Predicting the severity of obsessive-compulsive syndrome based on perceived parenting style: The mediating role of obsessive beliefs

Document Type : Research Paper

Authors

1 Ph.D. student in clinical psychology, Ferdowsi University of Mashhad, Mashhad, Iran

2 M. A. student in clinical psychology, Faculty of Educational Science and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

3 Bachelor of psychology, Faculty of Educational Science and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

4 Bachelor in psychology, Faculty of Educational Science and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

Abstract

Introduction: Obsessive-Compulsive Disorder (OCD) reduces the quality of life and is the fourth most common psychiatric disorder. Therefore, it is important to investigate the causes of the development and maintenance of this syndrome. The present study aimed to predict the severity of Obsessive-Compulsive Syndrome (OCS) based on perceived parenting style through the mediating role of obsessive beliefs.
Materials and Methods: The present study was descriptive-correlational and path analysis. Among the people who were referred to counseling centers in Mashhad, Iran for the treatment of OCD in 2020-2021, 200 cases were selected by the convenient sampling. Data were collected using the Yale-Brown, Obsessive Beliefs, and Young parenting style scales. Data were analyzed using Pearson correlation, multiple regression, and path analysis.
 Results: The findings showed that there was a significant correlation (P <0.01) between the Early Maladaptive Schemas (EMSs) of emotional deprivation, abandonment/instability, defectiveness/shame, and unrelenting standards, and obsessive beliefs with the severity of OCS. In addition, the results of Bootstrap indicate that the mediating role of obsessive beliefs was significant about the mentioned EMSs with the severity of OCS (χ2/df = 1.93, P= 0.001).
 Conclusion: Based on the findings, early maladaptive schemas of emotional deprivation, abandonment/instability, defectiveness/shame, and unrelenting standards can predict the severity of obsessive-compulsive syndrome through the mediating role of obsessive beliefs. Therefore, interventions based on parenting style education to reduce obsessive beliefs can be considered as prevention and treatment programs in obsessive-compulsive disorder patients.

Keywords


  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®): Washington. D.C.: American Psychiatric Publication; 2013.
  2. Sachs G, Erfurth A. Obsessive compulsive and related disorders–from the biological basis to a rational pharmacological treatment. Int J Neuropsychopharmacol 2018; 21(1): 59-62.
  3. Fawcett EJ, Power H, Fawcett JM. Women are at greater risk of OCD than men: A meta-analytic review of OCD prevalence worldwide. J Clin Psychiatry 2020; 81(4): 1-10.
  4. Van Oudheusden LJ, Van de Schoot R, Hoogendoorn A, van Oppen P, Kaarsemaker M, Meynen G, et al. Classification of comorbidity in obsessive–compulsive disorder: A latent class analysis. Brain Behav 2020; 10(7): 1-10.
  5. Norman LJ, Carlisi C, Lukito S, Hart H, Mataix-Cols D, Radua J, et al. Structural and functional brain abnormalities in attention-deficit/hyperactivity disorder and obsessive-compulsive disorder: a comparative meta-analysis. JAMA Psychiatry 2016; 73(8): 815-25.
  6. Abramowitz JS. Presidential address: are the obsessive-compulsive related disorders related to obsessive-compulsive disorder? A critical look at DSM-5 new category. Behav Ther 2018; 49(1): 1-11.
  7. Bruin W, Denys D, van Wingen G. Diagnostic neuroimaging markers of obsessive-compulsive disorder: Initial evidence from structural and functional MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91: 49-59.
  8. Amirzahedi N, Asgharnezhad Farid A. Relationship between schemas and child-rearing styles with obsessive-compulsive disorder in students of Iran University of Science and Technology. Razavi international journal of medicine 2019; 7(3-4): 9-14.
  9. Tenore K, Mancini F, Basile B. Schemas, modes and coping strategies in obsessive-compulsive like symptoms. Clin Neuropsychiatry 2018; 15(6): 384-92.
  10. Reuman L, Buchholz J, Abramowitz JS. Obsessive beliefs, experiential avoidance, and cognitive fusion as predictors of obsessive-compulsive disorder symptom dimensions. J Contextual Behav Sci 2018; 9: 15-20.
  11. Young JE, Klosko JS, Weishaar ME. Schema therapy: A practitioner's guide. New York: Guilford; 2006.
  12. Sunde T, Hummelen B, Himle JA, Walseth LT, Vogel PA, Launes G, et al. Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry 2019; 19(1): 1-13.
  13. Luppino OI, Tenore K, Mancini F, Basile B. A theoretical integration of schema therapy and cognitive therapy in OCD treatment: Goals and beliefs of the obsessive mind (Part I). Psychology 2018; 9(9): 22-61.
  14. Kizilagac F, Cerit C. [Assessment of early maladaptive schemas in patients with obsessive-compulsive disorder]. Dusunen Adam 2019; 32(1): 14-22. (Turkish)
  15. Kim JE, Lee SW, Lee SJ. Relationship between early maladaptive schemas and symptom dimensions in patients with obsessive-compulsive disorder. Psychiatry Res 2014; 215(1): 134-40.
  16. Khosravani V, Bastan FS, Mohammadzadeh A, Amirinezhad A, Ardestani SMS. Early maladaptive schemas in patients with obsessive-compulsive disorder, bipolar disorder, and schizophrenia: a comparative study. Curr Psychol 2021; 40(5): 2442-52.
  17. Basile B, Tenore K, Luppino OI, Mancini F. Schema therapy mode model applied to OCD. Clin Neuropsychiatry 2017; 14(6): 407-14.
  18. Shariatzadeh M. Prediction of obsessive-compulsive disorder symptoms via early maladaptive schemas. International journal of innovation and research in educational sciences 2017; 4(3): 265-70.
  19. Yoosefi A, RajeziEsfahani S, Pourshahbaz A, Dolatshahee B, Assadi A, Maleki F, et al. Early maladaptive schemas in obsessive-compulsive disorder and anxiety disorders. Glob J Health Sci 2016; 8(10): 167-77.
  20. Reuther ET, Davis III TE, Rudy BM, Jenkins WS, Whiting SE, May AC. Intolerance of uncertainty as a mediator of the relationship between perfectionism and obsessive‐compulsive symptom severity. Depress Anxiety 2013; 30(8): 773-7.
  21. Miegel F, Jelinek L, Moritz S. Dysfunctional beliefs in patients with obsessive-compulsive disorder and depression as assessed with the Beliefs Questionnaire (BQ). Psychiatry Res 2019; 272: 265-74.
  22. Frost RO, Novara C, Rhéaume J. Perfectionism in obsessive compulsive disorder. In: Frost RO, Steketee G. (editors). Cognitive approaches to obsessions and compulsions: Theory, assessment, and treatment.  Pergamon: Elsevier Science Inc.; 2002: 91-105.
  23. Group OCCW. Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory-Part 2: Factor analyses and testing of a brief version. Behav Res Ther 2005; 43(11): 1527-42.
  24. Berman NC, Weingarden H, Wilhelm S. Symptom-specific threat perception mediates the relationship between obsessive beliefs and OCD symptoms. Cognit Ther Res 2019; 43(4): 705-12.
  25. Hellberg SN, Buchholz JL, Twohig MP, Abramowitz JS. Not just thinking, but believing: Obsessive beliefs and domains of cognitive fusion in the prediction of OCD symptom dimensions. Clin Psychol Psychother 2020; 27(1): 69-78.
  26. Manos RC, Cahill SP, Wetterneck CT, Conelea CA, Ross AR, Riemann BC. The impact of experiential avoidance and obsessive beliefs on obsessive-compulsive symptoms in a severe clinical sample. J Anxiety Disord 2010; 24(7): 700-8.
  27. Diedrich A, Sckopke P, Schwartz C, Schlegl S, Osen B, Stierle C, et al. Change in obsessive beliefs as predictor and mediator of symptom change during treatment of obsessive-compulsive disorder–a process-outcome study. BMC Psychiatry 2016; 16(1): 1-10.
  28. Wilhelm S, Berman NC, Keshaviah A, Schwartz RA, Steketee G. Mechanisms of change in cognitive therapy for obsessive compulsive disorder: Role of maladaptive beliefs and schemas. Behav Res ther 2015; 65: 5-10.
  29. Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, et al. The Yale-Brown Obsessive Compulsive Scale: II. Validity. Arch Gen Psychiatry 1989; 46(11): 1012-6.
  30. Deacon BJ, Abramowitz JS. The Yale-Brown Obsessive Compulsive Scale: factor analysis, construct validity, and suggestions for refinement. J Anxiety Disord 2005; 19(5): 573-85.
  31. Esfahani SR, Motaghipour Y, Kamkari K, Zahiredin A, Janbozorgi M. [Reliability and validity of the Persian version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCD)]. Iranian journal of psychiatry and clinical psychology 2012; 17(4): 297-303. (Persian)
  32. Group OCCW. Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory. Behav Res Ther 2001; 39(8): 987-1006.
  33. Group OCCW. Psychometric validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory: Part I. Behav Res Ther 2003; 41(8): 863-78.
  34. Shams G, Karam Ghadiri N, Esmaeli Torkanbori Y, Ebrahimkhani N. [Validation and reliability assessment of the Persian version of Obsessive Beliefs Questionnaire-44]. Advances in cognitive sciences 2004; 6(1): 23-36. (Persian)
  35. Sheffield A, Waller G, Emanuelli F, Murray J, Meyer C. Links between parenting and core beliefs: Preliminary psychometric validation of the Young Parenting Inventory. Cognit Ther Res 2005; 29(6): 787-802.
  36. Monajem A, Aghayousefi A, Zare H. [The comparison of schemas, parenting style, and life traps in married and divorced women]. Journal of behavioral sciences 2013; 7(2): 133-42. (Persian)