Interaction Of Childhood Trauma,Family Function And Executive Function In Patients With Obsessive-Compulsive Disorder

Background Obsessive-compulsive disorder（OCD）is a clinically common and one of the most difficult-to-treat mental disorders characterized by obsessions and/or compulsions,with poor treatment outcomes and long healing times,causing significant inconvenience to patients’ normal social lives.It is very inconvenient to come.According to the World Health Organization and the Global Burden of Disease Study,OCD is one of the most devastating non-communicable diseases globally.The pathogenesis of obsessive-compulsive disorder is multifactorial and multidimensional.In terms of psychosocial aspects,childhood experiences may play a role,including emotional attachments between children and their parents,parenting styles or traumatic childhood experiences.Childhood trauma and family functioning have been shown to have a strong influence on an individual’s mental health and executive functioning,but it is unclear what role the interaction between childhood trauma and family functioning has on the executive functioning of individuals with OCD.This study hypothesizes that childhood trauma may further contribute to problems in family functioning,which in turn may have an impact on executive functioning in individuals with OCD.Objectives1.To explore the characteristics of childhood trauma and family functioning in patients with OCD,and to analyze the influence of both on the prevalence of OCD and the executive functioning of people with OCD,in order to provide a basis for a deeper understanding of the psychosocial factors of OCD.2.To analyze the relationship between general demographic data,childhood trauma,family functioning,severity of OCD and executive functioning in OCD,and to provide a theoretical basis and new ideas for the psychotherapy of OCD.3.To explore the relationship between family functioning in childhood trauma and executive functioning in patients with OCD,with a view to developing a model of family functioning as a mediator between childhood trauma and OCD,with a view to providing a theoretical basis for clinical psychological counselling and treatment.Methods In this study,54 patients with OCD who were treated in outpatient and inpatient settings at Zhumadian Psychiatric Hospital from November 2020 to December 2021 were selected as the OCD group using a random sampling method.By the method of recruitment,50 healthy controls were included as the control group during the same period.General situation questionnaire,Childhood Trauma Questionnaire（CTQ-SF）,Yale-Brown Obsessive-Compulsive Scale（Y-BOCS）,Family Assessment Device（FAD）,Trail Making Test A（TMT A）,Stroop color-word Test（SCWT）,Maze as a research tool for measurement and evaluation.SPSS 25.0 statistical software package was used for statistical analysis to compare the differences in childhood trauma,family function and executive function between the obsessive-compulsive disorder group and the healthy control group.Results1.Physical abuse（t=-2.998,P < 0.05）and sexual abuse（t=-4.097,P<0.001）were both significantly higher in the OCD group than in the HC group.2.The OCD group had significantly higher behavior control（t=2.587,P<0.05）than the HC group.3.The OCD group showed significant differences（P<0.05）in the SCWT,TMT A and Maze scores compared to the HC group.4.Taking the total score of childhood trauma questionnaire,physical neglect,emotional neglect,emotional abuse,physical abuse,sexual abuse,problem solving,communication,role,affective responsiveness,affective involvement,behavioral control,and general functioning as independent variables,the executive function was divided into different categories.Ridge regression analysis was performed on the variables as dependent variables in turn,and the k value was taken as 0.990.The results showed that physical neglect and emotional abuse had a significant positive correlation effect on SCWT Card A elapsed time,SCWT Card B elapsed time and SCWT Card C elapsed time（P<0.05）;total Childhood Trauma Questionnaire score,physical neglect and emotional abuse had a significant positive correlation effect on the number of correct SCWT Card C readings and TMT A（P< 0.05）;physical abuse,emotional abuse and sexual abuse would have a significant positive correlated effect on the maze（P< 0.05）.There was a significant negative correlation between affective responsiveness in family functioning and the number of correct SCWT card C readings（P<0.05）;a significant positive correlation between communication in family functioning and TMT A and maze scores（P<0.05）.5.In terms of childhood trauma,sexual abuse scores were significantly higher in males than in females（t=2.287,P<0.05）;in terms of family functioning,differences in problem solving（F=3.227,P<0.05）,emotional response（F=3.657,P<0.05）,and total functioning（F=4.766,P<0.05）among OCD patients with different literacy levels were significant.6.In terms of childhood trauma,the correlation coefficient value between Y-BOCS and somatic neglect was 0.369,and P<0.01,with a significant positive correlation;in terms of family functioning,the correlation coefficients between Y-BOCS and communication,role,affective responsiveness and affective involvement were 0.320,0.289,0.298 and0.284,respectively,and P<0.05,with a significant positive In terms of executive function,the correlation coefficients between Y-BOCS and SCWT card A time-consuming,SCWT card A number of correct readings,TMT A,SCWT card B time-consuming,SCWT card B number of correct readings and SCWT card C time-consuming were 0.322,0.290,0.311,0.322,0.290 and 0.311,respectively,and P< 0.05,showing a significant positive correlation.7.The group with childhood trauma OCD had significantly higher scores in problem solving（t=-3.293,P<0.01）,communication（t=-6.163,P<0.001）,role（t=-5.515,P<0.001）,affective responsiveness（t=-4.768,P<0.001）,affective involvement（t=-5.305,P<0.001）,and general functioning（t=-5.298,P < 0.001）scores on all six dimensions were significantly higher than in the group without childhood trauma OCD.8.In the group with childhood trauma OCD,the time taken for SCWT card A（t=-4.340,P<0.001）,SCWT card B（t=-5.089,P<0.001）,SCWT card C（t=-5.505,P<0.001）and TMT A（t=-6.626,P<0.001）were significantly higher than in the group without childhood trauma OCD.In the group with childhood trauma OCD,the number of correct readings on SCWT card A（t=-4.394,P<0.001）,SCWT card B（t=-4.345,P<0.001）,SCWT card C（t=5.052,P<0.001）and the maze（t=-2.787,P<0.05）were significantly lower than in the group without childhood trauma OCD were significantly lower than in the group without OCD with childhood trauma.9.The direct effect value of childhood trauma on family functioning was 0.725,with a significant effect value（P<0.001）;the direct effect value of family functioning on executive functioning in OCD was 0.280,with a significant effect value（P<0.05）;the direct effect value of childhood trauma on executive functioning in OCD was 0.600,with a significant effect value（P< 0.001）;the direct effect of childhood trauma on executive functioning in Both the direct and indirect effects of childhood trauma on executive functioning were significant,with family functioning playing a partially mediating role.Conclusions1.In terms of childhood trauma,family functioning and executive functioning,it was found that OCD patients suffered more physical and sexual abuse in childhood;showed unhealthy behavioural control in family functioning;and executive functioning was significantly lower in OCD patients than in healthy controls.2.Childhood trauma and family functioning are influential factors in the development of OCD and are closely related to the severity of OCD symptoms,with the greater the severity of OCD symptoms the greater the impairment of executive functioning in OCD patients.3.Executive functioning in OCD is associated with childhood trauma,family functioning,and family functioning partially mediates the relationship between childhood trauma and executive functioning in OCD.