Obsessive Compulsive and Related Disorders
Associations between childhood maltreatment and perinatal OCD
Quincy M. Beck, B.S.
Research Assistant
University of British Columbia
Vancouver, British Columbia, Canada
Cora Keeney, M.S.
Lab manager
The University of British Columbia
Vancouver, British Columbia, Canada
Nichole Fairbrother, Ph.D.
Clinical Associate Professor
University of British Columbia
Victoria, British Columbia, Canada
Background
Childhood maltreatment, such as emotional abuse/neglect, physical abuse/neglect, and sexual abuse, is a risk factor for psychopathology, including obsessive-compulsive disorder (OCD). The perinatal period also introduces increased risk of OCD onset or exacerbation. Perinatal obsessive-compulsive symptoms often involve unwanted, intrusive thoughts of infant-related harm. To our knowledge, no study to date has examined the relationship between childhood maltreatment and perinatal OCD. The goal of this secondary analysis was to assess self-reported history of child abuse and its association with perinatal OCD diagnostic status, symptom severity, and onset timing.
Methods
From a larger, prospective sample of pregnant and postpartum individuals (N = 767), 529 participants provided data for this analysis. Participants, recruited via community advertisements and maternity health clinics, completed questionnaires and interviews at 33-weeks gestation and at 2 and 4 months postpartum. In this evaluation, child abuse was measured prenatally via a single, dichotomous item from the Child Abuse Potential Inventory (“As a child I was abused.”; CAP). OCD was measured at all three time points via self-report (the Dimensional Obsessive-Compulsive Scale; DOCS), and at postpartum via diagnostic interview (Structured Clinical Interview for DSM-5; SCID-5). Independent t-tests were used to test for differences in DOCS total scores (at all three time points) between people who reported child abuse and those who didn’t. Chi-square analyses were employed to assess the association of child abuse with: (a) the presence of OCD at any time during pregnancy or the postpartum, and (b) perinatal OCD onset.
Results
Among the 529 participants included in this analysis, 83 (15.7%) endorsed childhood abuse on the CAP item. During the perinatal period, 16.1% (n = 85) of participants reported symptoms meeting criteria for OCD, with 24.7% (n = 21) of these endorsing childhood abuse. Participants who endorsed exposure to childhood abuse were more likely to meet criteria for OCD at some point during the current perinatal period, X2(1, N=529) = 6.22, p = .013, but not more likely to have developed OCD within a perinatal period, X2(1, N=85) = .032, p = .857. At all three time-points, DOCS scores were significantly higher for those who reported childhood abuse (prenatal, t(67) = -2.636, p = .010; early postpartum, t(103) = -2.492 p = .014; late postpartum, t(353) = -3.366, p < .001.
Discussion
Consistent with previous findings, our study highlights how experiences of childhood abuse are associated with OCD presence and severity. This study found no association, however, with childhood abuse and perinatal OCD onset. It should be noted that these analyses were exploratory, given a paucity of previous research in this area, and further investigation is required. Importantly, our findings are limited by the use of a dichotomous variable of childhood abuse presence/absence. These analyses should be replicated using a validated and comprehensive measure of childhood experiences of abuse and neglect.
