De invloed van rigiditeit en omgevingsfactoren op het ontstaan en in stand houden van Obsessief Compulsieve Stoornis

Abstract

Introduction It is unclear which genetic or environmental factors influence obsessive compulsive disorder (OCD). Two types of environment can be discerned: shared (common) environmental factors (measured by the Family Environment Scale and the Parental Bonding Instrument), and unique (individual-specific) environment (measured by the Childhood Trauma Questionnaire and the Dutch Schokverwerkings Inventarisatie Lijst). Further, it’s unclear to which extent cognitive rigidity interacts with environment factors to produce OC symptoms. Method In this family study the influence of neuropsychological and psychopathological factors on OC symptoms has been investigated in three matched groups (patients, their siblings and control subjects), of 21 participants. First the influence of rigidity was measured, using the Intradimensional/Extradimensional Set Shifting Task (ID/EDS) and the subscale attention switching (AS) of the Autism-spectrum Quotient. These instruments were not related, and seemed to measure different aspects of rigidity. Results The results regarding the ID/EDS were inconsistent, while AQ attention switch subscale results showed that patients appeared to be less able than controls and siblings to switch attention, suggesting that deficits in attention switching as a measure of autism might result from having OCD. Controls did not fare as well in the ID/EDS ED phase, while siblings did less well during the ID phase. Regarding environmental factors, patients reported more maternal care and overprotection and less cohesion within the family, and more often had to deal with emotional abuse than siblings and controls. Patients also reported more physical abuse than siblings. The death of family members (shared family factors) appeared to have a larger OCD-predictive value for patients than for their siblings. A high score on AS was associated with a more pronounced influence of the family environment, emotional neglect and sexual abuse. Discussion To summarize, these results suggest that higher scores on the AS of the AQ are associated with OC symptoms, and these higher scores seem to make persons vulnerable to life events and family influences. A strong point in this project is the high-risk design, where patients and their non-affected siblings are compared. A limitation however, is the power problem, resulting from the small sample size.