Emotion Regulation, Coping, and Alexithymia in Adolescents With Obsessive-Compulsive Disorder: A Mediational Analysis

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition that impacts daily functioning. In addition to classical symptoms, emotion regulation (ER), alexithymia and maladaptive coping are thought to be involved in the symptomology and maintenance of the disorder. This study aims to investigate the relationship between ER, alexithymia and coping in adolescents with a sole diagnosis of OCD.

The study comprised of 93 participants with OCD and 92 healthy controls. Patients with any psychiatric disorder other than OCD were set as exclusion criteria. A sociodemographic form, Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children, Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Difficulties in Emotion Regulation Scale (DERS), Toronto Alexithymia Scale (TAS) and KidCOPE were applied.

The TAS and DERS scores of participants with every subscale, except awareness in DERS, and the KIDCOPE-Avoidant Coping scores were significantly higher in the OCD group (p < 0.05). A positive and moderately significant relationship was identified between the CY-BOCS-Obsession, CY-BOCS-Compulsion and CY-BOCS-Total scores and the DERS-Total (p < 0.05). Linear regression analysis revealed that CY-BOCS-Total scores significantly predicted DERS-Total scores in a positive direction even when TAS-Total and KidCOPE scores were controlled (p = 0.001). Difficulties in ER mediated the relationship between OCD and the severity of negative coping (b = 0.064, 95% CI (0.036-0.097)).

There is limited evidence regarding the specific contribution of OCD with emotion dysregulation, alexithymia and avoidant coping. Our study suggests a possible relationship with OCD and these parameters, highlighting the need to develop effective intervention techniques tailored to this population.