Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Skåne Child and Adolescent Psychiatry, Lund, Sweden.
Lund University, Department of Psychology, Lund, Sweden.
J Anxiety Disord. 2020 Jan;69:102175. doi: 10.1016/j.janxdis.2019.102175. Epub 2019 Dec 19.
Psychological models of pediatric obsessive-compulsive disorder (OCD) place a heavy emphasis on harm avoidance as a maintaining factor and target for treatment. Incompleteness and disgust may also play a role in pediatric OCD but remain understudied. Youth with OCD (n = 100), anxiety disorders (n = 96), and no impairing psychiatric symptoms (n = 25) completed self-report measures of trait-level incompleteness, harm avoidance, and disgust and current symptoms of OCD, anxiety, and depression. Group differences and associations between emotions, symptoms, and pre- to post-treatment change in overall OCD severity were examined. Youth with OCD and anxiety disorders scored higher on harm avoidance and disgust than youth with no psychiatric disorder. Youth with OCD scored higher on incompleteness than youth with anxiety disorders and youth with no psychiatric disorder. Harm avoidance showed unique associations to self-reported symptoms of OCD, anxiety, and depression while incompleteness was uniquely related to OCD and disgust to anxiety. Within the OCD sample, incompleteness and harm avoidance were differentially related to the major OCD symptom dimensions, and change in incompleteness was uniquely related to pre- to post-treatment change in OCD severity. Trait-level incompleteness appears to play a central role in pediatric OCD and studies investigating its direct involvement in symptoms and associations with treatment outcome are needed. The role of disgust in relation to pediatric OCD remains unclear.
儿童强迫症（OCD）的心理模型非常强调回避伤害作为维持因素和治疗目标。不完整性和厌恶感在儿童 OCD 中也可能起作用，但研究较少。100 名患有 OCD 的青少年、96 名患有焦虑症的青少年和 25 名没有精神障碍症状的青少年完成了特质水平不完整性、回避伤害和厌恶感以及当前 OCD、焦虑和抑郁症状的自我报告测量。检查了情绪、症状之间的差异以及 OCD 总体严重程度的治疗前后变化。患有 OCD 和焦虑症的青少年的回避伤害和厌恶感得分高于没有精神障碍的青少年。患有 OCD 的青少年的不完整性得分高于患有焦虑症的青少年和没有精神障碍的青少年。回避伤害与 OCD、焦虑和抑郁的自我报告症状有独特的关联，而不完整性与 OCD 有关，厌恶与焦虑有关。在 OCD 样本中，不完整性和回避伤害与 OCD 的主要症状维度有不同的关系，不完整性的变化与 OCD 严重程度的治疗前后变化有独特的关系。特质水平的不完整性似乎在儿童 OCD 中起着核心作用，需要研究其对症状的直接参与以及与治疗结果的关系。厌恶感在儿童 OCD 中的作用尚不清楚。
