Rozenman Michelle, Peris Tara, Bergman R Lindsey, Chang Susanna, O'Neill Joseph, McCracken James T, Piacentini John
Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, 67-455, Los Angeles, CA, 90095, USA.
Child Psychiatry Hum Dev. 2017 Feb;48(1):63-72. doi: 10.1007/s10578-016-0653-4.
Prior research has identified OCD subtypes or "clusters" of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7-17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment.
先前的研究已经确定了强迫症的亚型或症状“集群”，这些与该疾病的临床特征存在不同的关联。鉴于强迫症与焦虑症之间的高共病率，强迫症症状集群可能更广泛地与恐惧和/或内化的痛苦结构相关联。本研究考察了恐惧和痛苦维度，包括身体担忧（恐惧）、分离焦虑（恐惧）、完美主义（痛苦）和焦虑应对（痛苦），作为215名被诊断为原发性强迫症的青少年（年龄7 - 17岁，平均年龄 = 12.25岁）样本中先前通过实证得出的强迫症症状集群的预测因素。自我报告的分离恐惧预测了第1组（攻击性、性、宗教、躯体强迫观念以及检查强迫行为）的成员资格，而躯体/自主神经恐惧预测了第2组（对称强迫观念以及排序、计数、重复强迫行为）的成员资格。结果凸显了儿童强迫症症状的多样性及其与恐惧的不同关联，表明需要仔细评估强迫症和可能在治疗中直接作为靶点的整体恐惧结构。
