Student thesis: Doctoral ThesisDoctor of Philosophy


Background: OCD is a relatively common and often disabling disorder that can have serious effects for the sufferer and those around them. Mothers may be more vulnerable to developing OCD after having a child, yet nothing is known about the adverse consequences on parenting and infants, and further if treatment ameliorates such effects. Patterns of help-seeking and treatment in this group are not well described.
Method: Study 1: Community mothers defined on a screener as low (n=33) or high (n=16) risk of developing OCD were assessed in detail antenatally and at six and twelve months postnatally using questionnaires, clinical interview and observed mother-infant interactions. The development of symptomatology was compared in the two groups.
Study 2: A group of 34 mothers with postnatally occurring OCD were recruited and assessed using the same methodology and compared with the low risk group in order to clearly delineate the effect on parenting of OC symptomatology.
Study 3: In a pilot randomized controlled trial to establish the effect of treatment on both symptoms and parenting, mothers with OCD received intensive CBT or treatment as usual following 6m assessment, with reassessment at 12m.
Results: (1) 3/16 high risk mothers and no low risk mothers had OCD at six months. However, 2/3 lost the diagnosis by twelve months. (2) Mothers with OCD were less sensitive in interactions (ES=0.8) and reported interference with parenting. (3) CBT was successful in ameliorating symptoms (ES=0.92-1.09). However, interactions were unchanged by treatment. The distribution of attachment categories was similar in both clinical groups and healthy controls.
Conclusions: An antenatal screening measure detected women who developed OCD at 6m. The diagnosis was not stable at 12m. OCD affects parenting and interactions. Although CBT was effective in this group, mother-infant interactions did not improve. However, attachment was unaffected.
Date of Award2014
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorPaul Salkovskis (Supervisor)

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