Stress and Trauma Impacts OCD
Obsessive-compulsive disorder (OCD) is a long-term disorder where an individual experiences obsessions and or compulsions (U.S. Department of Health, 2022). Obsessions can be characterized as recurring and unwanted thoughts, urges, or fears (U.S. Department of Health, 2022). Commonly reported obsessions include: fear of contamination, harmful thoughts towards other individuals or themselves, and needing items to be in a symmetrical/perfect order (U.S. Department of Health, 2022). According to the U.S. Department of Health and Human Services compulsions are repetitive behaviors that the individual feels the need to perform in order to make the obsessions go away. Many feel the urge to excessively wash their hands or clean, arrange belongings in a specific order, or constantly check on items (U.S. Department of Health, 2022). These symptoms typically affect an individual's day-to-day life in terms of their work, relationships, and school. While the causes of OCD are still unknown, risk factors such as brain function, genetics, and environmental factors appear to be associated with OCD. However, recent studies have shown that stress and trauma have a significant impact on the onset of OCD.
Stress has been found to influence the onset associated with OCD in many individuals. Childbirth complications, marriage, socioeconomic struggles, bodily injuries, and age-related reproductive changes have all been identified as stressors that can contribute to OCD (Murayama et al., 2020). Self-reported studies by individuals with OCD have shown that 25-67% of OCD patients have reported stressful incidents occurring prior to their onset of their OCD symptoms (Adams et al., 2018). Another study containing 281 OCD participants recorded that 172 (61.2%) of the participants expressed they experienced stressful life events prior to their diagnosis (Murayama et al., 2020). It has also been reported that individuals with OCD experience stressful events occurring 6 months and 12 months prior to their onset of the disorder (Adams et al., 2018). Similarly, those individuals who vocalized their experience with stress prior to their diagnosis also experienced cleaning and contamination-related obsessions related to those stressful events (Murayama et al., 2020).
Trauma has also been identified as a factor which intensifies the severity and onset of OCD symptoms (Adams et al., 2018). Traumatic events may include: war combat, sexual assault, and violence. Other potential traumatic events, which are commonly associated with childhood-related trauma, include neglect, physical, sexual, or emotional abuse (Pinciotti et al., 2022 ). Individuals who have experienced traumatic events during their childhood were found to be 5 to 9 times more likely to meet the criteria for OCD in their adulthood. These childhood-related traumas have been associated with higher suicide risk, as well as more severe OCD symptoms (Pinciotti et al., 2022 ). There is also a correlation between expressed childhood trauma and other mental health-related disorders including; anxiety, depression, impulsivity, and attention deficit hyperactivity disorder (Pinciotti et al., 2022 ). In addition, in a study with 954 OCD patients, leaving a relationship was identified as a stressor that accelerated the progression of OCD (Murayama et al., 2020). Furthermore, there are findings that suggest that lifelong trauma is linked with a higher obsession with checking items and ordering/symmetry symptoms, while sexual trauma is related to higher rates of contamination and washing compulsions (Pinciotti et al., 2022 ).
Although extensive research is being performed to better understand the neurological mechanisms that are associated with OCD, there should also be more focus on understanding the relationships between OCD symptoms, stress, and trauma. Insight into these OCD-related factors can allow for more treatment options to be provided to OCD patients. More importantly, prevention methods can be developed to prevent the early onset of OCD and the development of this disorder when not associated with genetic factors.
References
Adams, T. G., Kelmendi, B., Brake, C. A., Gruner, P., Badour, C. L., & Pittenger, C. (2018). The role of stress in the pathogenesis and maintenance of obsessive-compulsive disorder. Chronic stress (Thousand Oaks, Calif.). Retrieved October 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841259/
Murayama, K., Nakao, T., Ohno, A., Tsuruta, S., Tomiyama, H., Hasuzawa, S., Mizobe, T., Kato, K., & Kanba, S. (2020, December 3). Impacts of stressful life events and traumatic experiences on onset of obsessive-compulsive disorder. Frontiers in psychiatry. Retrieved October 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744562/
Pinciotti, C. M., & Fisher, E. K. (2022, April 6). Perceived traumatic and stressful etiology of obsessive-compulsive disorder. Psychiatry Research Communications. Retrieved October 23, 2022, from https://www.sciencedirect.com/science/article/pii/S2772598722000253
U.S. Department of Health and Human Services. (n.d.). Obsessive-compulsive disorder. National Institute of Mental Health. Retrieved October 23, 2022, from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd
Photo: Spratt, A. (2021, May 6). White and Brown Cat Print Textile Photo. Unsplash. Retrieved October 23, 2022, from https://unsplash.com/photos/4BwcmbExs5c