Cognitive Beliefs Across the Symptom Dimensions of Pediatric Obsessive-Compulsive Disorder: Type of Symptom Matters.
Cognitive Beliefs Across the Symptom Dimensions of Pediatric Obsessive-Compulsive Disorder: Type of Symptom Matters.
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DOI：
10.1016/j.beth.2021.08.001
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发表时间：
2022-03
期刊：
影响因子：
3.7
通讯作者：
Storch, Eric A
中科院分区：
文献类型：
--
作者：
Cervin, Matti;McNeel, Morgan M;Wilhelm, Sabine;McGuire, Joseph F;Murphy, Tanya K;Small, Brent J;Geller, Daniel A;Storch, Eric A
强迫症（OCD）的认知模型假定，功能失调的认知信念是至关重要的强迫症的发病和维持;然而，这些认知信念和儿童和青少年的强迫症症状的异质性之间的关系仍然未知。我们研究了认知模型的主要信念域（膨胀的责任/威胁估计，完美主义/不容忍的不确定性，思想的重要性/控制）和功能失调的元认知如何与以下维度的强迫症症状相关：怀疑/检查，痴迷，囤积，清洗，订购和中和。分析了137名寻求治疗的强迫症青少年的自我报告评级。当认知信念和症状维度被串联分析时，膨胀的责任/威胁估计和功能失调的元认知与怀疑/检查、强迫、囤积和完美主义/不容忍不确定性的命令有独特的关系。认知信念在怀疑/检查（61%）和痴迷（46%）方面解释了很大一部分差异，但在订购（15%）、囤积（14%）、中和（8%）和清洗（3%）方面解释得较少。儿童和青少年的认知信念和症状维度之间存在类似的关系。认知信念似乎与儿童强迫症有关的伤害，责任和检查，但它们并没有明确映射到污染和中毒相关的症状。强迫症的病因和治疗的影响进行了讨论。
The cognitive model of obsessive-compulsive disorder (OCD) posits that dysfunctional cognitive beliefs are crucial to the onset and maintenance of OCD; however, the relationship between these cognitive beliefs and the heterogeneity of OCD symptoms in children and adolescents remains unknown. We examined how the major belief domains of the cognitive model (inflated responsibility/threat estimation, perfectionism/intolerance of uncertainty, importance/control of thoughts) and dysfunctional metacognitions were related to OCD symptoms across the following dimensions: doubting/checking, obsessing, hoarding, washing, ordering, and neutralization. Self-report ratings from 137 treatment-seeking youth with OCD were analyzed. When cognitive beliefs and symptom dimensions were analyzed in tandem, inflated responsibility/threat estimation and dysfunctional metacognitions were uniquely related to doubting/checking, obsessing, and hoarding and perfectionism/intolerance of uncertainty to ordering. Cognitive beliefs explained a large proportion of variation in doubting/checking (61%) and obsessing (46%), but much less so in ordering (15%), hoarding (14%), neutralization (8%), and washing (3%). Similar relations between cognitive beliefs and symptom dimensions were present in children and adolescents. Cognitive beliefs appear to be relevant for pediatric OCD related to harm, responsibility, and checking, but they do not map clearly onto contamination and symmetry-related symptoms. Implications for OCD etiology and treatment are discussed.