Anxiety sensitivity and family accommodation in obsessive-compulsive disorder

- Anxiety sensitivity (AS) is under-researched in obsessive-compulsive disorder.
- AS (especially cognitive fears) was associated with multiple domains of impairment.
- AS correlated with family accommodation, anxiety, and depressive symptoms.
- The patient's fear of cognitive dyscontrol predicted family accommodation.
- Family accommodation mediated the link between cognitive fears and impairment.

BackgroundAlthough anxiety sensitivity (AS) presents in adults with obsessive-compulsive disorder (OCD), it has received minimal empirical attention. There are postulated connections between AS and family accommodation, but this relationship has yet to be formally examined. Methods: The present study included 58 adults with OCD who completed a clinician-rated measure of OCD symptom severity, as well as self-report measures assessing AS, family variables, impairment, and co-occurring psychopathology. Results: Participants' AS moderately correlated with family accommodation, family functioning, and depression, while strongly correlating with anxiety symptoms. The Fear of Cognitive Dyscontrol AS subscale moderately correlated with multiple domains of functional impairment, and predicted family accommodation beyond the effects of OCD symptom severity. Family accommodation mediated the relationship between the Fear of Cognitive Dyscontrol AS subscale and functional impairment. Limitations: The study was cross-sectional in nature, limiting the ability to establish directionality and causation. The sample was also limited to adults with OCD and their own symptomology, necessitating further investigations of these constructs in pediatric samples and psychopathology in the caregivers/relatives. Conclusions: These findings highlight the importance of considering fears regarding the loss of mental control within the context of family accommodation in OCD when evaluating functional impairment.