Effects of traumatic experiences on obsessive-compulsive and internalizing symptoms: The role of avoidance and mindfulness

Abstract

Background Trauma exposure is associated with adverse psychological outcomes including anxiety, depression, and obsessive-compulsive (OC) symptoms. Adolescence is increasingly recognized as a period of vulnerability for the onset of these types of psychological symptoms. The current study explored the mediating roles of experiential avoidance and mindfulness processes in the association between retrospective reports of childhood trauma and current internalizing and OC symptoms in adolescents. Method A group of at-risk adolescents (N =51) and a group of college students (N =400) reported on childhood trauma, experiential avoidance, mindfulness, anxiety, depressive, and OC symptoms. Mediation analyses were performed to examine the mechanistic roles of avoidance and mindfulness in the association between trauma and internalizing and OC-specific symptoms. Results In the group of at-risk adolescents, experiential avoidance and mindfulness both significantly mediated the association between childhood trauma and OC symptoms. In the college student sample, experiential avoidance mediated the association between trauma and OC symptoms. Experiential avoidance, as well as the observe, act with awareness, and nonjudgmental facets of mindfulness all significantly mediated the association between trauma and internalizing symptoms. Limitations The group of at-risk adolescents was small, and the college student group was demographically homogeneous. All data was self-report and cross-sectional. Conclusion The current study demonstrated that experiential avoidance and mindfulness processes may be the mechanisms through which the association between trauma and obsessive-compulsive and trauma and internalizing symptoms exist in adolescents. These findings provide potential targets for clinical intervention to improve outcomes for adolescents who have experienced trauma.

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

“…Importantly, this relationship remained even after controlling for levels of depression, anxiety and PTSD. These results replicated similar findings in non-clinical samples (Briggs & Price, 2009 ; Kroska et al, 2018 ; Mathews et al, 2008 ; Vidal-Ribas et al, 2015 ), as well as an earlier study in a large clinical sample (Semiz et al, 2014 ). However, the association between childhood maltreatment and OCD symptomatology was rendered non-significant when controlling for stress symptoms as assessed by the DASS.…”

“…Results from studies in subclinical samples have mostly supported such a link. Higher levels of childhood maltreatment were associated with increased OCD symptom severity in two large college student samples (Kroska, Miller, Roche, Kroska, & O’Hara, 2018 ; Mathews, Kaur, & Stein, 2008 ) as well as in a general population sample (Briggs & Price, 2009 ). However, in the latter study this link was fully mediated by current levels of anxiety and depression.…”

Obsessive-compulsive symptom profiles in individuals exposed to interpersonal versus noninterpersonal trauma

“…Nevertheless, these initial results showing typical OC symptoms related to distinct trauma types may guide clinicians to personalize assessment of OC symptoms (McKay et al, 2004;Sookman, Abramowitz, Calamari, Wilhelm, & McKay, 2005) as they function in relation to experiences of trauma and related symptoms (Gershuny et al, 2003). Once supported by further research, this framework may guide the design of exposures surrounding OC symptoms and trauma-related stimuli and cognitions, as well as selection of specific acceptance and mindfulness-based approaches, given evidence that experiential avoidance mediates the relation between childhood trauma and OC symptoms (Kroska, Miller, Roche, Kroska, & O'Hara, 2018). Enhancing treatment for this population is critical given that lifetime PTSD is associated with more severe OCD symptoms and course than without lifetime PTSD (Fontenelle et al, 2012;Ojserkis et al, 2017).…”

Association Between Childhood Maltreatment and Symptoms of Obsessive-Compulsive Disorder: A Meta-Analysis

“…Moreover, it is well-established that early traumatic events could also increase the frequency and impact content of intrusive thoughts ( 43 ). Additionally, two studies conducted by Briggs et al ( 16 ) and Kroska et al ( 44 ) have described that individuals who have experience of CM appear to adopt negative coping styles, which had been proved to function as a mediator in the association between CM and OCS severity in OCD patients. A maladaptive coping strategy, typically defined as an attempt to withdraw when facing the stressor or a belief of inability to deal with the situation, was proved to bring about more severe distress and intensify the severity of OCS ( 45 ).…”