强迫症患者完美主义程度在父母教养方式和道德判断能力之间的中介效应

Mediating effect of perfectionism on parenting style and moral judgment ability in patients with obsessive-compulsive disorder

目的 探讨强迫症患者父母教养方式、道德判断能力与完美主义程度之间的关系,并比较3者在患者与健康人群中的差异。方法 采用方便抽样法,随机选取2021年1—10月在北京市某三甲医院心理科门诊就诊的100例强迫症患者为研究组,同时招募100名健康对照者为对照组。使用道德判断测验(MJT)中文标准版、父母教养方式评价量表(EMBU)以及Frost多维完美主义量表中文版(FMPS-C)比较两组患者的道德判断能力、父母教养方式及完美主义程度的差异。采用Pearson相关和多重线性回归分析强迫症患者父母教养方式、完美主义、道德判断能力3者之间的关系。结果 研究组FMPS-C非适应性维度得分高于对照组[(76.2±7.3)分比(58.3±12.6)分],FMPS-C适应性维度得分、MJT中文标准版C分数低于对照组[(18.5±3.1)分比(23.8±4.7)分、(9.5±1.7)分比(14.7±6.3)分],差异有统计学意义(P<0.01)。研究组EMBU中的父亲惩罚、严厉,过分干涉,拒绝、否认,过度保护因子得分高于对照组,差异有统计学意义(P<0.05);母亲过度干涉和保护,拒绝、否认,惩罚、严厉因子得分高于对照组,差异有统计学意义(P<0.05)。强迫症患者母亲过度干涉和保护,拒绝、否认,惩罚、严厉与非适应性完美主义程度呈正相关(r=0.954、0.412、0.419;P<0.01),与道德判断能力呈负相关(r=-0.853、-0.244、-0.358;P<0.05)。强迫症患者父亲惩罚、严厉,过分干涉,拒绝、否认,过度保护与非适应性完美主义程度呈正相关(r=0.304、0.240、0.690、0.248;P<0.05);父亲拒绝、否认与道德判断能力呈负相关(r=-0.717,P<0.01)。强迫症患者母亲过度干涉和保护,拒绝、否认,惩罚、严厉与父亲拒绝、否认通过非适应性完美主义程度对道德判断能力起部分中介作用(均P<0.05)。结论 强迫症患者道德判断能力低于健康人群;父母过度控制、否认,惩罚等教养方式与非适应性完美主义程度高于健康人群。父母教养方式通过非适应性完美主义程度部分作用于强迫症患者的道德判断能力。

Objective To explore the relationship between parenting style,moral judgment ability and perfectionism degree of obsessive-compulsive disorder(OCD) patients,and to compare the differences between the patients and healthy people.Methods A total of 100 patients with OCD in the psychology outpatient department of a 3 A hospital in Beijing from January to October 2021 were selected by convenience sampling method as study group.At the same time,100 healthy controls were recruited as the control group.The Chinese standard version of Moral Judgment Test(MJT),Egma Minnen av Bardndosnauppforstran(EMBU) and Chinese version of Frost’s Multidimensional Perfectionism Scale(FMPS-C) were used to compare the differences of moral judgment ability,parenting style and perfectionism degree between the two groups.Pearson correlation and multiple linear regression were used to analyze the relationship among parental rearing style,perfectionism,and moral judgment ability of OCD patients.Results The score of FMPS-C non adaptability dimension in the study group was higher than that in the control group [(76.2±7.3) vs(58.3±12.6)].The scores of FMPS-C adaptability dimension and Chinese standard version of MJT in the study group were lower than those of the control group [(18.5±3.1) vs(23.8±4.7),(9.5±1.7) vs(14.7±6.3)].The differences were statistically significant(P <0.01).The scores of father’s punishment,severity,excessive interference,refusal,denial and overprotection factors in EMBU of the study group were higher than those of the control group,and the differences were statistically significant(P <0.05).The scores of excessive interference and protection,refusal,denial,punishment and severity of mothers were higher than those of the control group,and the differences were statistically significant(P <0.05).Excessive intervention and protection,refusal,denial,punishment and severity of mothers of OCD patients were positively correlated with the degree of nonadaptive perfectionism(r=0.954,0.412,0.419;P <0.01),and negatively correlated with moral judgment ability(r=-0.853,-0.244,-0.358;P <0.05).Punishment,severity,excessive interference,refusal,denial,and excessive protection of fathers of OCD patients were positively correlated with the degree of nonadaptive perfectionism(r=0.304,0.240,0.690,0.248;P <0.05).Father ’s refusal and denial were negatively correlated with moral judgment(r=-0.717,P<0.01).The excessive intervention and protection,refusal and denial,punishment and severity of mothers,and refusal and denial of fathers partially mediate the moral judgment ability through the degree of nonadaptive perfectionism(P <0.05).Conclusions The moral judgment ability of patients with OCD was lower than that of healthy people;Parents’ excessive control,denial,punishment and other parenting styles and nonadaptive perfectionism were higher than those of healthy people.Parenting style partially affects the moral judgment ability of OCD patients through the degree of nonadaptive perfectionism.