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Attention Deficit Hyperactivity Disorder, Impulsivity, Anxiety, and Depression Symptoms Mediating the Relationship Between Childhood Trauma and Symptoms Severity of Obsessive-Compulsive Disorder
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A growing body of research associates childhood trauma with obsessive-compulsive disorder (OCD). The aim of this study was to investigate the relationships between childhood trauma and OCD, including both its severity and OCD patients' comorbid impulsivity, ADHD, anxiety, and depressive symptoms.

In two studies conducted on nonclinical samples, no association between the severity of obsessive-compulsive symptoms and childhood trauma was observed by either Mathew et al. (6) or Briggs et al. (8), who controlled for depression and anxiety. It is also known that childhood trauma has an effect on anxiety and depression in OCD patients (6, 8). Moreover, the severity of anxiety and that of depression symptoms were shown to increase the severity of OCD symptoms (40). Regarding this point, our study showed that childhood psychiatric traumas increased the severity of anxiety and depression symptoms in OCD patients and that this effect caused an increase in the severity of OCD symptoms. The reason for the lack of a Table 3. Comparison of the Y-BOCS scores between patients with and without a specific trauma subtype Y-BOCS Total Y-BOCS Obsession Y-BOCS Compulsion MeanSD p MeanSD p MeanSD p Emotional Neglect
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Yes No 22.677.42 21.816.57 a0.536 12.554.22 11.114.52 a0.104 10.125.15 10.554.37 a0.648 Physical Neglect Yes No 21.886.87 22.486.99 a0.658 11.764.18 11.584.78 a0.841 9.975.11 10.884.09 a0.322 Sexual Abuse Yes No 22.186.14 22.147.19 a0.980 12.503.32 11.384.76 a0.257 9.984.20 10.634.84 a0.360 Emotional Abuse Yes No 21.766.70 22.417.06 a0.640 11.904.26 11.534.58 a0.674 9.834.96 10.734.48 a0.335 Physical Abuse Yes No 20.706.60 22.656.96 a0.208 11.933.01 11.594.85 a0.740 8.785.26 10.924.36 a0.039* Y-BOCS, Yale-Brown obsession compulsion scale; OCD, obsessive compulsive disorder. a Students t test, b Mann-Whitney U Test, *p<0.05. 40
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Arch Neuropsychiatry 2020;57:3743 Table 4. Comparison of emotional neglect, physical neglect, sexual abuse, emotional abuse, physical abuse, and minimization scores between females and males Total CTQ Emotional Neglect Physical Neglect Sexual Abuse Emotional Abuse Physical Abuse Minimization Females with OCD (n=46) Mean SD 36.529.06 10.854.31 6.761.55 5.781.61 7.873.76 5.260.74 0.520.78 Males with OCD (n=60) Mean SD 39.059.48 12.024.83 7.482.30 5.802.24 7.722.98 6.032.09 0.480.81 T/Z -1.385 0.706 -1.926 -0.154 -0.378 -2.305 -0.327 p b0.166 b0.217 a0.057 b0.877 b0.706 b0.021* b0.744 Y-BOCS, Yale-Brown obsession compulsion scale; OCD, obsessive compulsive disorder. aStudents t test, bMann-Whitney U Test, *p<0.05. Table 5. Correlations among age, Y-BOCS, HAM-D, BAI, BIS-11, WURS, and CTQ Age Age 1 YBOCS YBOCS-O YBOCS-C HAM-D BAI BIS-11 BIS-A BIS-M BIS-N WURS CTQ EA EN PA PN SA YBOCS 0.162 1 YBOCS-O 0.097 0.727** 1 YBOCS-C 0.144 0.764** 0.131 1
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HAM - D 0.082 0.544* * 0.525* * 0.291* * 1 BAI 0.051 0.391* * 0.349* * 0.232 * 0.659* * 1 BIS - 11 0.108 0.084 0.036 0.178 0.050 0.007 1 BIS - A 0.188 0.000 0.151 0.134 0.147 0.151 0.799* * 1 BIS - M 0.096 0.079 0.052 0.095 0.067 0.061 0.784* * 0.425* * 1 BIS - N 0.001 0.114 0.009 0.202 * 0.058 0.077 0.856* * 0.587* * 0.469* * 1 WURS 0.098 0.059 0.111 0.014 0.197 0.389* * 0.222 * 0.339* * 0.125 0.107 1 CTQ 0.041 0.059 0.118 0.180 0.108 0.197 * 0.288* * 0.280* * 0.281* * 0.154 0.381* * 1 EA 0.213 * 0.047 0.027 0.080 0.099 0.163 0.242 * 0.256 * 0.267 * 0.086 0.297* * 0.755* * 1 EN 0.005 0.023 0.173 0.104 0.152 0.188 0.198 0.223 * 0.160 0.114 0.353* * 0.845* * 0.461* * 1 PA 0.147 0.150 0.023 0.191 0.052 0.007 0.230 * 0.177 0.309* * 0.082 0.109 0.535* * 0.423* * 0.263* * 1 PN 0.075 0.011 0.126 0.151 0.091 0.129 0.290* * 0.187 0.288* * 0.228 * 0.198 * 0.704* * 0.340* * 0.587* * 0.304* * 1
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