Postpartum obsessive compulsive symptom onset: Modeling a pathway of risk

The perinatal period represents uniquely elevated risk for the development of obsessive-compulsive symptoms compared to any other period in the lifespan but the variables of risk and the specific pathways that lead to symptom development are not well understood. The goal of the current study was to evaluate an integrated, theoretically-derived model of risk focusing on a pathway from genes through personality vulnerability to dysfunctional beliefs to symptom development in the postpartum period. It was hypothesized that women with elevated stress reactivity, via genetic and personality vulnerability, and elevated dysfunctional obsessive beliefs would be at risk of developing postpartum obsessive-compulsive (OC) symptoms. This pathway model for postpartum OC symptom development was evaluated in relation to hypothesized pathways for the development of mood and anxiety symptoms based on shared (genes, personality, stress) and unique risk (specific dysfunctional beliefs). In a prospective study with a community perinatal sample (N = 196), women completed a test battery in late pregnancy (Time 1) and again at six weeks postpartum (Time 2). All indicators of the measurement and structural models with genes, personality, and obsessive beliefs demonstrated good fit for the pathway of risk to the development of OC symptoms, and this pathway differed from the paths to the development of mood and anxiety symptoms. In addition to the established role of obsessive beliefs, genetic and personality vulnerability related to stress reactivity need to be considered in contributing to risk and can be modelled effectively on the same pathway to predicting postpartum OC symptom onset.