A third element of OCD is the avoidance of situations that cause distress. Sometimes compulsions are so elaborate and demanding, it can be easier to steer clear of those things that trigger the compulsions.
It is estimated that the lifetime prevalence rate for OCD is 2.5% – that’s almost 800,000 people in the United States who will experience OCD at some point in their lives.
For 80% of adults with OCD, their symptoms started in childhood or adolescence. The difference between adult and childhood OCD is developmental, with respect to the level of insight demonstrated. OCD may have a magical element for children because they do not have the cognitive skills that allow for the rational explanations often made by adults with OCD. Additionally, Piaget described the presence of some obsessive and compulsive behaviors as normative. Age-dependent obsessive-compulsive behaviors are relevant to the progression of cognitive development. Unlike the repetitive behaviors associated with cognitive development, OCD behaviors do not foster a sense of mastery and may actually interfere with the child’s ability to socialize and develop relationships with peers.
Individuals with OCD often recognize that these obsessions and compulsions are excessive or irrational but they feel the need to engage in them anyway. This tug-of-war between what makes sense and what is being demanded of them by OCD can further the distress experienced as a result of the OCD.