Skip to main content Accessibility help

Children's Naive Concepts of OCD and How They Are Affected by Biomedical Versus Cognitive Behavioural Psychoeducation

  • B. Butlin (a1) and C. Wilson (a2)


Background: How we conceptualize mental health conditions is important as it impacts on a wide range of mediators of treatment outcome. We do not know how children intuitively conceptualize obsessive-compulsive disorder (OCD), nor do we know the relative impact of biomedical or cognitive behavioural conceptual explanations, yet both are being widely used in psychoeducation for children with OCD. Aims: This study identified children's naive concepts of OCD, and the comparative impact of biomedical versus cognitive behavioural psychoeducation on perceived prognosis. Method: A within- and between-subjects experimental design was used. After watching a video of a young person describing their OCD, 202 children completed a questionnaire examining their concepts of the condition. They repeated the questionnaire following a second equivalent video, this time preceded by either biomedical or cognitive behavioural psychoeducation. Results: Participants’ naive concepts of OCD reflected predominant models of OCD in healthcare. Even at the minimal dose of psychoeducation, participants’ conceptualizations of OCD changed. Prior exposure to OCD resulted in a stronger alignment with the biomedical model. Exposure to biomedical psychoeducation resulted in participants predicting a slower recovery with less chance of complete remission. Conclusion: Psychoeducation for childhood OCD is impactful. Despite its wide use by clinicians and mental health services, biomedical psychoeducation appears to have deleterious effects. Children's concepts of OCD merit attention but caution should be applied in how they are targeted.


Corresponding author

*Correspondence to B. Butlin, School of Psychology, Trinity College Dublin, Dublin 2, Ireland. E-mail:


Hide All
Ader, H. and Mellenbergh, G. (2008). Advising on Research Methods: A Consultant's Companion. The Netherlands: Huizen.
Ahmari, S. E., Spellman, T., Douglass, N. L., Kheirbek, M. A., Simpson, H. B., Deisseroth, K. and Hen, R. (2013). Repeated cortico-striatal stimulation generates persistent OCD-like behaviour. Science, 340, 12341239
Alibali, M. W. (1999). How children change their minds: strategy change can be gradual or abrupt. Developmental Psychology, 35, 127145.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publications.
Baines, T. and Wittkowski, A. (2013). A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model. Journal of Clinical Psychology in Medical Settings, 20, 263274.
Broadbent, E., Petrie, K. J., Main, J. and Weinman, J. (2006). The Brief Illness Perception Questionnaire. Journal of Psychosomatic Research, 60, 631637.
Cameron, L. D., Leventhal, H., Kelly, K. M., Hertel, A. W. and Saioveyl, P. (2003). The Self-Regulation of Health and Illness Behaviour. Psychology Press.
Central Statistics Office (2011). Census 2011. Retrieved from CSO website:
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (ed Erlbaum, L.), Statistical Power Analysis for the Behavioral Sciences (vol. 2). Lawrence Erlbaum Associates.
Crystal, D. S. (2000). Concepts of deviance and disturbance in children and adolescents: a comparison between the United States and Japan. International Journal of Psychology, 35, 207218.
Deacon, B. J. (2013). The biomedical model of mental disorder: a critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33, 846861.
Denys, D. (2006). Pharmacotherapy of obsessive-compulsive disorder and obsessive-compulsive spectrum disorders. Psychiatric Clinics of North America, 22, 189201.
Derisley, J., Libby, S., Clark, S. and Reynolds, S. (2005). Mental health, coping and family-functioning in parents of young people with obsessive-compulsive disorder and with anxiety disorders. British Journal of Clinical Psychology, 44, 439444.
Diamond, L. M. and Savin-Williams, R. C. (2009). Handbook of Adolescent Psychology, pp. 479523. New York: Wiley.
Donker, T., Griffiths, K. M., Cuijpers, P. and Christensen, H. (2009). Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC Medicine, 7, 79.
Duncan, G. (2000). Mind-body dualism and the biopsychosocial model of pain: what did Descartes really say? The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 25, 485513.
Eddy, K. T., Dutra, L., Bradley, R. and Westen, D. (2004). A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clinical Psychology Review, 24, 10111030.
Fallon, C. (2004). Mary Immaculate Reading Attainment Test (MICRA-T). Curriculum Development Unit, Mary Immaculate College, Limerick, Ireland.
Field, A. P., Cartwright-Hatton, S., Reynolds, S. and Creswell, C. (2008). Future directions for child anxiety theory and treatment. Cognition and Emotion, 22, 385394.
Figueiras, M. and Alves, N. (2007). Lay perceptions of serious illnesses: an adapted version of the Revised Illness Perception Questionnaire (IPQ-R) for healthy people. Psychology & Health, 22, 143158.
Fox, C., Buchanan-Barrow, E. and Barrett, M. (2010). Children's conceptions of mental illness: a naive theory approach. British Journal of Developmental Psychology, 28, 603625.
Freeman, J. B., Choate-Summers, M. L., Moore, P. S., Garcia, A. M., Sapyta, J. J., Leonard, H. L. and Franklin, M. E. (2007). Cognitive behavioral treatment for young children with obsessive-compulsive disorder. Biological Psychiatry, 61, 337343.
Gause, C., Morris, C., Vernekar, S., Pardo-Villamizar, C., Grados, M. A. and Singer, H. S. (2009). Antineuronal antibodies in OCD: comparisons in children with OCD-only, Journal of Neuroimmunology, 214, 118124.
Gelman, S. A. (2004). Psychological essentialism in children. Trends in Cognitive Sciences, 8, 404409.
Goossens, F., Bokhorst, K., Bruinsma, C. and van Boxtel, H. (2002). Judgments of aggressive, withdrawn and prosocial behavior: perceived control, anger, pity and sympathy in young Dutch children. Journal of School Psychology, 40, 309327.
Hagger, M. S. and Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology and Health, 18, 141184.
Harland, R., Antonova, E., Owen, G. S., Broome, M., Landau, S., Deeley, Q. and Murray, R. (2009). A study of psychiatrists’ concepts of mental illness. Psychological Medicine, 39, 967976.
Hennessy, E. and Heary, C. (2009). The development of children's understanding of common psychological problems. Child and Adolescent Mental Health, 14, 4247.
Horvath, A. O. and Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Counseling Psychology, 38, 139149.
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S. and Ustün, T. B. (2007). Age of onset of mental disorders: a review of recent literature. Current Opinion in Psychiatry, 20, 359364.
Kuhn, D. and Franklin, S. (2006). The Second Decade: What Develops (and How). John Wiley and Sons, Inc.
Lam, D. C. K. and Salkovskis, P. M. (2007). An experimental investigation of the impact of biological and psychological causal explanations on anxious and depressed patients’ perception of a person with panic disorder. Behaviour Research and Therapy, 45, 405411.
Legare, C. H., Gelman, S. A. and Wellman, H. M. (2010). Inconsistency with prior knowledge triggers children's causal explanatory reasoning. Child Development, 81, 929944.
Lewison, G., Roe, P., Wentworth, A. and Szmukler, G. (2012). The reporting of mental disorders research in British media. Psychological Medicine, 42, 435441.
Maas, E., Marecek, J. and Travers, J. R. (1978). Children's conceptions of disordered behavior. Child Development, 49, 146154.
March, J. S. and Mulle, K. (1998). OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manual. Guilford Press.
Meyer, V. (1966). Modification of expectations in cases with obsessional rituals. Behaviour Research and Therapy, 4, 273280.
NICE (2017). Obsessive-compulsive disorder and body dysmorphic disorder: treatment. Guidance and guidelines. Available at: (accessed 11 September 2017).
Öst, L.-G., Riise, E. N., Wergeland, G. J., Hansen, B. and Kvale, G. (2016). Cognitive behavioral and pharmacological treatments of OCD in children: a systematic review and meta-analysis. Journal of Anxiety Disorders, 43, 5869.
Petrie, K. J., Broadbent, E. and Kydd, R. (1997). Illness perceptions in mental health: issues and potential applications. Causal Journal of Mental Health, 17, 559564.
Reid, G. J., Shanley, D., Goffin, R., Belle Brown, J., Evans, B., Vanier Children, M., London, S. et al. (2008). Parents’ Perceptions of Child Mental Health Problems: Development of a Parent Report Measure. Centre of Excellence for Child and Youth Mental Health at CHEO: Final Report.
Rimes, K. A. and Salkovskis, P. M. (1998). Psychological effects of genetic testing for psychological disorders. Behavioural and Cognitive Psychotherapy, 26, 2942.
Robinson, E. J. and Whitcombe, E. L. (2003). Children's suggestibility in relation to their understanding about sources of knowledge. Child Development, 74, 4862.
Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37, S29–52.
Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P. W., Grabe, H. J., Carta, M. G. and Angermeyer, M. C. (2012). Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 125, 440452.
Stewart, S. E., Geller, D. A., Jenike, M., Pauls, D., Shaw, D., Mullin, B. and Faraone, S. V. (2004). Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature. Acta Psychiatrica Scandinavica, 110, 413.
Taylor, S. (2011). Etiology of obsessions and compulsions: a meta-analysis and narrative review of twin studies. Clinical Psychology Review, 31, 13611372.
Valderhaug, R. and Ivarsson, T. (2005). Functional impairment in clinical samples of Norwegian and Swedish children and adolescents with obsessive-compulsive disorder. European Child and Adolescent Psychiatry, 14, 164173.
Waite, P. and Williams, T. (eds) (2009). Obsessive Compulsive Disorder: Cognitive Behaviour Therapy with Children and Young People. Routledge.
Winters, N. C., Hanson, G. and Stoyanova, V. (2007). The case formulation in child and adolescent psychiatry. Child and Adolescent Psychiatric Clinics, 16, 111132.


Related content

Powered by UNSILO

Children's Naive Concepts of OCD and How They Are Affected by Biomedical Versus Cognitive Behavioural Psychoeducation

  • B. Butlin (a1) and C. Wilson (a2)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

Children's Naive Concepts of OCD and How They Are Affected by Biomedical Versus Cognitive Behavioural Psychoeducation

  • B. Butlin (a1) and C. Wilson (a2)
Submit a response


No Comments have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *