Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, 77520 Olomouc, Czech Republic.
Department of Pedagogy and Psychology, Faculty of Science, Humanities and Education, Technical University of Liberec, Czech Republic.
Neuro Endocrinol Lett. 2022 Dec 29;43(6):333-344.
Obsessive-compulsive disorder (OCD) has been connected to various psychosocial factors that might influence its onset and course. Developmental factors, such as parenting styles or early adverse experiences, and adult attachment have been listed as examples. However, the research on the interconnections of these factors brought mixed results. The study explores the relationship between demographic, clinical, and selected psychosocial factors and the severity of adult OCD.
Eighty-seven pharmacoresistant inpatients with OCD were admitted between October 2019 and August 2022 for a 6-week cognitive behavioural therapy inpatient program in the psychotherapeutic department. The participants completed the following scales at the start of the hospitalisation: the self-report Yale-Brown Obsessive-Compulsive Scale (Y-BOCS-SR), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire-Short Form (CTQ-SF), PBI (Parental Bonding Instrument), ECR-R (Experiences in Close Relationships - Revised), and a demographic questionnaire. A skilled psychologist administered Mini International Neuropsychiatric Interview (MINI) to confirm the OCD diagnosis and Hamilton Anxiety Rating Scale (HAMA).
OCD patients with more severe adverse childhood experiences (ACEs) showed earlier onset of the disorder and more pronounced attachment anxiety, depressive symptoms, and dissociation and subjectively rated the severity of the disorder as more severe. Physical abuse and physical neglect were related to the severity of specific OCD symptoms. Maternal care negatively correlates with clinician-rated anxiety, patient-rated depressive symptoms, and dissociation. The maternal and paternal control positively correlated with patient-rated anxiety and depression. Attachment anxiety negatively correlated with the age of onset and positively with the severity of the clinician-rated anxiety and the patient-rated anxiety, depressive symptoms, and dissociation.
Early adverse experiences, perceived parental styles, and adult attachment anxiety could play a significant role in the symptoms of anxiety, depression, and dissociation. The connection with the specific obsessive-compulsive symptoms is less apparent. Still, adverse childhood events and adult attachment anxiety seem to influence the age of OCD onset.
强迫症（OCD）与多种可能影响其发病和病程的心理社会因素有关。例如，有研究列出了发展因素（如父母教养方式或早期不良经历）和成人依恋。然而，关于这些因素相互关系的研究结果喜忧参半。本研究探讨了人口统计学、临床和选定的心理社会因素与成人 OCD 严重程度之间的关系。
2019 年 10 月至 2022 年 8 月期间，87 名药物难治性强迫症住院患者因参加心理治疗科的 6 周认知行为治疗住院计划而入院。患者在住院时完成了以下量表：耶鲁-布朗强迫症量表自评版（Y-BOCS-SR）、贝克焦虑量表（BAI）、贝克抑郁量表（BDI-II）、分离体验量表（DES）、儿童创伤问卷-短式（CTQ-SF）、父母养育方式问卷（PBI）、依恋关系体验问卷修订版（ECR-R）和人口统计学问卷。一位熟练的心理学家进行了迷你国际神经精神访谈（MINI）以确认 OCD 诊断和汉密尔顿焦虑量表（HAMA）。
具有更严重不良童年经历（ACEs）的 OCD 患者发病更早，依恋焦虑、抑郁症状和分离更为明显，并主观评定疾病严重程度更严重。身体虐待和身体忽视与特定 OCD 症状的严重程度有关。母亲关怀与临床医生评定的焦虑、患者评定的抑郁症状和分离呈负相关。母亲和父亲的控制与患者评定的焦虑和抑郁呈正相关。依恋焦虑与发病年龄呈负相关，与临床医生评定的焦虑、患者评定的焦虑、抑郁症状和分离呈正相关。
早期不良经历、感知的父母教养方式和成人依恋焦虑可能在焦虑、抑郁和分离症状中起重要作用。与特定的强迫症症状的相关性不太明显。尽管如此，不良的童年经历和成人依恋焦虑似乎会影响 OCD 的发病年龄。
