Gifted Issues Discussion homepage Forums Twice Exceptional OCD

It is looking like we may be looking at a pure-obsessional OCD dx for DD. This has come as something as a surprise (we thought she just had anxiety), but DD is nothing if not endlessly surprising. Does anyone have any experience with it?

Kind of. Experience in researching/trying to understand it.

You've mentioned DD is ASD/ADHD-ish before, I think? It wouldn't surprise me if it's all related.

This is an interesting article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227121/

The gist of it is that "Pure O" may be a little off base, descriptively, because people may have "mental compulsions" that are difficult to observe.

Is your DD having intrusive thoughts?

I agree with Eco. My older dd12 has anxiety and at times it manifests as OCD but the underlying issue is anxiety

She is having intrusive thoughts as well as obsessions centering around worry about harm coming to loved ones and her own physical health. She does not have any compulsive behaviors, other than asking for reassurance. I did not understand that this could be OCD at all. The suggestion was made by her therapist especially after a battery suggested cause for concern in this area, and discussion with DD has revealed that this is happening a lot, inside her head.

I see that article considers "reassurance seeking" (we definitely have this) as a compulsion. In that case, she does have that one compulsion.

Interestingly, this is the only battery she completed out of many that came up as problematic.

Speaking of obsessions, I am "obsessing" about this potential dx a little myself. (Not really. But I am really worrying about it. Some of the articles and info I found are really scary and distressing. If anyone has any success stories, it would help right now. I feel terrible for my DD. I didn't know that this was at this level inside her brain. )

DS12 (ASD/ADHD) has fixated about health issues as well, along with the asking for reassurance bit. It was out of control for him (first grade) for months and was the first time I contacted NP about possible OCD.

OCD is an anxiety disorder. It's also common for ASD (as is anxiety, generally), from what I've read.

DS new psychiatrist was running through the DSM ASD criteria with us and when he brought up fixative type behaviors--DS surprised me by sharing he can become very worried/fixated at school about something like "my leg hurt while I was climbing the stairs--I wonder what that could be?" I guess there are things going on in his mind about which I'm completely unaware.

The psychiatrist said sometimes the fixations are somatic in nature. He thought it fit with ASD.

All this to say: it doesn't seem so surprising, giving your description of DD as ASD/ADHD-ish, that she has this thing going on. Has she had a neuropsych eval? When DS was younger, we had psych evaluation and the diagnoses were Generalized Anxiety, Depression NOS, and rule-out on ODD, ADHD. Looking backward through ASD lens, the entire report described an Asperger's kid. The neuropsychologist actually cited the earlier report in her narrative and said it was consistent with ASD.

DS stopped the reassurance seeking (at least about health concerns) as he matured. When he was little, we did all kinds of deep breathing exercises at bedtime, which was his witching hour.


This is a poorly organized response. I hope you can make sense of it!

This is EXACTLY the kind of thing DD is reporting. And it is apparently bad enough at school that it is a distraction. But it's new that it's bad enough to make her be off in space at school, though she has been described as "spacey" off and on her whole life by some adults (yet she has always also been a straight A student). Of note, she is starting to experience the very beginnings of puberty.


Not....exactly. Oh, I don't even KNOW what she's had anymore. She was informally assessed for ASD by early intervention as part of another assessment for large motor delay at age 3 (they thought I was nuts, and she did not qualify for large motor delay either). She was screened with a computer screener for ADHD as part of a CAPD eval at age 8 (passed both eval and screener with flying colors). She was eval'ed for depression and anxiety at age 9 and was borderline for both, more diagnosable on anxiety. With this new practice, we all completed multiple screeners for ADHD (we requested this particularly) depression, anxiety, apparently OCD, and who even knows what else. Kit and caboodle, seemed like. They were not convinced by these results to do an ADHD eval, but said they'd get to know her better and see whether it seemed indicated. We had one appointment where she looked COMPLETELY ADHD to me so maybe they'll do one now! I also asked them to be aware for the need for ASD eval. The psych said she didn't think this was needed based on her observations.

So we have had a lot of random psych stuff but I guess never a full diagnostic eval. I think? We did spend hours filling out forms?

DD has a way of not looking ASD even though IMO she has a ton of things about her that subtly show it. She does not meet the criteria if we look at them in a formal sense. Most importantly, she is highly functional socially, even popular. But man, there are a lot of things about her that fit.

True for DS here, as well. He is very funny and gregarious and was always admired in elementary school for his wit. In MS, he has friends he pals around with and is very invested in his friendships, although they are a bit odd in that he only wants to interact with them at school

DeeDee is the expert, so I'll just parrot her advice: I'd specifically want ADOS. That's how DS was finally diagnosed, in the end. IQ patterns and other instruments supported the diagnosis, but not would not have been diagnostic in and of themselves.

It matters because treatment is different for a neurobiological disorder and an purely psychiatric disorder. I wouldn't expect a regular psychologist to understand how gifted/ASD might present.

CBT is good for this type of thing--also mindfulness. Poor DD, it is hard to imagine they are worrying all the time and we have no idea!

I thought of something else: my DS also passed the computerized ADHD thing with flying colors in second grade (during regular psych eval).

Nobody in their right mind could argue that DS isn't extraordinarily impaired in executive function--he takes 10 minutes to put on a sock, for instance. No matter what I do. It is the most pronounced feature of his ASD so neuropsych retained ADHD diagnosis.

A girl with ADHD-I (without impulsivity/hyperactivity) is likely to just look like a space cadet. Teachers really only seem to express concern when there are disruptive classroom behaviors associated. My DS doesn't have hyperactivity but is *kind of* (not terribly) impulsive, in that he will interrupt/blurt/talk too much. I think that is really more a social skill thing for him than impulsivity, though.