Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (9): 1315-1322.doi: 10.3969/j.issn.1674-8115.2022.09.019

• Clinical research • Previous Articles    

Mediating effects of neuroticism and immature defense on relationship between childhood trauma and obsessive-compulsive symptoms in patients with obsessive-compulsive disorder

ZHAO Qing(), GU Wenjie, WANG Zhen()   

  1. Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Received:2022-05-27 Accepted:2022-07-17 Online:2022-09-28 Published:2022-09-28
  • Contact: WANG Zhen E-mail:zhaoqing@smhc.org.cn;wangzhen@smhc.org.cn
  • Supported by:
    Grants for Important Weak Discipline—Psychosomatic Medicine from Shanghai Municipal Health Commission(2019ZB0201)

Abstract:

Objective ·To explore the characteristics of childhood trauma, personality traits and defense mechanism in the patients with obsessive-compulsive disorder (OCD), and investigate the mediating effects of personality traits and defense style on the relationship between childhood trauma and obsessive-compulsive symptoms in the OCD patients. Methods ·Totally 113 patients with OCD who met the criteria of Diagnostic and Statistical Manual of Mental Disorders-5 (DMS-5), and 66 age- and gender-matched health controls with similar education level distribution were selected. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to evaluate the severity of obsessive-compulsive symptoms. Childhood Trauma Questionnaire (CTQ) was used to evaluate the childhood trauma experience. NEO Five-Factor Inventory (NEO-FFI) was used to measure the personality traits. Defense Style Questionnaire (DSQ) was used to evaluate the defense style. The correlations among childhood experience, obsessive-compulsive symptoms, personality traits and defense style as well as mediating role of personality traits and defense style between childhood trauma and obsessive-compulsive symptoms were analyzed. Results ·Compared with the health controls, the OCD patients showed higher scores of emotional abuse [8 (5, 25) points vs 6 (5, 22) points, P<0.05] and immature defense [(4.65±1.01) points vs (3.60±0.99) points, P<0.05]. In the OCD patients, the scores of emotional abuse (r=0.211, P<0.05) and immature defense (r=0.274, P<0.05) were positively correlated with the total scores of Y-BOCS, and the neuroticism scores of NEO-FFI were positively correlated with the total scores of Y-BOCS (r=0.468, P<0.05). The pathway analysis showed the indirect effect from emotional abuse to Y-BOCS via immature defense was 0.088 (95%CI 0.003?0.173, P<0.05). The immature defense played a completely mediated role, and indirect effect from emotional abuse to immature defense via neuroticism was 0.117 (95%CI 0.014?0.219, P<0.05). Conclusion ·Compared with healthy people, OCD patients have experienced more emotional and physical childhood trauma, and have abnormal personality traits of neuroticism, extraversion and conscientiousness. They tend to use immature defense mechanisms. The emotional abuse has an impact on immature defense via neuroticism, and finally affect the obsessive-compulsive symptoms.

Key words: obsessive-compulsive disorder (OCD), childhood trauma, defense style, personality strait, mediating effect

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