Understanding the co-occurrence of OCD and PTSD: A network approach

Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) often co-occur, complicating the presentation, severity, and treatment of these conditions. Relationships among the symptoms of these disorders may contribute to their co-occurrence. This study aimed to extend recent work on comorbid OCD+PTSD and to examine its network structure in a clinical sample of 137 treatment-seeking patients at two large healthcare institutions. Confirmatory factor analysis was used to examine the OCD+PTSD factor structure and the optimal solution subjected to network analysis. The best fitting factor solution, consistent with Pinciotti, Horvath, and colleagues (2022), included seven PTSD factors and two OCD factors. The strongest symptom-level associations were among: a) trauma-related intrusions and avoidance and b) obsessions and compulsions. Affective symptoms (e.g., dysphoric arousal) emerged as central bridge symptoms connecting obsessions/compulsions to trauma-related intrusions/avoidance symptoms. Findings converge with models suggesting these disorders are functionally related, albeit distinct, conditions.