Rituals in childhood may predict later OCD

Exaggerated rituals and sensory hypersensitivities in a child may be early warning signs of adult obsessive-compulsive disorder (OCD), according to 2 studies from Israeli researchers.

Investigators asked parents of children aged 4 to 6 years to complete questionnaires and scales that measured childhood rituals, trait anxiety, and reactions to everyday sensory events.

Strong reactions to everyday sensory events, in particular oral and tactile hypersensitivity (ie, avoids going barefoot in sand or grass, avoids tastes or smells typical of children's diets, expresses distress during grooming) correlated with childhood ritualism.

A recollection of oral and tactile hypersensitivity as children was positively correlated with obsessive-compulsive symptoms as adults, as measured by scores on the Obsessive-Compulsive Inventory-Revised scale.

Repetitive behaviors may constitute an attempt by a child to achieve a sense of control in the sensory universe. "In cases where the lack of sensory integration is particularly distressing, these rituals may become obsessive and develop into obsessive-compulsive symptoms," the researchers write. A heightened need for control in OCD and attempts to achieve a sense of control through rituals "may in some cases be rooted in deficient sensory integration."

Dar R, Kahn DT, Carmeli R. The relationship between sensory processing, childhood rituals and obsessive-compulsive symptoms. J Behav Ther Exp Psychiatry. 2012;43(1):679-684.