Impact of childhood maltreatment on obsessive-compulsive disorder symptom severity and treatment outcome

European Journal of Psychotraumatology

Sabrina Boger, Thomas Ehring, Götz Berberich & Gabriela G. Werner

https://doi.org/10.1080/20008198.2020.1753942

Background: Preliminary evidence suggests childhood maltreatment (CM) to play a causal role in the development and maintenance of obsessive-compulsive disorder (OCD). However, both the effect of CM on the course of OCD treatment and the role of specific subtypes of CM remain largely unknown.

Objective: This study aimed to investigate the relationship between CM and the severity and time course of OCD symptoms within a clinical sample of OCD patients (N=68). We hypothesized that higher levels of CM in OCD patients would be associated with higher symptom severity and worse treatment outcomes.

Method: Assessments of CM, OCD symptomatology, and related variables were completed in a sample of OCD patients before and after inpatient treatment as well as at 6 month follow-up.

Results: Emotional abuse, sexual abuse and neglect were highly prevalent in our sample. Additionally, severity of experienced CM was associated with higher OCD symptom severity, with the strongest association found for emotional abuse. Hierarchical linear models indicated that patients with CM showed higher OCD symptom severity at pre-treatment, post-treatment, and follow-up compared to patients without CM. However, CM did not moderate symptom improvement during treatment.

Conclusion: Thus, although CM is not related to treatment outcome, it is highly prevalent among OCD patients and CM survivors still show higher OCD symptom severity after treatment. Therefore, CM should be considered in psychological interventions in individuals with OCD.

Keywords: child abuse; emotional abuse; obsessive-compulsive disorder; childhood trauma; childhood maltreatment

Received 28 Oct 2019, Accepted 03 Apr 2020, Published online: 08 Jun 2020