Journal of Rafsanjan University of Medical Sciences
Volume 25, Issue 3 (6-2026)
JRUMS 2026, 25(3): 209-224 |
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Ethics code: IR.SEMUMS.REC.1404.060
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Ameri N, Najafi M. The Mediating Role of Maladaptive Daydreaming in the Relationship between Childhood Trauma and Suicide Probability in Patients with Obsessive-Compulsive Disorder: A Descriptive Study. JRUMS 2026; 25 (3) :209-224
URL: http://journal.rums.ac.ir/article-1-7952-en.html
URL: http://journal.rums.ac.ir/article-1-7952-en.html
2. Associate Professor, Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran
Keywords: Childhood trauma, Suicide probability, Obsessive-compulsive disorder, Maladaptive daydreaming
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The Mediating Role of Maladaptive Daydreaming in the Relationship between Childhood Trauma and Suicide Probability in Patients with Obsessive-Compulsive Disorder: A Descriptive Study
Narjes Ameri[1], Mahmoud Najafi[2]
Received: 30/03/26 Sent for Revision: 05/05/26 Received Revised Manuscript: 07/06/26 Accepted: 10/06/26
Background and Objectives: Obsessive-compulsive disorder (OCD) is associated with self-destructive tendencies that are rooted in phenomenological constructs and developmental experiences of the individual. The present study aimed to determine the mediating role of maladaptive fantasy in the relationship between childhood trauma and the likelihood of suicide in patients with OCD.
Materials and Methods: This is a descriptive-correlational study utilizing structural equation modeling. The statistical population consisted of all patients with OCD who referred to counseling centers, hospitals, and psychotherapy clinics in Tehran in 2025; of them, 332 people were selected using convenience sampling. The main data collection instruments included the Childhood Trauma Questionnaire by Bremner et al. (2007), the Maladaptive Daydreaming Scale by Somer et al. (2017), and the Suicide Probability Scale by Cull and Gill (1988). Data were analyzed using Pearson’s correlation and structural equation modeling.
Results: The findings indicated that childhood trauma had a significant positive effect on suicidal attempts (β= 0.307, p<0.001); maladaptive daydreaming was a significant predictor of suicidal attempts (β= 0.455, p<0.001); and a significant positive relationship was observed between childhood trauma and maladaptive daydreaming (β= 0.214, p<0.001). Also, childhood trauma affected the likelihood of suicide in obsessive-compulsive patients through maladaptive fantasy (β= 0.097, p<0.001).
Conclusion: According to the results, although maladaptive fantasy reduces anxiety caused by trauma and obsession in the short term, in the long term, it facilitates the effect of trauma on suicidal attempts by increasing self-alienation. This study emphasizes the need to review treatments and integrate trauma-focused approaches with strengthening the connection with reality to prevent these dissociative defenses from turning into catastrophic consequences.
Keywords: Childhood trauma, Suicide probability, Obsessive-compulsive disorder, Maladaptive daydreaming
Funding: This study did not receive any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics Committee of Semnan University of Medical Sciences approved the study (IR.SEMUMS.REC.1404.060).
Authors’ contributions:
- Conceptualization: Mahmoud Najafi, Narjes Ameri
- Methodology: Mahmoud Najafi, Narjes Ameri
- Data collection: Narjes Ameri
- Formal analysis: Narjes Ameri
- Supervision: Mahmoud Najafi
- Project administration: Mahmoud Najafi
- Writing – original draft: Mahmoud Najafi, Narjes Ameri
- Writing – review & editing: Mahmoud Najafi, Narjes Ameri
Narjes Ameri[1], Mahmoud Najafi[2]
Received: 30/03/26 Sent for Revision: 05/05/26 Received Revised Manuscript: 07/06/26 Accepted: 10/06/26
Background and Objectives: Obsessive-compulsive disorder (OCD) is associated with self-destructive tendencies that are rooted in phenomenological constructs and developmental experiences of the individual. The present study aimed to determine the mediating role of maladaptive fantasy in the relationship between childhood trauma and the likelihood of suicide in patients with OCD.
Materials and Methods: This is a descriptive-correlational study utilizing structural equation modeling. The statistical population consisted of all patients with OCD who referred to counseling centers, hospitals, and psychotherapy clinics in Tehran in 2025; of them, 332 people were selected using convenience sampling. The main data collection instruments included the Childhood Trauma Questionnaire by Bremner et al. (2007), the Maladaptive Daydreaming Scale by Somer et al. (2017), and the Suicide Probability Scale by Cull and Gill (1988). Data were analyzed using Pearson’s correlation and structural equation modeling.
Results: The findings indicated that childhood trauma had a significant positive effect on suicidal attempts (β= 0.307, p<0.001); maladaptive daydreaming was a significant predictor of suicidal attempts (β= 0.455, p<0.001); and a significant positive relationship was observed between childhood trauma and maladaptive daydreaming (β= 0.214, p<0.001). Also, childhood trauma affected the likelihood of suicide in obsessive-compulsive patients through maladaptive fantasy (β= 0.097, p<0.001).
Conclusion: According to the results, although maladaptive fantasy reduces anxiety caused by trauma and obsession in the short term, in the long term, it facilitates the effect of trauma on suicidal attempts by increasing self-alienation. This study emphasizes the need to review treatments and integrate trauma-focused approaches with strengthening the connection with reality to prevent these dissociative defenses from turning into catastrophic consequences.
Keywords: Childhood trauma, Suicide probability, Obsessive-compulsive disorder, Maladaptive daydreaming
Funding: This study did not receive any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics Committee of Semnan University of Medical Sciences approved the study (IR.SEMUMS.REC.1404.060).
Authors’ contributions:
- Conceptualization: Mahmoud Najafi, Narjes Ameri
- Methodology: Mahmoud Najafi, Narjes Ameri
- Data collection: Narjes Ameri
- Formal analysis: Narjes Ameri
- Supervision: Mahmoud Najafi
- Project administration: Mahmoud Najafi
- Writing – original draft: Mahmoud Najafi, Narjes Ameri
- Writing – review & editing: Mahmoud Najafi, Narjes Ameri
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Citation: Ameri N, Najafi M. The Mediating Role of Maladaptive Daydreaming in the Relationship between Childhood Trauma and Suicide Probability in Patients with Obsessive-Compulsive Disorder: A Descriptive Study. J Rafsanjan Univ Med Sci 2026; 25 (3): 209-24. doi: 10.66224/jrums.25.3.209. [Farsi].
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[1]- PhD Student in Psychology, Dept. of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran
[2]- Associate Prof., Dept. of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran
ORCID: 0000-0002-1160-2117
(Corresponding Author) Tel: (023) 31533018, E-mail: m_najafi@semnan.ac.ir
ORCID: 0000-0002-1160-2117
(Corresponding Author) Tel: (023) 31533018, E-mail: m_najafi@semnan.ac.ir
Type of Study: Research |
Subject:
روانپزشكي
Received: 2026/03/14 | Accepted: 2026/06/28 | Published: 2026/06/20
Received: 2026/03/14 | Accepted: 2026/06/28 | Published: 2026/06/20
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