Understanding Obsessive-Compulsive Disorder in university students: Exploring the roles of neurotic perfectionism, parental perception, and stressful life events

This study examined the direct, mediating, and interactive roles of neurotic perfectionism, negative parental perceptions, and stressful life events in relation to obsessive-compulsive disorder (OCD) symptom severity among university students. Using a cross-sectional correlational design, data were collected from 390 university students (61.8% males, 38.2% females; aged ≥18 years) through convenience sampling. Participants completed the Obsessive-Compulsive Inventory-Revised (OCI-R), Frost Multidimensional Perfectionism Scale-Brief (FMPS-B), Parental Bonding Instrument (PBI), and Impact of Event Scale-Revised (IES-R). Results indicated that both striving perfectionism (β = 0.276, p < 0.001) and evaluative concerns (β = 0.490, p < 0.001) were significantly associated with OCD symptom severity, with evaluative concerns demonstrating a stronger association. Stressful life events were positively related to OCD symptoms (B = 0.6977, p < 0.001). Negative maternal perceptions showed a direct association with OCD symptoms (β = -0.167, p = 0.001), whereas paternal perceptions demonstrated weaker effects. Mediation analyses revealed significant indirect effects of stressful life events on OCD through striving perfectionism (B = 0.0672, 95% CI [0.0340, 0.1066]) and evaluative concerns (B = 0.1031, 95% CI [0.0708, 0.1409]). Additionally, stressful life events mediated the association between negative maternal (B = 0.5933, 95% CI [0.2813, 0.9453]) and paternal perceptions (B = 0.6409, 95% CI [0.3787, 0.9393]) and OCD symptoms. Moderation analyses did not support a moderating role of neurotic perfectionism or negative parental perceptions (p > 0.05). However, a significant three-way interaction was observed between striving perfectionism, negative maternal perceptions, and stressful life events (β = 0.0168, p = 0.0257). These findings partially support the integration of the Diathesis-Stress Model and the Obsessive-Compulsive Cognitions Working Group (OCCWG) framework, highlighting the combined influence of cognitive vulnerability, parental perceptions, and stress exposure in relation to OCD symptom severity among university students.