Structural Model of Obsessive-Compulsive Symptoms Based on Childhood Trauma with the Mediating Role of Thought-Action Fusion and Mentalization in Medical Students

Abstract Background and Objective: Obsessive-compulsive disorder is one of the complex psychological disorders that is formed under the influence of developmental, cognitive, and emotional factors. Research evidence shows that childhood trauma can be a precursor to psychological vulnerabilities in adulthood. Among them, thought-action fusion (TAF) and mentalization are important cognitive constructs in explaining obsessive symptoms. This study aimed to investigate a structural model of obsessive-compulsive symptoms based on childhood trauma with the mediating role of TAF and mentalization. Methods: This study was a fundamental, descriptive-correlational study based on structural equation modeling. The statistical population comprised students at Qom Azad University of Medical Sciences in the academic year ۲۰۲۴-۲۰۲۵, selected via convenience sampling. Data were collected using the Maudsley Obsessive-Compulsive Inventory, Childhood Trauma Questionnaire, Fonagy Mentalization Questionnaire, and Revised Thought-Action Fusion Scale and data were analyzed using IBM SPSS Statistics version ۲۶ and PLS version ۳ software. Results: The results showed that childhood trauma is directly related to obsessive symptoms. Childhood trauma was also significantly associated with TAF, uncertainty mentalization and was directly associated with obsessive symptoms. TAF and uncertainty mentalization were also directly associated with increased obsessive symptoms. In contrast, the relationship between childhood trauma and certainty mentalization was not significant, and certainty mentalization did not show a significant relationship with obsessive symptoms. In the indirect path analysis, the mediating role of TAF and uncertainty mentalization in the relationship between childhood trauma and obsessive symptoms was confirmed, but the mediating role of certainty mentalization was not confirmed. Conclusion: The findings of the study indicate that childhood trauma leads to the exacerbation of obsessive symptoms both directly and through increased TAF and uncertainty mentalization. These results emphasize the importance of cognitive-transformational processes in the formation of obsessions and can be a basis for designing therapeutic interventions focused on reducing TAF and modifying dysfunctional mentalization patterns.

کلیدواژه ها:

Childhood trauma ، Mentalization ، Obsessive-Compulsive