Past adversity and obsessive-compulsive symptoms: The mediating roles of posttraumatic cognitions and posttraumatic stress symptoms

Abstract

Obsessive-compulsive (OC) symptoms are more common among survivors of abuse and family disruption. Abuse and family disruption may result in intrusions, which may lead to OC symptom development if followed by obsessive cognitions, metacognitions, or posttraumatic cognitions. This study examined these relationships and tested a model in which the relationship between abuse and family disruption and OC symptoms is statistically mediated by (1) posttraumatic cognitions and metacognitions (both directly, and indirectly through posttraumatic stress symptoms (PTSS)) and (2) obsessive cognitions. A diverse sample of undergraduate students (N = 402) completed measures of each construct. A principal components analysis of measures of cognition and metacognition yielded two well-defined components: Obsessive Cognitions and Posttraumatic Cognitions. Surprisingly, "positive" posttraumatic metacognitions loaded onto Obsessive Cognitions, suggesting a possible shared cognitive pathway from stressful life events to both OC symptoms and PTSS. Abuse and family disruption appeared to have specific relationships with two OC symptom dimensions, i.e., unacceptable thoughts and symmetry/completeness, but not with two other OC symptom dimensions, i.e., contamination and responsibility for harm. Mediation analyses suggested the relationship between abuse and family disruption and OC symptoms was fully mediated by Posttraumatic Cognitions, Obsessive Cognitions, and PTSS. Results, implications, and limitations are discussed.