Graduation Year

2014

Document Type

Thesis

Degree

M.A.

Degree Name

Master of Arts (M.A.)

Department

Psychology

Degree Granting Department

Psychology

Major Professor

Eric A. Storch, Ph.D.

Co-Major Professor

Vicky Phares, Ph.D.

Committee Member

Joseph Vandello, Ph.D.

Keywords

Assessment, Relative, Reliability, Self-Report, Validity

Abstract

Family accommodation is a salient construct within the context of obsessive-compulsive disorder (OCD) and occurs in a large majority of affected individuals and their families. Accommodating behaviors can manifest in various ways, including participation in the patient's rituals, modifying everyday routines, facilitating compulsive behaviors, or providing reassurance. It has been repeatedly linked to negative outcomes, such as attenuated treatment response, increased obsessive-compulsive symptom severity, higher levels of family distress, and lower levels of functioning. As such, it is of significant clinical importance to have a standardized measure that is able to be used in research and clinical practice.

The Family Accommodation Scale for Obsessive-Compulsive Disorder (FAS) was the initial attempt at a measure to systematically assess for family accommodation in patients with OCD, with different clinician-rated and self-reported versions completed by the relative arising thereafter. However, to date, there is not a patient-reported version of the instrument. Existing measures focus on reports from the relative (e.g., the patient's significant other, parent), overlooking information from the patient themselves. Additionally, adult patients with OCD often present to clinical services alone, frequently making it impractical to obtain information from their relative. As such, it is important to have a standardized patient-reported measure to examine the accommodating behaviors.

The present study sought to evaluate the psychometric properties of the Family Accommodation Scale for Obsessive-Compulsive Disorder - Patient Version (FAS-PV). A large majority of the participants (88.5%) endorsed at least one type of accommodating behavior in the previous week. Provision of reassurance and waiting for completion of compulsions were the most frequently reported behaviors, while helping with personal tasks and making excuses/lying due to OCD-related impairment were the least frequently endorsed. The FAS-PV demonstrated good internal consistency and test-retest reliability, as well as good convergent/divergent validity. The FAS-PV did not significantly differ from the relative-reported measure of family accommodation in terms of internal consistency or mean scores. Ultimately, the FAS-PV demonstrated sound psychometric properties and utility in assessing family accommodation from the patient's perspective.

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