Murphy Yolanda E, Flessner Christopher A
Kent State University, Kent, Ohio, USA.
Br J Clin Psychol. 2015 Nov;54(4):414-34. doi: 10.1111/bjc.12088. Epub 2015 May 28.
Research among youths with obsessive compulsive disorder (OCD) has shown a significant relationship between illness severity, treatment outcome, and the family environment yet little work has been undertaken among the broader class of obsessive compulsive and related disorders (OCRDs) - Trichotillomania, body dysmorphic disorder (BDD), skin picking disorder (SPD), and hoarding. The aim of this study was to (1) review the family functioning literature among paediatric OCRDs, (2) address limitations to previous studies, and (3) highlight areas in need of further research.
A review of the literature was conducted using several databases (i.e., Google Scholar, PubMed, ScienceDirect) and employing key search terms (e.g., 'family functioning', 'paediatric OCD'). The resultant articles examined several domains subsumed under the broader heading of family environment including parental mental health, parenting practices, family dynamics, family involvement with symptoms, and family emotional climate.
The literature reviewed demonstrated a strong relationship between paediatric OCD and adverse family functioning (e.g., parental symptoms of anxiety and depression, family accommodation, family strain and stress, parental guilt and fear) in all identified domains. While family functioning research in paediatric HPD was relatively scant, research suggested similar familial dysfunction (e.g., limited independence, low family cohesion, family violence). Collectively, only 1 article, examining BDD, assessed family functioning within other OCRDs.
This review supports the need for further research in the OCRDs. Limitations to the available literature and targeted suggestions for future research are discussed.
The domains of family environment in this study indicate specific family functioning deficits that may serve as aetiological and/or maintenance factors in paediatric OCRDs, possibly contributing to the understanding of these complex disorders. The recognition of family deficits in paediatric OCRDs may prove beneficial in developing or bolstering preventative and/or therapeutic interventions. Insufficient number of articles pertaining to family functioning in some paediatric OCRDs (i.e., hoarding, skin picking) inhibits formal conclusions. Magnitudes of family functioning effects were not calculated; therefore, future research should consider meta-analytic analyses.
针对患有强迫症（OCD）的青少年的研究表明，疾病严重程度、治疗结果与家庭环境之间存在显著关联，但在更广泛的强迫及相关障碍（OCRD）类别——拔毛癖、躯体变形障碍（BDD）、皮肤搔抓障碍（SPD）和囤积障碍方面，相关研究较少。本研究的目的是：（1）回顾儿科OCRD患者家庭功能的文献；（2）解决以往研究的局限性；（3）突出需要进一步研究的领域。
使用多个数据库（即谷歌学术、PubMed、ScienceDirect）进行文献综述，并采用关键搜索词（如“家庭功能”“儿科强迫症”）。所得文章考察了家庭环境这一宽泛标题下包含的几个领域，包括父母心理健康、养育方式、家庭动态、家庭对症状的影响以及家庭情感氛围。
综述的文献表明，在所有确定的领域中，儿科强迫症与不良家庭功能（如父母的焦虑和抑郁症状、家庭迁就、家庭压力和紧张、父母的内疚和恐惧）之间存在密切关系。虽然儿科囤积障碍的家庭功能研究相对较少，但研究表明存在类似的家庭功能障碍（如独立性有限、家庭凝聚力低、家庭暴力）。总体而言，只有1篇研究躯体变形障碍的文章评估了其他OCRD中的家庭功能。
本综述支持对OCRD进行进一步研究的必要性。讨论了现有文献的局限性以及对未来研究的针对性建议。
本研究中的家庭环境领域表明了特定的家庭功能缺陷可能是儿科OCRD的病因和/或维持因素，这可能有助于理解这些复杂疾病。认识到儿科OCRD中的家庭缺陷可能对制定或加强预防和/或治疗干预措施有益。一些儿科OCRD（即囤积障碍、皮肤搔抓障碍）中与家庭功能相关的文章数量不足，妨碍了得出正式结论。未计算家庭功能影响的大小；因此未来研究应考虑进行荟萃分析。
