Emotion dysregulation and social communication problems but not ToM properties may predict obsessive-compulsive disorder symptom severity

Abstract

Objective

Studies have shown that theory of mind, emotion regulation and pragmatic abilities are negatively affected in people with obsessive-compulsive disorder (OCD). We aimed to investigate theory of mind (ToM) abilities, social responsiveness, pragmatic language, and emotion regulation skills in children with OCD and to compare them to healthy controls.

Methods

This study was designed as a single-center, cross-sectional, case-control study. ToM abilities were evaluated via “Reading the Mind in the Eyes Test” (RMET), “Faces Test”, “Faux-Pas Test”, “Comprehension Test” and “Unexpected Outcomes Test”. Social responsiveness, pragmatic language and emotion regulation were evaluated by Social Responsiveness Scale (SRS), Children’s Communication Checklist- Second Edition (CCC-2), Difficulties in Emotion Regulation Scale (DERS) and Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Within the study period, we enrolled 85 adolescents (42 with OCD and 43 controls).

Results

The OCD group performed significantly lower than healthy controls in the Faux Pass and Comprehension tests (p = 0.003 for both). We found a statistically significant difference between groups in terms of the goal, strategy, non-acceptance subscales of the DERS (p < 0.001, p = 0.006, p = 0.008, respectively) as well as the total DERS score (p < 0.001). CY-BOCS total scores correlated significantly and negatively with Comprehension, Faux Pas and Unexpected Outcomes tests, and positively with CCC total, SRS total and DERS total scores. In regression analysis the DERS, SRS and CCC tests emerged as significant predictors of CY-BOCS total score.

Conclusion

Addressing ToM, pragmatic, and ER difficulties when planning the treatment of young people with OCD may contribute to positive outcomes.

Keywords:

• OCD
• adolescents
• theory of mind
• emotion regulation
• pragmatic abilities

Author contributions

Y.Ö., G.Ö., and S.K. conceptualized the study design and methodology; A.E.T. and A.P.A. did clinical evaluation; Y.Ö., G.Ö., and S.K. conducted the investigation and the data collection; Y.Ö., A.E.T. and A.P.A. performed statistical analysis and data interpretation; G.Ö. and S.K. wrote the original draft of the manuscript; all authors contributed to the discussion of the results and agreed on the final version of the manuscript.

Consent to participate

Written informed consent was obtained from the parents.

Notes on contributors

Yusuf Öztürk, MD is a member of the Turkish Association of Child and Adolescent Psychiatry (TACAP) and has published in international and national peer reviewed journals. He is interested in neurodevelopmental disorders, psychotherapeutic approaches and parent training programs.

Gonca Özyurt, MD is a member of the executive committee of the TACAP and has published extensively in international and national peer reviewed journals. She is interested in neuroscience, neurodevelopmental disorders and parent training programs.

Serkan Turan, MD is a member of editorial committee of the Turk J Child Adolesc Ment Health and has published extensively in international and national peer reviewed journals. He was selected Donald J Cohen Fellow (2020) and Early Career Psychiatrist Fellow (2021). He is interested in ADHD, psychopharmacology, psyhosis.

Ali EvrenTufan, MD is a member of the executive committee of the TACAP and has published extensively in international and national peer reviewed journals. He was selected Donald J Cohen Fellow (2010) and Early Career Psychiatrist Fellow (2011). He is interested in epidemiology, psychopharmacology, neural sciences, and neurodevelopmental disorders.

Aynur Pekcanlar Akay, MD is a member of the TACAP and has published in international and national peer reviewed journals. She has received many national and international awards. She is interested in neurodevelopmental disorders especially ADHD, consultation liaison psychiatry and eating disorders.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. IRB approval for the study was obtained from İzmir Katip Çelebi University Clinical Trials Ethics Committee (Approval date: 08/08/2019, Approval number: 282).

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Data presented in this study are available from the corresponding author upon reasonable request.