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儿童期强迫观念与强迫行为的结构:门诊样本中的维度

The structure of childhood obsessions and compulsions: dimensions in an outpatient sample.

作者信息

McKay Dean, Piacentini John, Greisberg Scott, Graae Flemming, Jaffer Margaret, Miller Jillian

机构信息

Department of Psychology, Fordham University, Bronx, NY10458-5198, USA.

出版信息

Behav Res Ther. 2006 Jan;44(1):137-46. doi: 10.1016/j.brat.2005.02.001.

DOI:10.1016/j.brat.2005.02.001
PMID:16301019
Abstract

While obsessive-compulsive disorder (OCD) is defined as a unitary condition, prior research has identified meaningful and distinct symptom dimensions in adult samples. In contrast, there have been no investigations of symptom dimensions in samples of children diagnosed with OCD. The present study sought to address this gap. Children diagnosed with OCD (n = 137) were administered the Children's Yale-Brown Obsessive-Compulsive Scale symptom checklist and severity index. Symptoms were analyzed using principal components analysis. As with adult samples, four factors were identified from the checklist. However, these four factors (compulsions, sexual/aggressive obsessions, superstitions, and hoarding/ordering/somatic concerns) were different in content from adult studies. Further, several symptoms significantly contributed to more than one dimension. Each dimension was significantly correlated with scores from the severity index, with the exception of the obsession score with the hoarding/ordering/somatic concerns factor. Results suggest that there are distinct dimensions of symptoms in childhood OCD, but that these dimensions do not correspond to those identified in adults. Instead, it appears that some factors share variance, and the dimensions themselves are separated based upon developmental trajectories. The dimensions examined may be useful in future treatment studies using pharmacological and/or behavioral interventions.

摘要

虽然强迫症(OCD)被定义为一种单一的病症,但先前的研究已经在成人样本中确定了有意义且不同的症状维度。相比之下,尚未有对被诊断为强迫症的儿童样本中的症状维度进行的调查。本研究旨在填补这一空白。对被诊断为强迫症的儿童(n = 137)进行了儿童耶鲁-布朗强迫症量表症状清单和严重程度指数的评估。使用主成分分析对症状进行了分析。与成人样本一样,从清单中识别出了四个因素。然而,这四个因素(强迫行为、性/攻击性强迫观念、迷信以及囤积/秩序/躯体关注)在内容上与成人研究不同。此外,有几种症状对不止一个维度有显著贡献。每个维度与严重程度指数得分均显著相关,但囤积/秩序/躯体关注因素的强迫观念得分除外。结果表明,儿童强迫症存在不同的症状维度,但这些维度与成人中确定的维度并不对应。相反,似乎一些因素存在方差共享,并且维度本身是根据发展轨迹划分的。所研究的维度可能在未来使用药物和/或行为干预的治疗研究中有用。

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