Etiology of obsessions and compulsions: a behavioral-genetic analysis

It is unknown whether various types of obsessive-compulsive (OC) symptoms have a common genetic or environmental etiology. For example, it is unknown whether hoarding is etiologically associated with prototypic OC symptoms, such as washing, checking, and obsessing. Also unknown is whether particular OC-related symptoms are etiologically linked to the general tendency to experience emotional distress (negative emotionality). To investigate these and other issues, a community sample of 307 pairs of monozygotic and dizygotic adult twins provided scores on 6 OC-related symptoms (obsessing, neutralizing, checking, washing, ordering, and hoarding) and 2 markers of negative emotionality (trait anxiety and affective lability). Genetic factors accounted for 40%-56% of variance in the 8 phenotypic scores (M = 49% of variance for OC-related symptoms). Remaining variance was due to nonshared (person-specific) environment. More detailed analyses revealed a complex etiologic architecture, where OC-related symptoms arise from a mix of common and symptom-specific genetic and environmental factors. A general genetic factor was identified, which influenced all symptoms and negative emotionality. An environmental factor was identified that influenced all symptoms but did not influence negative emotionality. Each of the 6 types of symptoms was also shaped by its own set of symptom-specific genetic and environmental factors. The importance of genetic factors did not vary as a function of age or sex, and the architecture of general and specific etiologic factors was replicated for participants having relatively more severe OC symptoms. Gene-environment interactions were identified. Implications for an etiology-based classification system are discussed.