The relationship between childhood trauma, metacognition and neurological soft signs in obsessive compulsive disorder

Objective: Obsessive Compulsive Disorder (OCD) is a heterogeneous psychiatric disorder characterized by obsessions and/or compulsions. There are studies investigating childhood traumas, metacognitive functions and neurologic soft signs in OCD patients. In this study, it was aimed to evaluate the relationship between childhood traumas, metacognitive characteristics and neurologic soft signs in OCD patients. Method: The study included 40 patients with OCD and 40 healty contol groups who matched with patient group for age, sex and education. Sociodemographic Data Form, Childhood Trauma Scale (CTS), Metacognition Scale (MCQ), Neurological Evaluation Scale (NES), Beck Anxiety Scale (BAI) and Beck Depression Scale (BDI) were applied to the participants. The Dimensional Obsessive Compulsive Scale (DOCS) and Yale-Brown Obsession Compulsion Scale (Y-BOCS) were also applied to the patient group. Chi-square, mann whitney-u test and spearman correlation analysis were used for statistical analysis. Results: In OCD patients physical abuse, emotional abuse, physical neglect, emotional neglect and total scores of CTS; thought control need and cognitive awareness of metacognitions; sensory integration, other neurological symptoms, total score of neurologic soft signs were higher than healthy subjects. In addition, there was a positive correlation between emotional abuse of CTS and positive beliefs, uncontrollability danger, cognitive confidence, need for thought control of MCQ; emotional abuse of CTS and motor coordination, consecutive motor movements, total score of NES. There was a positive correlation between emotional neglect of CTS and motor coordination, sensory integration, consecutive motor movements, total score of NES. Emotional abuse, emotional neglect and total score of CTS were found to be effective in the severity of symptoms. Uncontrollable thoughts sub-dimension was positively correlated with physical abuse, emotional abuse, emotional neglect and total scores of CTS and symmetry sub-dimension was positively correlated with emotional abuse of CTS. Sensory integration of neurologic soft signs was affected by disease duration. Anxiety and depression scores were found to be high in OCD patients. Conclusion: OCD has been discussed separately in the literature in terms of childhood traumas, metacognitive characteristics and neurologic soft signs. The difference of our study is the evaluation of these features together. In conclusion, in OCD patients childhood traumas, neurologic soft signs and metacognitive functions differ from healthy controls. It was found that childhood traumas were positively correlated with metacognitive functions, neurologic soft signs and symptom severity; metacognitive functions and neurologic soft signs were positively correlated with obsessive-compulsive symptom dimensions and severity. Although SNB was thought to be more related to genetic and perinatal period, it was more severe in children with high childhood traumas. These findings provide information about the pathophysiological processes of OCD, but larger studies are needed to investigate the relationship between childhood traumas, metacognitions and neurologic soft signs in OCD patients. Gaining awareness about childhood traumas, understanding the metacognitive model of OCD may contribute to the treatment methods to be planned and the psychotherapeutic process of OCD. Keywords: Obsession, Compulsion, Childhood Trauma, Metacognition, Neurological Soft Signs