Research report Obsessive-compulsive symptoms and personal disposition, family coherence and school environment in Chinese adolescents: A resilience approach Jing Sun a,n,1 , Zhan-Jiang Li b,n,1 , Nicholas J. Buys c , Eric A. Storch d,e,f , Ji-sheng Wang g a Griffith Health Institute and School of Medicine, Griffith University, QLD Q4222, Australia b Department of Clinical Psychology, Beijing Key Lab of Mental Disorders; Beijing Anding Hospital, Capital Medical University; Center of Schizophrenia; Beijing Institute for Brain Disorders, Beijing, China 100088 c Griffith Health Institute, Griffith University, QLD Q4222, Australia d Department of Pediatrics, University of South Florida, United States e Rogers Behavioral Health – Tampa Bay, Tampa, FL, USA f All Children's Hospital – Johns Hopkins Medicine, St. Petersburg, FL, USA g Institute of Psychology, Chinese Academy of Sciences, Beijing, China article info Article history: Received 10 April 2014 Received in revised form 8 July 2014 Accepted 9 July 2014 Available online 18 July 2014 Keywords: Obsessive-compulsive disorder Resilience Personal disposition Family coherence School environment abstract Background: Risk factors of adolescents with obsessive-compulsive symptoms (OC) have been extensively examined, but protective resilience factors have not been explored, particularly in Chinese adolescents. Aim: This study aimed to investigate the association of resilience factors with the occurrence of OC and its symptoms in Chinese adolescents. Method: This study consisted of two phases. The first phase used a cross-sectional design involving a stratified clustered non-clinical sample of 3185 secondary school students. A clinical interview procedure was then employed to diagnose OC in students who had a Leyton Obsessional Inventory ‘yes’ score of Z15. The second phase used a case-control study design to analyse the relationship between resilience factors and OC in a matched sample of 288 adolescents with diagnosed OC relative to 246 healthy adolescents. Results: Low personal disposition scores in self-fulfilment, flexibility and self-esteem, and low peer relation scores in the school environment were associated with a higher probability of having OC. Canonical correlation analysis indicated that OC symptoms were significantly associated with personal dispositions, poor peer relationships and maladaptive social life, but not to family coherence. Limitations: The study is not prospective in nature, so the causal relationship between OC occurrence and resilience factors cannot be confirmed. Second, the use of self-report instruments in personal disposition, family coherence, and school environment may be a source of error. Conclusions: Resilience factors at both the personal disposition and school environment levels are important predictors of OC symptoms and caseness. Future studies using prospective designs are needed to confirm these relationships. & 2014 Elsevier B.V. All rights reserved. 1. Introduction Obsessive-compulsive (OC) symptoms are characterised by recur- rent obsessional thoughts, urges or images that are experienced as unwanted and intrusive. Obsessions are typically accompanied by repetitive intentional compulsive behaviours or mental acts that are functionally linked to obsessions and serve to reduce associated distress. OC is a relatively common disorder, with a lifetime pre- valence of 1–2% across both adults and youth worldwide (American Psychiatric Association, 2000; Horwath and Weissman, 2000). Recently there has been an increased focus on paediatric OC and its causal factors, given its debilitating nature, to better inform treatment approaches. Past studies in this area have examined the impact of childhood onset OC on psychological and social functioning, including Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/jad Journal of Affective Disorders http://dx.doi.org/10.1016/j.jad.2014.07.015 0165-0327/& 2014 Elsevier B.V. All rights reserved. n Corresponding authors. E-mail addresses: j.sun@griffith.edu.au (J. Sun), lizhj8@ccmu.edu.cn (Z.-J. Li), n.buys@griffith.edu.au (N.J. Buys), estorch@health.usf.edu (E.A. Storch), wangjisheng9@126.com (J.-s. Wang). 1 Contribute equally to the paper and first authors. Journal of Affective Disorders 168 (2014) 459–465