تأثیر ترومای کودکی بر نشانه¬های اختلال وسواسی- جبری با نقش واسطه¬ای خودتنظیم¬گری در بیماران مبتلا به اختلال وسواسی- جبری
محورهای موضوعی : بالینیفرناز رادمهر 1 , خدامراد مومنی 2 , جهانگیر کرمی 3 , عمران داوری نژاد 4
1 - دکتری روان شناسی، دانشکده علوم اجتماعی، دانشگاه رازی، کرمانشاه، ایران.
2 - استاد گروه روان شناسی، دانشکده علوم اجتماعی، دانشگاه رازی، کرمانشاه، ایران.
3 - دانشیار گروه روان شناسی، دانشکده علوم اجتماعی، دانشگاه رازی، کرمانشاه، ایران.
4 - دانشیار گروه روان پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.
کلید واژه: خودتنظیم¬گری, ترومای کودکی, اختلال وسواسی- جبری,
چکیده مقاله :
این پژوهش با هدف بررسی تأثیر ترومای کودکی بر نشانههای اختلال وسواسی- جبری با نقش واسطهای خودتنظیمگری در بیماران مبتلا به اختلال وسواسی- جبری انجام گرفت. در اين پژوهش توصیفی از نوع همبستگی، 300 نفر بیمار مبتلا به اختلال وسواسی- جبری(161 نفر زن و 139 نفر مرد) مراجعهکننده به کلینیکهای عمومی و خصوصی روانپزشکی در سطح شهر کرمانشاه با توجه به معیارهای ورود و خروج و دريافت تشخيص اختلال وسواسی- جبری توسط روانپزشک و بر اساس مصاحبه بالینی ساختاريافته(DSM-5) به شیوه تصادفی با توجه به شماره پروندههای پزشکی آنان، انتخاب شدند. ابزارهای مورد استفاده در این پژوهش شامل مصاحبه بالینی ساختاریافته(SCID-V)، پرسشنامه بازنگری شده اختلال وسواسی- جبری فوا و همکاران(2002) و فرم کوتاه پرسشنامه ترومای کودکی برنشتاین و همکاران(2003) بود. دادهها به وسيله تحليل معادلات ساختاري و نرمافزارهای SPSS-22 و AMOS-24 مورد تجزیه و تحلیل قرار گرفت. يافتهها نشان داد كه مدل پيشنهادي، برازش مناسبي با دادهها دارد. در این مدل، معناداری اثر مستقیم و معنادار هر یک از متغیرهای ترومای کودکی(405/0) و خودتنظیمگری(163/0-) بر اختلال وسواسی- جبری و نیز اثر غیرمستقیم و معنادار ترومای کودکی بر اختلال وسواسی- جبری(712/0) با مقادیر مذکور نشان داده شد(001/0all P s<).
The aim of this study investigated the effect of childhood trauma on the symptoms of obsessive-compulsive disorder with a mediating role of self-regulation in patients with obsessive-compulsive disorder. In this descriptive correlational study, 300 patients with obsessive-compulsive disorder (161 females and 139 males) referred to public and private psychiatric clinics in Kermanshah according to the inclusion and exclusion criteria and receiving a diagnosis Obsessive-compulsive disorder was selected by a psychiatrist based on structured clinical interview (DSM-5) randomly according to the number of their medical records. The instruments used in this study included Structured Clinical Interview (SCID-V), Revised Obsessive-Compulsive Disorder Questionnaire by Foua et al. (2002) and the short form of Bernstein et al.'s (2003) Child Trauma Questionnaire. Data were analyzed by structural equation analysis in SPSS-21 and AMOS-24 software. The findings showed that the proposed model has a good fit with the data. In this model, the significant and direct effect of each of the variables of childhood trauma (0.405) and self-regulation (-0.163) on obsessive-compulsive disorder and also the indirect and significant effect of childhood trauma on obsessive-compulsive disorder (0.712) 0) was shown with the mentioned values (all P s <0.001).
Adams, T. G., Kelmendi, B., Brake, C. A., Gruner, P., Badour, C. L., & Pittenger, C. (2018). The role of stress in the pathogenesis and maintenance of obsessive-compulsive disorder. Chronic Stress, 2: 2470547018758043.
Akbari Renani N. (2018). Examination of Casual Model of Childhood Trauma in Adulthood Somatization Symptoms with Mediating Role of Percieved Social Support and Cognitive Emotion Regulation Strategies. Master Thesis in Clinical Psychology, Shahid Bahonar University of Kerman Faculty of Faculty of Humanities & Literature.
American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorder (5th Ed- DSM-5). Washington, DC: Author.
Angelakis, I., Gooding, P., Tarrier, N., & Panagioti, M. (2015). Suicidality in obsessive compulsive disorder (OCD): a systematic review and meta-analysis. Clinical Psychology Review. 39(1): 1-15.
Arya, S., Filkowski, M.M., Nanda, P., Sheth, S.A. (2019). Deep brain stimulation for obsessive-compulsive disorder. Bulletin of the Menninger Clinic. 83(1):84-96.
Ay, R., Erbay, L.G. (2018). Relationship between childhood trauma and suicide probability in obsessive-compulsive disorder. Psychiatry Research. 261:132-136.
Bermudez, J. (1999). Personality and health-protective behavior. European Journal of Personality. 13(2):83-103.
Besharat, M.A. (2011). Investigating the psychometric properties of the short form of the self-regulation scale in a sample of Iranian society, Clinical and Counseling Psychology Research, 1(2): 53-70.
Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., Stokes, J., Handelsman, L., Medrano, M.., Desmond, D., Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2): 169–190.
Brennan, B. P., Rauch, S. L., Jensen, J. E., & Pope Jr, H. G. (2013). A critical review of magnetic resonance spectroscopy studies of obsessive-compulsive disorder. Biological Psychiatry. 73(1), 24-31.
Brodsky, B.S., Mann, J. J., Stanley, B., Tin, A., Oquendo, M., Birmaher, B. (2008). Familial transmission of suicidal behavior: Factors mediating the relationship between childhood abuse and offspring suicide attempts. Journal Clinical Psychiatry, 69(4) 584-596.
Brown, L. A., Wakschal, E., Russman-Block, S., Boisseau, C. L., Mancebo, M. C., Eisen, J. L., & Rasmussen, S. A. (2019). Directionality of change in obsessive compulsive disorder (OCD) and suicidal ideation over six years in a naturalistic clinical sample. Journal of Affective Disorders, 245, 841-847.
Carver, C.S., & Scheier, M.F. (2011). Self-regulation of action and affect In Vohs KD & Baumeister RF, Handbook of Self-Regulation (2nd ed., pp. 3–21). New York: The Guilford Press.
Ebrahimi, H., Dejkam, M., Seghatoleslam, T. (2014). Childhood Traumas and Suicide Attempt in adulthood. Iranian Journal of Psychiatry and Clinical Psychology; 19 (4): 275-282
Fisher PL, Wells A. (2005). How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis. Behaviour Research and Therapy. 43(12):1543–1558.
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., Salkovskis, P. M. (2002). The obsessive- compulsive inventory: Development and validation of a short version. Psychological Assessment, 14, 485-496.
Franzen, S.M. (2019). The Impact of trauma-informed strategies on self-regulation and sense of belonging in elementary students. Retrieved from Sophia, the St. Catherine University repository.
Hofer, P.D., Wahl, K., Meyer, A.H., Miche, M., Beesdo-Baum, K., & Lieb, R. (2020). Parental emotional warmth interacts with traumatic life events in predicting the onset of obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 26, 1-6.
Hofer, P.D., Wahl, K., Meyer, A.H., Miche, M., Beesdo-Baum, K., Wong, S.F., Grisham, J.R., Wittchen, H.U., Lieb, R. (2018). Obsessive-compulsive disorder and the risk of subsequent mental disorders: A community study of adolescents and young adults. Depression and Anxiety. 35(4):339-345.
Hosseini, K., Solimani, E. (2020). Investigating the differential role of childhood trauma and cognitive istortions associated with clinical symptoms of obsessive-compulsive disorder. JOURNAL OF THOUGHT & BEHAVIOR IN CLINICAL PSYCHOLOGY, 14 (54), 17-26.
Lau, J.Y.F., Gregory, A.M., Rijsdijk, F., McGuffin, P., Eley, T.C. (2007). Pathways to childhood depressive symptoms: The role of social, cognitive, and genetic risk factors. Development Psychology. 43(6):1402-1414.
Middleton, S. E. (2011). Do punitive ostracism experiences add to our understanding of obsessive compulsive beliefs and their relationship to obsessive compulsive symptoms? An exploratory study and pilot of a new measure. Thesis submitted in the Degree of Doctor of Psychology (clinical) University of Hull.
Miller, M. L., & Brock, R. L. (2017). The effect of trauma on the severity of obsessive-compulsive spectrum symptoms: A meta-analysis. Journal of Anxiety Disorders, 47, 29–44.
Nouie, Z. (2007). Comparison of primary maladaptive schemas and parental roots of these schemas in obsessive-compulsive personality disorder, obsessive-compulsive disorder and non-clinical group. Master's Thesis in Clinical Psychology, Institute of Psychiatry: Tehran.
Nordahl, H., Havnen, A., Hansen, B., Ost, L.G., Kvale, G. (2018). Sleep disturbances in treatment-seeking OCD-patients: Changes after concentrated exposure treatment. Scandinavian Journal of Psychology, 59(2): 186–191.
Ost, L.G., Havnen, A., Hansen, B., Kvale, G. (2015). Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014. Clinical Psychology Review. 40,156-69.
Ozhiganova, G.V. (2018).Self-regulation and self-regulatory capacities: components, levels, models. RUDN Journal of Psychology and Pedagogics, 15(3): 255-270.
Panlilio, C.C., Ferrara, A., MacNeill, L. (2019). Trauma, self-regulation, and learning. In: Panlilio C.(eds) trauma-informed schools. Child Maltreatment Solutions Network. Springer, Cham (pp.61-78).
Pauls, D. L., Abramovitch, A., Rauch, S. L., & Geller, D. A. (2014). Obsessive–compulsive disorder: An integrative genetic and neurobiological perspective. Nature Reviews Neuroscience, 15, 410–424.
Posner, M. I., & Rothbart, M. K. (2000). Developing mechanisms of self-regulation. Development and Psychopathology, 12(3): 427-441.
Renkema, T.C., deHaan, L., Schirmbeck, F., Alizadeh, B.Z., GROUP Investigators. (2020). Childhood trauma and coping in patients with psychotic disorders and obsessive-compulsive symptoms and in un-affected siblings. Child Abuse & Neglect, 99, 104243.
Robinson, L.J., Freeston, M.H. (2014). Emotion and internal experience in obsessive compulsive disorder: reviewing the role of alexithymia, anxiety sensitivity and distress tolerance. Clinical Psychology Review.34 (3):256-571.
Roy, A. (2011). Combination of family history of suicidal behavior and childhood trauma may represent correlate of increased suicide risk. Journal of Affective Disorders, 130(1-2): 205-208.
Sarafraz, M.R., Hemati, S., Asadi-Lari, H. (2020). The relationship between perfectionism and obsessive compulsive disorder (OCD): Self-regulation processes as moderator. International Journal of School Health, 7(2): 30-36.
Shalev, I., Sulkowski, M.L. (2009). Relations between distinct aspects of self-regulation to symptomsof impulsivity and compulsivity. Personality and Individual Differences 47(2):84–88.
Shields, G.S., Moons, W.G., Slavich, G.M. (2017). Inflammation, self-regulation, and health: An immunologic model of self-regulatory failure. Perspectives on Psychological Science. 12(4):588-612.
Shirzadi, M., Jozanifard, Y., Eskandari, S., Farhang, S., Khazaei, H. An epidemiological survey of psychiatric disorders in Iran: Kermanshah. Asian Journal of Psychiatry. 2019; 43:67-69.
Simmen-Janevska, K., Forstmeier, S., Krammer, S., Maercker, A. (2015). Does trauma impair self-control? Differences in delaying gratification between former indentured child laborers and nontraumatized controls. Violence and Victims. 30(6):1068-1081.
Simpson, H.B., Franklin, M.E., Cheng, J., Foa, E.B., Liebowitz, M.R. (2005).Standard criteria for relapse are needed in obsessive-compulsive disorder. Depress Anxiety. 21(1):1–8.
Sunde, T., Hummelen, B., Himle, J.A., Walseth, L.T., Vogel, P.A., Launes, G., Haaland, V.O., Haaland, A.T. (2019). Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry. 26; 19(1):318-330.
Tibi, L., vanOppen, P., vanBalkom, A.J.L.M., Eikelenboom, M., Hendriks, G.J., Anholt, G.E. (2020). Childhood trauma and attachment style predict the four year course of obsessive compulsive disorder: Findings from the Netherlands obsessive compulsive disorder study. Journal of Affective Disorders. 264,206-214.
Toftdahl, N.G., Nordentoft, M., Hjorthoj, C. (2016). Prevalence of substance use disorders in psychiatric patients: a nationwide Danish population-based study. Social Psychiatry and Psychiatric Epidemiology, 51(1): 129–140.
Veale, D., Roberts, A. (2014). Obsessive-compulsive disorder. British Medical Journal. 2014; 7; 348.
Wang, P., Zhao, Q., Xu, T., Gu, Q., Liu, Q., Wang, Y., Lin, G.N., Wang, Z. (2020). Interaction between PGRN gene and the early trauma on clinical characteristics in patients with obsessive-compulsive disorder. Journal of Affective Disorders, 263, 134-140.
Weidner, G., Sieverding, M., Chesney, M.A. (2016).The role of self-regulation in health and illness. Psychology, Health & Medicine. 21(2):135-137.
Whittal, M.L., Thordarson, D.S. & MacLean P.D. (2004). Treatment of obsessive compulsive disorder: cognitive behavioural therapy vs. exposure and response prevention. Behaviour, Research and Therapy. 43, 1559-1574.