(PS7-C60) Behavioral Predictors of Obsessive-compulsive Symptoms During a High Vulnerability to Onset Period

Background: Obsessive-compulsive disorder (OCD) is characterized by obsessions (unwanted or intrusive thoughts, images, or urges that typically cause anxiety or distress) and compulsions (actions done to attempt to alleviate this distress). The age of onset of OCD has a bimodal distribution, peaking at 10 and early 20s (Geller et al., 1998). College students may be especially vulnerable to the development of OCD not only because they are developmentally more at risk for the onset of psychopathology (Vaingankar et al., 2012), but also as a result of added stressors associated with adjusting to college (e.g., forming new friend groups, additional pressure of academics, establishing or maintaining leisure activities outside of the structure of high school) (Pedrelli et al., 2015). Various maladaptive behaviors have been positively associated with worsening of Obsessive-Compulsive Symptoms (OCS), including worry (Dar & Iqbal, 2015) and procrastination (Ferrari et al., 2013); whereas self-improving behaviors have been negatively associated with OCS, such as engagement in hobbies (Spencer et al., 2023) and social functioning (Kugler et al., 2013; Rosa et al., 2012). If these non-stigmatized behaviors can be used to predict short-term OCS development in college students, then we can potentially intervene more easily using approachable, low-touch methods and possibly reduce the need for more intense intervention later.

Methods: In the current study, we explored whether the presence of maladaptive behaviors and absence of self-improving behaviors would predict greater OCS symptoms. We surveyed undergraduate students from San Diego State University over the course of two weeks (5 times per day) on their momentary worry, procrastination, quantity of socialization, and engagement in hobbies. We then measured the participants’ OCS at the end of the two weeks using the Obsessive-Compulsive Inventory Revised (Foa et al., 2002). To assess the reliability of our findings, results were cross-validated in two samples of undergraduates (Sample 1: n = 210; Sample 2: n = 235) across different semesters of data collection.

Results: When all momentary items were averaged across each individual within the two-week assessment period, exploratory analyses revealed that increased worry consistently predicted greater OCS across both samples (Sample 1: β = 0.23, p < 0.001, Sample 2: β = 0.22, p < 0.001). Decreased engagement in hobbies predicted greater OCS in Sample 1 (β = -0.09, p = 0.03), however this effect was not replicated in Sample 2 (β= 0.02, p = 0.58). Similarly, socialization (β = -0.09, p = 0.02) and procrastination (β =0.08, p = 0.03) predicted OCS in Sample 2, but did not predict OCS in Sample 1 (socialization: β = -0.02, p = 0.74; procrastination: β = 0.01, p = 0.81).

Conclusions: Although lower self-improvement behaviors (i.e., socialization and hobbies) and greater procrastination predicted greater OCS, these effects were not consistent across samples. However, increased worry reliably predicted worsening of OCS across. These findings further validate worry as a risk and early intervention factor for future OCS. We advise that future studies investigate low-touch, targeted intervention, specifically for college students.