Wilcox Holly C, Grados Marco, Samuels Jack, Riddle Mark A, Bienvenu Oscar J, Pinto Anthony, Cullen Bernadette, Wang Ying, Shugart Yin Y, Liang Kung-Yee, Nestadt Gerald
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287-7228, USA.
J Affect Disord. 2008 Nov;111(1):31-9. doi: 10.1016/j.jad.2008.01.025. Epub 2008 Mar 4.
The aim of the current study is to estimate the association between parenting factors derived from the Parental Bonding Instrument (PBI) and a lifetime DSM-IV diagnosis of OCD.
Data were from approximately 1200 adults from 465 families assessed as part of a large family and genetic study of OCD. The association of three parenting factors, for fathers and mothers, with offspring OCD status were examined; analyses were stratified by parental OCD status and family loading for OCD (multiplex versus sporadic).
Three factors were derived by principal components factor analysis of the PBI (maternal and paternal care, overprotection and control). Maternal overprotection was associated with OCD in offspring with familial OCD (familial cases) but only if neither parent was affected with OCD, which suggests independent but additive environmental and genetic risk (OR = 5.9, 95% CI 1.2, 29.9, p = 0.031). Paternal care was a protective factor in those not at high genetic risk (sporadic cases) (OR = 0.2, 95% CI 0.0, 0.8, p = 0.027). Maternal overprotection was also associated with offspring OCD in sporadic families (OR = 2.9, 95% CI 1.3, 6.6, p = 0.012). The finding that parental overprotection and care were not associated with offspring OCD when at least one parent had OCD addressed directly the hypothesis of maternal or paternal OCD adversely impacting parenting.
This study provides evidence that aspects of parenting may contribute to the development of OCD among offspring. Prospective studies of children at risk for OCD are needed to explore the direction of causality.
本研究旨在评估源自父母教养方式问卷（PBI）的养育因素与终生DSM-IV诊断的强迫症之间的关联。
数据来自约1200名来自465个家庭的成年人，这些家庭作为强迫症大型家庭和基因研究的一部分接受了评估。研究考察了父亲和母亲的三种养育因素与后代强迫症状况之间的关联；分析按父母的强迫症状况和家庭中强迫症的负荷情况（多发性与散发性）进行分层。
通过对PBI进行主成分因子分析得出了三个因素（母亲和父亲的关爱、过度保护和控制）。母亲的过度保护与家族性强迫症后代的强迫症有关（家族性病例），但前提是父母双方均未患强迫症，这表明环境和遗传风险具有独立性且具有累加性（优势比=5.9，95%置信区间1.2，29.9，p=0.031）。父亲的关爱对那些遗传风险不高的人（散发性病例）是一个保护因素（优势比=0.2，95%置信区间0.0，0.8，p=0.027）。在散发性家庭中，母亲的过度保护也与后代的强迫症有关（优势比=2.9，95%置信区间1.3，6.6，p=0.012）。当至少有一方父母患有强迫症时，父母的过度保护和关爱与后代强迫症无关，这一发现直接针对了母亲或父亲患强迫症会对养育方式产生不利影响的假设。
本研究提供了证据，表明养育方式的某些方面可能促使后代患强迫症。需要对有患强迫症风险的儿童进行前瞻性研究，以探讨因果关系的方向。
