Postpartum obsessive compulsive symptom onset: Modelling vulnerability longitudinally

The perinatal period represents risk for the development of postpartum obsessive-compulsive symptoms (POCS) but the variables of risk that lead to symptom development are not well understood. The goal of the current study was to evaluate the longitudinal, cross-lagged associations between obsessive beliefs and subsequent postpartum symptom onset, in the context of genetic and personality vulnerability, from early pregnancy to approximately 20 weeks postpartum. The study also tested cognitive specificity, namely whether obsessive beliefs are uniquely predictive of POCS compared to general mood and anxiety symptoms, and conversely, whether cognitive vulnerabilities thematically congruent to mood and anxiety symptoms are predictive of POCS.

In a prospective study with a community perinatal sample (N = 599), women completed a genetic assay and a test battery of measures assessing personality, stress, symptom functioning and cognitive vulnerability in early pregnancy (Time 1), and symptom and cognitive measures again in the early postpartum period (Time 2), and in the later postpartum period (Time 3).

The model fit was acceptable, and the results supported the hypothesized cross-lagged associations between elevated obsessive beliefs about inflated responsibility/threat and subsequent POCS development at each phase of the study. Obsessive beliefs were not associated with the development of mood and anxiety symptoms in the postpartum period, nor were thematically congruent cognitive vulnerabilities for depression and anxiety symptoms predictive of POCS onset.

Obsessive beliefs focusing on inflated responsibility/threat demonstrate specificity and temporal salience in predicting POCS onset longitudinally.