The mediating role of anxiety and depression in the relationship between childhood abuse and obsessive-compulsive symptoms

Authors
semnan university
Abstract
The present study was conducted with the aim of determining the mediating role of anxiety and depression in the relationship between childhood maltreatment and obsessive-compulsive symptoms. The research method was descriptive and of the correlation type (structural equation modeling). From among the general population of social media users in 2022, 350 people were selected according to the entry criteria by voluntary sampling method. The tools used in this research included the Revised scale of obsessive–compulsive Syndrome (Foa and et al), Childhood Trauma Questionnaire (Bernstein & Stein), Beck Anxiety Inventory & Beck Depression Inventory-II. Pearson's correlation test and structural equation modeling were used to analyze the data. The results showed that childhood abuse has a direct and significant relationship with obsessive-compulsive symptoms, and anxiety and depression play a mediating role in the relationship between childhood abuse and obsessive-compulsive symptoms, and overall, the results show that the model fits well. According to the obtained results, it can be said that childhood trauma, anxiety and depression play an important role in the formation of obsessive-compulsive symptoms. In general, it can be concluded that childhood trauma can cause obsessive-compulsive symptoms by affecting anxiety and depression.
Keywords

Chowdhury AR, Hossain MD, lbne Haq A, Kowser A, Khan MSA, Parveen M. Psychiatric comorbidity in patients with obsessive-compulsive. Age (year). 2020;278:7.
Fineberg NA, Apergis-Schoute AM, Vaghi MM, Banca P, Gillan CM, Voon V, et al. Mapping compulsivity in the DSM-5 obsessive compulsive and related disorders: cognitive domains, neural circuitry, and treatment. International Journal of Neuropsychopharmacology. 2018;21(1):42-58.
Markarian Y, Larson MJ, Aldea MA, Baldwin SA, Good D, Berkeljon A, et al. Multiple pathways to functional impairment in obsessive–compulsive disorder. Clinical psychology review. 2010;30(1):78-88.
Öst L-G, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical psychology review. 2015;40:156-69.
Politis S, Magklara K, Petrikis P, Michalis G, Simos G, Skapinakis P. Epidemiology and comorbidity of obsessive–compulsive disorder in late adolescence: a cross-sectional study in senior high schools in Greece. International Journal of psychiatry in clinical practice. 2017;21(3):188-94.
American Psychiatric Association D, Association AP. Diagnostic and statistical manual of mental disorders: DSM-5-R: American psychiatric association Washington, DC; 2022.
Iervolino AC, Rijsdijk FV, Cherkas L, Fullana MA, Mataix-Cols D. A multivariate twin study of obsessive-compulsive symptom dimensions. Archives of general psychiatry. 2011;68(6):637-44.
English D, Thompson R, White CR, Wilson D. Why should child welfare pay more attention to emotional maltreatment? Children and youth services review. 2015;50:53-63.
Hager AD, Runtz MG. Physical and psychological maltreatment in childhood and later health problems in women: An exploratory investigation of the roles of perceived stress and coping strategies. Child abuse & neglect. 2012;36(5):393-403.
Sethi D, Yon Y, Parekh N, Anderson T, Huber J, Rakovac I, et al. European status report on preventing child maltreatment. 2018.
Organization WH. Preventing child maltreatment: a guide to taking action and generating evidence: World Health Organization; 2006.
Cecil CA, Viding E, Fearon P, Glaser D, McCrory EJ. Disentangling the mental health impact of childhood abuse and neglect. Child abuse & neglect. 2017;63:106-19.
Copeland WE, Shanahan L, Hinesley J, Chan RF, Aberg KA, Fairbank JA, et al. Association of childhood trauma exposure with adult psychiatric disorders and functional outcomes. JAMA network open. 2018;1(7):e184493-e.
Jaffee SR. Child maltreatment and risk for psychopathology in childhood and adulthood. Annual review of clinical psychology. 2017;13:525-51.
Lewis SJ, Arseneault L, Caspi A, Fisher HL, Matthews T, Moffitt TE, et al. The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales. The Lancet Psychiatry. 2019;6(3):247-56.
Salokangas RK, Schultze-Lutter F, Schmidt SJ, Pesonen H, Luutonen S, Patterson P, et al. Childhood physical abuse and emotional neglect are specifically associated with adult mental disorders. Journal of Mental Health. 2019.
Gu W, Zhao Q, Yuan C, Yi Z, Zhao M, Wang Z. Impact of adverse childhood experiences on the symptom severity of different mental disorders: a cross-diagnostic study. General Psychiatry. 2022;35(2).
Cross D, Fani N, Powers A, Bradley B. Neurobiological development in the context of childhood trauma. Clinical psychology: science and practice. 2017;24(2):111.
Destree L, Brierley M-EE, Albertella L, Jobson L, Fontenelle LF. The effect of childhood trauma on the severity of obsessive-compulsive symptoms: A systematic review. Journal of psychiatric research. 2021;142:345-60.
Kart A, Türkçapar H. The effects of childhood emotional abuse on aggressive obsessions among patients with obsessive compulsive disorder may be mediated by symptoms of depression and anxiety. Psychiatry and Clinical Psychopharmacology. 2019;29(4):411-7.
Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. The lancet. 2013;382(9904):1575-86.
Martins-Monteverde CMS, Baes CVW, Reisdorfer E, Padovan T, Tofoli SMdC, Juruena MF. Relationship between depression and subtypes of early life stress in adult psychiatric patients. Frontiers in psychiatry. 2019;10:19.
Heim C, Shugart M, Craighead WE, Nemeroff CB. Neurobiological and psychiatric consequences of child abuse and neglect. Developmental psychobiology. 2010;52(7):671-90.
Vallati M, Cunningham S, Mazurka R, Stewart JG, Larocque C, Milev RV, et al. Childhood maltreatment and the clinical characteristics of major depressive disorder in adolescence and adulthood. Journal of abnormal psychology. 2020;129(5):469.
Torres AR, Fontenelle LF, Shavitt RG, Ferrão YA, Do Rosário MC, Storch EA, et al. Comorbidity variation in patients with obsessive–compulsive disorder according to symptom dimensions: Results from a large multicentre clinical sample. Journal of affective disorders. 2016;190:508-16.
Segalàs C, Labad J, Salvat-Pujol N, Real E, Alonso P, Bertolín S, et al. Sleep disturbances in obsessive-compulsive disorder: influence of depression symptoms and trait anxiety. BMC psychiatry. 2021;21(1):1-10.
Miegel F, Jelinek L, Moritz S. Dysfunctional beliefs in patients with obsessive-compulsive disorder and depression as assessed with the Beliefs Questionnaire (BQ). Psychiatry Research. 2019;272:265-74.
Ou W, Li Z, Zheng Q, Chen W, Liu J, Liu B, et al. Association between childhood maltreatment and symptoms of obsessive-compulsive disorder: a meta-analysis. Frontiers in psychiatry. 2021;11:612586.
Rohrs B, Gangewere B, Kaplan A, Chopra A. Anxiety, Obsessive-Compulsive, and Related Disorders. Management of Sleep Disorders in Psychiatry. 2020:318.
Çoban A, Tan O. Attention deficit hyperactivity disorder, impulsivity, anxiety, and depression symptoms mediating the relationship between childhood trauma and symptoms severity of obsessive-compulsive disorder. Archives of Neuropsychiatry. 2020;57(1):37.
Berber Çelik Ç, Odacı H. Does child abuse have an impact on self-esteem, depression, anxiety and stress conditions of individuals? International journal of social psychiatry. 2020;66(2):171-8.
Stein DJ, Fineberg NA, Bienvenu OJ, Denys D, Lochner C, Nestadt G, et al. Should OCD be classified as an anxiety disorder in DSM‐V? Depression and anxiety. 2010;27(6):495-506.
Ivarsson T, Melin K, Wallin L. Categorical and dimensional aspects of co-morbidity in obsessive-compulsive disorder (OCD). European child & adolescent psychiatry. 2008;17:20-31.
Rukiye A, Erbay LG. Relationship between childhood trauma and suicide probability in obsessive-compulsive disorder. Psychiatry research. 2018;261:132-6.
Selvi Y, Besiroglu L, Aydin A, Gulec M, Atli A, Boysan M, et al. Relations between childhood traumatic experiences, dissociation, and cognitive models in obsessive compulsive disorder. International Journal of Psychiatry in Clinical Practice. 2012;16(1):53-9.
Visser HA, van Minnen A, van Megen H, Eikelenboom M, Hoogendoorn AW, Kaarsemaker M, et al. The relationship between adverse childhood experiences and symptom severity, chronicity, and comorbidity in patients with obsessive-compulsive disorder. The Journal of clinical psychiatry. 2014;75(10):17275.
Kline RB. Principles and practice of structural equation modeling (3rd ed): Guilford Press; 2016.
Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, et al. The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological assessment. 2002;14(4):485.
Abramowitz JS, Deacon BJ. Psychometric properties and construct validity of the Obsessive–Compulsive Inventory—Revised: Replication and extension with a clinical sample. Journal of anxiety disorders. 2006;20(8):1016-35.
Huppert JD, Walther MR, Hajcak G, Yadin E, Foa EB, Simpson HB, et al. The OCI-R: validation of the subscales in a clinical sample. Journal of anxiety disorders. 2007;21(3):394-406.
Beck AT, Steer RA. Beck anxiety inventory: BAI; manual: Psychological Corporation, Harcourt Brace Jovanovich; 1990.
Narimani M, Abolghasemi A. Psychological tests2005.
Beck AT, Steer RA, Brown G. Beck depression inventory–II. Psychological assessment. 1996.
Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child abuse & neglect. 2003;27(2):169-90.
Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling: a multidisciplinary journal. 1999;6(1):1-55.
Angelakis I, Gooding P. Adverse social relationships in childhood: are there links with depression, obsessive-compulsive disorder and suicidality in adulthood? Child Psychiatry & Human Development. 2021;52:945-56.