An Evolutionary Model for the Etiology of Obsessive-Compulsive Disorder: The Mediating Role of Emotional Awareness and Uncertainty Intolerance in the Relationship between Childhood Fears and Behavioral Brain Systems with Obsessive-Compulsive Disorder in Secondary School Students of Kouhdasht City

The purpose of this research is to investigate the mediating role of emotional awareness and intolerance of ambiguity in the relationship between childhood fears and brain-behavioral systems with signs and symptoms of obsessive-compulsive disorder in high school girls and boys in Kouhdasht city. The purpose of this research is fundamental, and it is a descriptive-correlation form of structural equations in terms of its research method. The statistical population of this research is comprised of all pupils enrolled in the second secondary level of Kouhdasht city in Lorestan province during the academic year 2022-2023. According to the number of subscales (29 subscales), the sample size should be a minimum of 435. The analysis of 441 samples (273 girls and 168 boys) was conducted in this study. To collect data from the Fear Questionnaire for Children and Adolescents (FSSC-R), Behavioral Inhibition/Activation Systems Scale, Emotional Awareness Questionnaire (EAQ-30), Intolerance of Uncertainty Questionnaire (IUS), and Obsessive-Compulsive Inventory – Revised (OCI-R) were employed to gather data from the Fear Questionnaire for Children and Adolescents (FSSC-R). The data classification, processing, and analysis were conducted using SPSS 22 and Lisrel 8.85 statistical software. The structural equation modeling method was employed to evaluate the fit of the hypothetical model. The data analysis results indicated that the proposed model for the etiology of OCD was a reasonable fit. The findings indicated that obsessive-compulsive disorder is directly influenced by childhood fears, behavioral brain systems, emotional awareness, and intolerance of ambiguity. Additionally, this disorder is indirectly influenced by childhood anxieties and behavioral brain systems, which are characterized by an intolerance of ambiguity and an excitement of awareness. Therefore, it is recommended that these variables be incorporated into future research and the development of preventive and treatment protocols for OCD.