Week 8: Studying Trauma and OCD

Helga A L -

Hello, everyone!

It has been quite awhile since I last posted, and it feels good to be back! I mentioned previously that I began researching a new research gap prior to my spring break and will now fill you in on the progress I made in the past few days.

Up until now, I have been focusing very heavily on the neuroscience aspect of OCD, but as part of studying psychotherapies, I looked into another factor that heavily impacts OCD: trauma. I read two articles which explored the effect of trauma on patients with OCD, with one focusing on PTSD specifically and the other on childhood trauma. I did not plan to go extremely in-depth into this factor, but I wanted to cover it somewhat comprehensively and chose to study trauma from two different points in life.

In the first article, Wadsworth et al. (2021) described that OCD often has a comorbidity with PTSD and patients will have a higher treatment resistance due to the relationship between each disorder’s symptoms. The order of onset significantly influences OCD symptom severity such that patients will likely have more severe symptoms if OCD develops at the same time as or after PTSD. OCD and PTSD symptoms also appear to be interconnected by possibly maintaining each other as a way to avoid triggers both for obsessions and traumatic memories. Due to the overlapping symptoms, the authors noted that different therapies designed to treat one disorder may be detrimental to the other; however, they can also aid in teaching skills applicable to both to some extent. For example, Prolonged Exposure is a therapy where patients recall traumatic memories and emotions and are prevented from avoiding them, which is similar to ERP and may help patients seek ERP as a treatment for OCD (Wadsworth et al., 2021). Unfortunately, the connection between PTSD and OCD symptoms are still not entirely clear, and additional research is needed to create effective treatment plans.

Boger et al. (2020) explored the impact of childhood trauma on OCD patients and found that the majority of OCD patients reported experiencing childhood trauma with higher severity and that more severe trauma lead to greater OCD symptom severity as well. This higher symptom severity also remained after treatment, although the authors did not find any correlation between childhood trauma and treatment outcome. Specific subtypes of trauma may also affect symptom severity differently; however, no definitive conclusion was reached due to a lack of data. The authors also controlled for other factors, such as stress, anxiety, depression, and PTSD, to verify the correlation between trauma and OCD symptoms, determining that stress appears to affect it the most. I found it interesting that the study mentioned that all the participants had high symptom severity yet childhood trauma did not affect treatment outcome as it seemed to cause more severe symptoms.

These studies provide more insight into the influence of different forms of trauma on OCD, but more studies must be conducted to understand the true impact it has. Learning about how crucial trauma is in OCD development added a new level of understanding for me that I intend to include into my final product design.

I hope you enjoyed reading my post, and I will see you all next week!

 

Wadsworth, L. P., Van Kirk, N., August, M., Kelly, J. M., Jackson, F., Nelson, J., & Luehrs, R. (2021). Understanding the overlap between OCD and trauma: Development of the OCD trauma timeline interview (OTTI) for clinical settings. Current Psychology, 42(9), 6937–6947. https://doi.org/10.1007/s12144-021-02118-3

Boger, S., Ehring, T., Berberich, G., & Werner, G. G. (2020). Impact of childhood maltreatment on obsessive-compulsive disorder symptom severity and treatment outcome. European Journal of Psychotraumatology, 11(1), 1753942. https://doi.org/10.1080/20008198.2020.1753942

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Comments:

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    Samee S
    Hi! Since the prefrontal cortex is responsible for impulse control, and trauma has been observed to cause underactivity in it, do you think this is what causes OCD symptoms to worsen from previous trauma?
    Angelina
    Hi Helga, Great progress on your research! It's really interesting how trauma, both from PTSD and childhood experiences, plays such a significant role in OCD symptom severity. Do you think there are any specific therapeutic approaches that might be more effective for patients with both PTSD and OCD compared to those with just one of the disorders?
    yoonseo_l
    Hi Helga! This is all so interesting! Have you explored the different types of trauma that can affect OCD rather than just the emotional trauma? What about medical ones, for example? And if not, how do you expect them to compare?
    Jolie L
    Hello, Helga! I hope you had a nice break :-). I was wondering if trauma can have a significant effect on treatments for OCD? Does it make it easier or harder to treat?
    helga_a_l
    Hello, Samee! I think it is possible that decreased activity in the prefrontal cortex due to trauma could lead to the greater OCD symptom severity observed in both studies. Many of the previous studies I researched mentioned hyperactivity in certain brain regions being a potential cause of OCD development; however, lower activity may also be a cause as both result in impaired functioning of brain regions. The change in brain activity as a result of trauma may then lead to OCD developing and rapidly increase symptom severity. Thank you for the question!
    helga_a_l
    Hello, Angelina! Unfortunately, I am not sure if there are any specific therapeutic approaches that are more effective for OCD patients with comorbid PTSD. The study investigating OCD and PTSD suggested three approaches, but none of them were guaranteed to succeed in treating OCD. The authors stated that patients may focus on treating one disorder at a time or try to treat both simultaneously. Combining treatments such as PE and ERP may lead to a better treatment outcome as treatments with similar mechanisms would be beneficial to both disorders. Sadly, more research is required to determine optimal treatment approaches and provide the most effective treatment for patients with OCD and PTSD. Thank you for the question!
    helga_a_l
    Hi, Linda! I unfortunately did not have time to research other types of trauma, but I believe most, if not all, forms of trauma have the potential to influence OCD development. I think they would have varying levels of impact on OCD symptoms, but they would all have a similar effect as emotional trauma. For both PTSD-related and childhood trauma, the studies found greater OCD symptom severity, and I believe something similar would be seen for other types of trauma. Thank you for the interesting question! I will look into that in the future!
    helga_a_l
    Hello, Jolie! There are mixed findings as to whether trauma impacts treatment for OCD. In the studies I read for example, PTSD-related trauma leads to high treatment resistance for OCD patients; however, the study investigating childhood trauma found no correlation between treatment and trauma. The second study seemed to indicate that treatment was just as effective for OCD patients with childhood trauma as for patients without traumatic experiences. Traumatic experiences likely add another component that must be considered during psychotherapy, but the inconsistent results make it difficult to determine whether trauma negatively impacts treatment or not. Thank you for the question!

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