The Repetitive Behavior Spectrum: From Harmful to Helpful

Robert H. Rice

Abstract


Systematic study comparing repetitive behaviors in autism with those observed in obsessive compulsive disorder (OCD) and other Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition-Text Revision (DSM-IV-TR) diagnoses is lacking despite its diagnostic and treatment significance.  This research examines repetitive behaviors in a sample of children and adults diagnosed with an autism spectrum disorder (ASD), (OCD), or both. Data were collected from three participant pools; clinic clients, parents/caregivers, and therapists; in order to test the psychometric properties of questions for assessing the functional characteristics of repetitive thoughts and behavior (i.e., stereotypy, compulsion, obsession, perseveration, preoccupation). Exploratory factor analyses revealed four factors that demonstrated reasonable consistency across the three types of informants. These four assessed factors included: 1) intrusive effects; 2) soothing effects; 3) level of distress, and; 4) pleasure-seeking qualities.  Reliability for the new scales was calculated separately for subjects, correspondents, and therapists revealing high internal consistency. Validity analyses were completed, first by examining bivariate correlations among the new scales and then by examining correlations between the new scales and established measures of functioning (i.e., Gilliam Autism Rating Scale-Second Edition; GARS-2, Yale-Brown Obsessive Compulsive Scale; Y-BOCS, and Adaptive Behavior Assessment System-Second Edition; ABAS-II).  As hypothesized, the new scales measuring soothing and pleasure-seeking qualities of repetitive behavior had higher correlations with measures of ASD than OCD and the new scales measuring level of distress and intrusiveness in repetitive behavior had higher correlations with measures of OCD than ASD.  The results of this study take a step toward better distinguishing what motivates repetitive behaviors and, thus, how to best think about them in the context of intervention strategies.

Keywords


repetitive behavior; autism; obsessive compulsive disorder

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