Poster #52 - Association Between Childhood Trauma and Obsessive Compulsive Symptoms in Community Youth

• In Event: 3-003 - Poster Session 09
  In Poster Session: PS 09 Section - Developmental Psychopathology

Integrative Statement

History of traumatic stressful event (TSE) is associated with psychopathology, including obsessive-compulsive disorder (OCD) (Barzilay et al. 2018; Bourdreaux et al., 1998). Experiencing multiple TSEs in childhood is associated with increased OCD risk and symptom severity in adulthood (Carpenter & Chung, 2011; Park et al., 2014). While previous studies examined associations between trauma and OCD, no study has thoroughly assessed the heterogeneous nature of obsessive-compulsive symptomatology, which in most individuals do not reach threshold level fulfilling OCD criteria. To reduce the phenotypic heterogeneity of obsessive-compulsive symptoms (OCS), three large-scale studies in community youth have identified the following factors: F1 – Bad Thoughts, F2 – Repeating/Checking, F3 – Symmetry, and F4 – Cleaning/Contamination (Alvarenga 2015; Barzilay 2018; Fullana 2008). OCS symptom dimensions are common in community youth (~40%) and some phenotypic OCS presentations are associated with serious psychopathology (Barzilay et al. 2018). The current study aims to (1) investigate the association between childhood trauma and OCS; (2) examine whether specific load or types of trauma are associated with specific OCS phenotypes; and (3) study the relationship among trauma exposure, OCS and serious psychopathology including depressive episode, suicide ideation and psychosis.
Participants (N=7054, age 11-21) were from the Philadelphia Neurodevelopmental Cohort, a community sample of non-mental-help seeking youth, assessed for psychopathology using a structured interview based on the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) (Kaufman et al., 1997). TSEs were assessed through screening of the following: (1) experienced a natural disaster; (2) experienced a bad accident; (3) thought that s/he or someone close to him/her could be killed or hurt badly; (4) witnessed someone getting killed, badly beaten, or die; (5) saw a dead body; or if s/he was a victim of one of the following assaults: (6) attacked or badly beaten, (7) threatened with a weapon, or (8) sexually forced (including but not limited to rape). Association of TSEs (cumulative exposure or type of exposure as being non-assaultive TSE, non-sexual assaultive TSE, or sexual assaultive TSE) with OCS, as well as with serious psychiatric conditions were conducted using binary logistic regressions. All models controlled for sex, pubertal status, age, and socioeconomic status.
History of traumatic events was associated with OCS (Figure 1, OR=1.5 for each additional TSE, p=0.000). This TSE-OCS association was stronger in females (TSE x Sex interaction, p=0.005) and more pronounced pre-puberty (TSE x Puberty interaction, p=.006) (Figure 1). All OCS factors were associated with trauma with F1 symptoms showing the strongest associations. Among specific trauma types, assaultive traumas showed stronger associations with OCS, with sexual assault victims having the highest rate of OCS (~70%) compared to other individuals (p<.001) (Figure 2). TSE exposure and OCS were both independently associated with higher rates of (1) depression, (2) suicide ideation, and (3) psychosis spectrum (for all three conditions, ORs>3.3 for TSE and all ORs=1.4 for OCS, all p’s<.001). The findings point to a significant association between history of childhood trauma and OCS in community non-mental-help seeking youth. Results suggest that TSE exposure and OCS are independently associated with serious psychopathology.

Authors

• Ariana Patrick, University of Pennsylvania
  Presenting Author

• Ran Barzilay, Children's Hospital of Philadelphia
  Non-Presenting Author

• Monica E Calkins, University of Pennsylvania
  Non-Presenting Author

• Tyler M Moore, University of Pennsylvania
  Non-Presenting Author

• Ruben C Gur, University of Pennsylvania
  Non-Presenting Author

• Raquel Gur, University of Pennsylvania
  Non-Presenting Author