UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room 47-417B, Los Angeles, CA, 90095, USA.
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Child Psychiatry Hum Dev. 2019 Oct;50(5):717-726. doi: 10.1007/s10578-019-00876-7.
Family accommodation (FA) has been linked with myriad negative outcomes in pediatric obsessive-compulsive disorder (OCD), but extant literature has yielded differential relationships between FA and clinical variables of interest. Consequently, this study examined the phenomenology, clinical profile, and effects of comorbid psychopathology on FA to better understand these behaviors. A total of 150 youths and their caregivers completed clinician- and self-reported measures at a baseline visit for a larger randomized controlled trial. Sociodemographic variables were not associated with FA, but specific types of OCD symptom clusters were. Higher OC-symptom severity and functional impairment were associated with increased FA. Comorbid anxiety disorders moderated the relationship between OC-symptom severity and FA, but comorbid attention deficit hyperactivity, oppositional defiant, and mood disorders did not. Internalizing and externalizing problems both mediated the relationship between FA and functional impairment. These findings provide clinical implications for important treatment targets and factors that may impact FA.
家庭适应（FA）与儿科强迫症（OCD）的诸多负面结果有关，但现有文献表明 FA 与相关临床变量之间的关系存在差异。因此，本研究通过考察共病精神病理学对 FA 的现象学、临床特征和影响，以更好地理解这些行为。共有 150 名青少年及其照料者在一项更大的随机对照试验的基线访视时完成了临床医生和自我报告的评估。社会人口学变量与 FA 无关，但特定类型的 OCD 症状群有关。较高的 OC 症状严重程度和功能障碍与 FA 的增加有关。共病焦虑障碍调节了 OC 症状严重程度与 FA 之间的关系，但共病注意缺陷多动、对立违抗和心境障碍则没有。内化和外化问题都介导了 FA 与功能障碍之间的关系。这些发现为重要的治疗目标和可能影响 FA 的因素提供了临床意义。
