Justin is a 3½ -year-old boy who comes in with his mother. She is concerned that he has
obsessive-compulsive disorder (OCD). Justin’s mother says that her husband has struggled with OCD all his life; he was first diagnosed when he was 11 years old thanks to an alert teacher who suggested mental health care. Justin’s mother has been very proactive in studying genetic risk, and she knows that Justin is at significantly increased risk due to the early-onset in his father. Which of the following behaviors by Justin would be most consistent with OCD?
A. Clear social difficulties in addition to an apparently unusual need for cleanliness and order in his bedroom
B. Refusal to go to bed without his blue stuffed elephant; this began over a year ago and is getting progressively worse
C. Insistence upon precise placement of plate, cup, utensils and food on plate when eating; when he cannot achieve this, he will not eat
D. A concomitant diagnosis of ADHD for which the family is currently in behavioral therapy
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