Cromer Kiara R, Schmidt Norman B, Murphy Dennis L
Department of Psychology, Florida State University, Tallahassee, FL 32306-1270, USA.
Behav Res Ther. 2007 Jul;45(7):1683-91. doi: 10.1016/j.brat.2006.08.018. Epub 2006 Oct 25.
Obsessive-compulsive disorder (OCD), like most other psychiatric disorders, is suspected of being influenced by an interaction between life events and genes, both with regard to onset and course of illness. To date, no specific genes have been identified as playing a frequent role, and only a relatively few empirical studies have assessed the association between stressful life events (SLEs) and OCD. The present study builds on past research by examining the potential contributions from traumatic life events (TLEs) on the severity and symptom features in 265 individuals with Structured Clinical Interview for DSM-IV (SCID)-diagnosed OCD. Of these participants 54% endorsed having experienced at least one TLE in their life time. The presence of one or more TLEs was associated with increased OCD symptom severity. This relationship remained significant despite controlling for key variables including age, OCD age-of-onset, comorbidity, and depressive symptoms. In addition, obsessions/checking and symmetry/ordering were two of four symptom factors that were specifically associated with the occurrence of TLEs. These results are generally supportive of a pathoplastic relationship between TLEs and OCD symptomatology and thus suggest the need for greater systematic consideration of life stresses in research focused on the nature and treatment of OCD.
与大多数其他精神障碍一样，强迫症（OCD）被怀疑在发病和病程方面受到生活事件与基因之间相互作用的影响。迄今为止，尚未确定有特定基因经常发挥作用，而且只有相对较少的实证研究评估了应激性生活事件（SLEs）与强迫症之间的关联。本研究基于以往的研究，通过调查创伤性生活事件（TLEs）对265名经《精神疾病诊断与统计手册》第四版（DSM-IV）结构化临床访谈（SCID）诊断为强迫症患者的症状严重程度和症状特征的潜在影响。在这些参与者中，54%的人认可自己在一生中经历过至少一次创伤性生活事件。存在一个或多个创伤性生活事件与强迫症症状严重程度增加有关。尽管对包括年龄、强迫症发病年龄、共病和抑郁症状等关键变量进行了控制，这种关系仍然显著。此外，强迫观念/检查和对称/秩序是与创伤性生活事件的发生特别相关的四个症状因素中的两个。这些结果总体上支持了创伤性生活事件与强迫症症状学之间的病理塑形关系，因此表明在专注于强迫症本质和治疗的研究中，需要更系统地考虑生活压力。
