Perfectionism in young children may develop OCD risk: Study

Researchers at Washington University School of Medicine in St. Louis found that young children who possess tendencies toward perfectionism and excessive self-control are twice as likely as other children to develop obsessive-compulsive disorder (OCD) by the time they reach their teens.

Moreover, MRI scans taken as part of the research revealed that the perfectionists often had smaller volumes of a brain structure previously linked to OCD.

The researchers enrolled 292 children aged 4 and 5. Over the next 12 years, 35 kids went on to develop OCD. Among children the researchers determined were exercising excessive self-control and perfectionism, an OCD diagnosis was twice as likely as among those who didn't care as much about performing a task absolutely correctly.

"The experimenter would hand the child a blank sheet of paper and a green marker and simply say, 'I need you to draw me a perfect, green circle," said Kirsten E. Gilbert, the study's first author and an instructor in child psychiatry at Washington University.

Drawing a perfect circle is difficult for almost anyone, but especially for young children. After a child would complete the drawing and show the circle to the researcher, the researcher would provide negative feedback, calling the circle "too small" or "too flat" and then would tell the child to try again. After 3.5 minutes of negative feedback, the experimenter would admit to being too harsh, would praise the child and would tell him or her that everything was fine.

The researchers evaluated the children's behaviour in videos of the attempts to draw perfect circles. The researchers rated the intensity of a child's own performance monitoring as the youngster attempted to do a better job.

"Some kids were very self-critical," Gilbert said. "The researcher would point out flaws, but the child was critical of the effort, too. That excessive perfectionism was the strongest predictor of OCD later on."

As the children got older, 152 of them had a series of three MRI brain scans over the next 10 to 12 years. The researchers found that those who behaved like perfectionists during the circle task also had smaller volumes of a brain structure called the anterior cingulate cortex, an anatomical feature in the brain that previously has been linked to OCD in adults.

One of the primary problems underlying the obsessive thoughts and compulsive behaviours in OCD is a deficit in cognitive control, particularly involving the anterior cingulate cortex, the researchers said, reports Xinhua.

Most treatments for OCD involve medications and psychotherapy. If untreated, the condition can be chronic and severe. In its most severe forms, OCD is a highly disabling and intractable disorder. Therefore, the identification of tangible risk behaviours in early childhood has opened new opportunities for the design of preventive interventions.

The findings were published on Wednesday in the journal JAMA Psychiatry.