Emotion dysregulation and social communication problems may predict severity of obsessive compulsive disorder symptoms among Turkish adolescents: A single-center, case-control study

Abstract

Abstract Studies have shown that theory of mind, emotion regulation and pragmatic abilities are negatively affected in people with OCD. We aimed to investigate ToM abilities, social responsiveness, pragmatic language, and emotion regulation skills in children with OCD, comparing them to healthy controls. This study was designed as a single-center, cross-sectional, case-control study. The participants were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL) implemented by blinded professionals [32]. All participants fulfilled tests evaluating their ToM abilities via “Reading the Mind in the Eyes Test” (RMET), “Faces Test”, “Faux-Pas Test”, “Comprehension Test” and “Unexpected Outcomes Test”, Social Responsiveness Scale (SRS), Children’s Communication Checklist- Second Edition (CCC-2), Difficulties in Emotion Regulation Scale (DERS) and Yale-Brown Obsession Compulsion Scale (YBOCS). Within the study period, we enrolled 85 adolescents (42 with OCD and 43 controls). The CCC-2 scores except for CCC-2 coherence subscaleand SRS-2 scale total were found to be statistically significantly elevated in the OCD group than healthy controls (p < 0.05). The OCD group performed lower in the Faux Pass, Comprehension tests than the healthy controls (p = 0.003 for both). We found a statistically significant difference between both groups in terms of the goal, strategy, non-acceptance subscales of the DERS (p < 0.001, p = 0.006, p = 0.008, respectively) and the total score of DERS (p < 0.001). YBOCS total scores correlated significantly and negatively with Comprehension test, Faux Pas test, unexpected outcomes tests, and positively with CCC total, SRS total and DERS total scores and the DERS, SRS and CCC tests emerged as significant predictors of YBOCS total score. Adolescents diagnosed with OCD face difficulties in advanced level mentalizing, various domains of language and emotion regulation. Addressing ToM, pragmatic, and ER difficulties when planning the treatment of young people with OCD may make an additional contribution to treatment.