experiential avoidance, or PEA). Approximately 27 parents (78% mothers) of children and adolescents diagnosed with moderate to severe OCD and their therapists participated in an online survey designed to identify why anxious parents are more likely to accommodate. Multiple hierarchical regression was used to estimate the pathways by which parent anxiety, PEA, and accommodation interact to influence perceived POCD-related child impairment. Although results did not support the influence of parent anxiety or PEA in accommodation, significant elevations of PEA associated with parent anxiety were found (β = .73, p = .000, r² = .65) in addition to the well-established role of accommodation on child impairment (β = .67, p < .01, r² = .73). Findings suggest that continued research into the function of PEA in accommodation with improved sampling and measurement is called for. With a better understanding of the mechanisms underlying accommodation, future research will continue to improve effectiveness and efficiency of treatment related to POCD and other disorders where accommodation plays a key role.