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Title: Caught Between a Rock and a Hard Place – An Exploratory Study of Family Accommodation in Obsessive Compulsive Disorder
Keywords: Obsessive compulsive disorder, caregivers, family accommodation
Issue Date: 27-Oct-2017
Citation: SHALENI D/O PANEERSELVAM (2017-10-27). Caught Between a Rock and a Hard Place – An Exploratory Study of Family Accommodation in Obsessive Compulsive Disorder. ScholarBank@NUS Repository.
Abstract: Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterized by persistent and recurrent obsessions and compulsions and is one of the most prevalent mental disorders in Singapore. A distinguishing characteristic of OCD is how family members often become involved in the OCD sufferer's symptoms, through a phenomenon known as Family Accommodation (FA). While FA has been investigated extensively in the literature, these studies are largely quantitative in nature and only provide a partial picture of how families experience this phenomenon on a daily basis. Using a semi-structured interview guide approach with five caregivers of adult children with OCD, this qualitative exploratory study examined the nature of accommodation caregivers participated in, their reasons for doing so, their perceptions of FA and the perceived impact that it had on them. The results from this study largely provide greater support for existing quantitative findings. FA was found to be a highly prevalent and dominant aspect of caregivers' experience of OCD. Caregivers participated in various forms of FA, both covertly and overtly. Using a conceptual model known as the Dependency Trap, it was found that caregivers and their loved ones engaged in a cyclical pattern of confrontation and accommodation which was reinforced by the OCD sufferers' use of coercive behaviours. Family members therefore found this process to be highly distressing and disruptive to family life. While they wanted to stop accommodating, they described an inability to manage their loved ones' coercive behaviours and therefore, experienced a sense of internal conflict. In light of the study's limitations, these findings contribute to a preliminary understanding of FA among OCD families in Singapore and emphasize the need for more family-inclusive OCD treatment in both acute and community mental health settings.
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