People with trauma exposure at increased risk for obsessive-compulsive symptoms

Trauma exposure appeared significantly associated with obsessive-compulsive symptoms among a community sample, according to a presentation from the Anxiety and Depression Association of America annual conference.

These findings aligned with those of prior research efforts into obsessive-compulsive symptoms following trauma exposure.

“Research back into the 1990s suggests endorsement of trauma is significantly, independently associated with OCD symptoms,” Rose Luehrs, MA, MS, a clinical psychology doctoral candidate at Suffolk University in Boston, said during the presentation. “Some individuals may be at an increased risk for developing comorbid PTSD plus OCD following trauma exposure compared with others. OCD and PTSD symptoms following trauma can be difficult to distinguish from traditional PTSD given the conceptual overlap.”

Leuhrs and colleagues aimed to assess the potential relationship between diagnosis of PTSD and obsessive-compulsive symptoms among the general population. They analyzed data included in the restricted access National Comorbidity Survey Replication (NCS-R) dataset, since this version allowed the researchers to observe various types of traumatic events that individuals had endorsed. The first part of the NCS-R included 9,282 participants who comprised a nationally representative sample aged 18 to 74 years. The second part included 5,692 participants. A total of 1,808 were assessed for OCD. Luehrs and colleagues selected for analyses PTSD and obsessive-compulsive symptom data that had been assessed via the WHO World Mental Health Composite International Diagnostic Interview (WHO WMH-CIDI).

Results showed participants’ worst traumatic event, on average, occurred at age 24.1 years. Participants endorsed an average of 11.5 PTSD symptoms, and 6.8% of the sample met criteria for lifetime PTSD and 1.6% for obsessive-compulsive symptoms at the clinical threshold. Further, bivariate correlation showed lifetime PTSD was significantly and positively associated with several obsessive-compulsive symptoms, including recurrent concern about germs and washing; recurrent impulse to check things; recurrent impulse to arrange and order things; urge to save unneeded things; recurrent disturbing thoughts about sexuality or religion; recurrent unpleasant thoughts about morality or sin; recurrent concern about doing something terrible; and recurrent concern about being seriously ill.

The researchers also noted significant, positive associations between type of trauma exposure and obsessive-compulsive symptoms, including experiencing a natural disaster and concern with dirt/germs and excessive washing; being mugged, held up or robbed and recurrent impulse to order or arrange things; and having a child with a life-threatening illness and excessive concern with dirt/germs. Participants who learned about a traumatic event happening to a loved one were more likely to exhibit recurrent impulse to order and arrange things, compulsion to collect unneeded things and excessive concern with dirt/germs.

“The literature both from a clinical and research standpoint would really benefit from having some more rigorous investigations on the relationship between trauma and OCD and PTSD for specifically treatment-seeking samples,” Luehrs said. “We really need research in these areas to clearly distinguish the theoretical differences between potentially overlapping symptoms in PTSD and OCD. We have difficulty differentiating symptoms of OCD from PTSD following trauma, and this may contribute to a lack of clarity around terminology and intervention planning.”

Reference:

Luehrs R, et al. The relationship between trauma, OCD and PTSD: Translating research into practice. Presented at: The Anxiety and Depression Association of America Annual Conference; Mar. 18-19, 2021 (virtual meeting).