Clinical characteristics and longitudinal associations with obsessive-compulsive disorder in youth exposed to trauma

Childhood trauma exposure is associated with posttraumatic stress symptoms (PTSS) and suicidality, however it is also a risk factor for obsessive-compulsive disorder (OCD) in adults. Research examining the relationship between childhood trauma and OCD in youth is mixed, and there is a dearth of research examining the associations among OCD, PTSS, and suicidality. As a result, conclusions have been drawn from primarily cross-sectional adult samples. No study has examined the clinical characteristics associated with OCD in trauma-exposed youth, nor its associations with PTSS and suicidality over time. To address this gap, the present study used logistic regressions and generalized estimating equations in 2068 trauma-exposed youth aged 8-20 who completed assessments at baseline, 6-month, and 12-month follow-ups. In total, trauma-exposed youth with OCD (n = 222, 10.7 %) were more likely to be female (OR = 0.646), had more severe PTSS (OR = 1.032), and more psychiatric comorbidities (OR = 1.391) compared to trauma-exposed youth without OCD. Interpersonal traumas (OR = 1.549) and bullying (OR = 1.294) were associated with a greater likelihood of having OCD; however, these effects were nonsignificant when adjusting for other mental health symptoms. There was no evidence that OCD was associated with the trajectory of PTSS nor suicidality at 6- and 12-month follow-ups. Trauma-exposed youth with OCD may cross-sectionally have more severe clinical presentations overall, but OCD may not be related to the trajectory of these symptoms over time. Future research is needed to understand the directionality of clinical characteristics associated with pediatric OCD and whether interpersonal traumas convey risk uniquely for OCD or for distress in general.