Obsessive-Compulsive Symptoms Among Children in the Adolescent Brain and Cognitive Development Study: Clinical, Cognitive, and Brain Connectivity Correlates

BACKGROUND: Childhood obsessive-compulsive symptoms (OCSs) are common and can be an early risk marker for obsessive-compulsive disorder. The Adolescent Brain and Cognitive Development (ABCD) Study provides a unique opportunity to characterize OCSs in a large normative sample of school-age children and to explore corticostriatal and task-control circuits implicated in pediatric obsessive-compulsive disorder. METHODS: The ABCD Study acquired data from 9- and 10-year-olds (N = 11,876). Linear mixed-effects models probed associations between OCSs (Child Behavior Checklist) and cognition (NIH Toolbox), brain structure (subcortical volume, cortical thickness), white matter (diffusion tensor imaging), and resting-state functional connectivity. RESULTS: OCS scores showed good psychometric properties and high prevalence, and they were related to familial/parental factors, including family conflict. Higher OCS scores related to better cognitive performance (beta = .06, t(9966.60) = 6.28, p < .001, eta(2)(p) = .01), particularly verbal, when controlling for attention-deficit/hyperactivity disorder, which related to worse performance. OCSs did not significantly relate to brain structure but did relate to lower superior corticostriatal tract fractional anisotropy (beta = -.03, t = -3.07, p = .002, eta(2)(p) = .02). Higher OCS scores were related to altered functional connectivity, including weaker connectivity within the dorsal attention network (beta = -.04, t(7262.87) = -3.71, p < .001, eta(2)(p) = .002) and weaker dorsal attention-default mode anticorrelation (beta = .04, t(7251.95) = 3.94, p < .001, eta(2)(p) = .002). Dorsal attention-default mode connectivity predicted OCS scores at 1 year (beta = -.04, t(2407.61 )= -2.23, p = .03, eta(2)(p) = .03). CONCLUSIONS: OCSs are common and may persist throughout childhood. Corticostriatal connectivity and attention network connectivity are likely mechanisms in the subclinical-to-clinical spectrum of OCSs. Understanding correlates and mechanisms of OCSs may elucidate their role in childhood psychiatric risk and suggest potential utility of neuroimaging, e.g., dorsal attention-default mode connectivity, for identifying children at increased risk for obsessive-compulsive disorder.