Ivarsson Tord, Saavedra Fanny, Granqvist Pehr, Broberg Anders G
Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Postboks 4623, Nydalen, 0405, Oslo, Norway.
Department of Psychology, University of Gothenburg, Göteborg, Sweden.
Child Psychiatry Hum Dev. 2016 Apr;47(2):270-80. doi: 10.1007/s10578-015-0563-x.
We investigated whether adverse attachment experience might contribute to the development of obsessive-compulsive disorder (OCD). We interviewed 100 adolescents, 25 each with primary OCD, depressive disorder (DD), OCD plus DD and general population controls (CTRs) using the adult attachment interview to assess attachment experiences (AEs), including traumatic and adverse AE (TAE). Adolescents with OCD, OCD+DD and DD had little evidence of secure base/safe haven parental behaviour and their childhood attachment needs judged to be rejected as compared to the controls. Overprotection was not characteristic of OCD, and parents using the child for their own needs (elevated levels of involving/role reversal) occurred only in DD, with low levels in OCD, OCD+DD and CTR. Traumatic experiences, often multiple, and/or attachment related were reported significantly more often in the DD group, and was less common in OCD+DD, CTR and particularly in the OCD group. In OCD, little TAE was reported and adverse AE were less serious and seem unlikely to contribute directly to OCD aetiology. In DD and to some degree in OCD+DD serious AE/TAE may have some etiological significance for the depressive states.
我们调查了不良依恋经历是否可能导致强迫症(OCD)的发生。我们使用成人依恋访谈对100名青少年进行了访谈,其中25名患有原发性强迫症、25名患有抑郁症(DD)、25名患有强迫症合并抑郁症以及25名作为普通人群对照(CTRs),以评估依恋经历(AEs),包括创伤性和不良依恋经历(TAE)。与对照组相比,患有强迫症、强迫症合并抑郁症和抑郁症的青少年几乎没有证据表明父母有安全基地/安全港湾行为,且他们童年的依恋需求被判定为被拒绝。过度保护并非强迫症的特征,将孩子作为满足自身需求的父母行为(卷入/角色反转水平升高)仅出现在抑郁症组,在强迫症、强迫症合并抑郁症和对照组中水平较低。抑郁症组报告的创伤经历通常较多且/或与依恋相关,在强迫症合并抑郁症组、对照组中较少见,在强迫症组中尤其少见。在强迫症中,报告的不良依恋经历较少,不良依恋经历也不那么严重,似乎不太可能直接导致强迫症的病因。在抑郁症以及在某种程度上在强迫症合并抑郁症中,严重的依恋经历/创伤性依恋经历可能对抑郁状态具有一定的病因学意义。