Association between specific childhood trauma and symptom dimensions in patients with obsessive-compulsive disorder: dimensional and network perspectives

<b>Background:</b> Childhood trauma has been increasingly recognised as an important environmental risk factor in the development and maintenance of obsessive-compulsive disorder (OCD). However, the specific ways in which different trauma types influence distinct OCD symptom dimensions remain unclear. This study aimed to investigate the multidimensional impact of childhood trauma on OCD using a network analysis approach.<b>Methods:</b> A total of 410 patients with OCD participated in this study. Factor analysis and exploratory graph analysis were conducted to identify symptom dimensions. Network analysis was used to explore connections between childhood trauma types and symptom dimensions.<b>Results:</b> Four distinct symptom dimensions were identified: <i>Compulsive Behavioural Tendencies</i>, <i>Obsessive Cognitive Tendencies</i>, <i>Pathological Obsessions and Compulsions</i>, and <i>Emotional Distress</i>. <i>Emotional Distress</i> exhibited the strongest connectivity in the network and served as a key bridge linking childhood trauma to psychopathology. Among the childhood trauma types, emotional abuse and physical neglect demonstrated the highest bridge centrality, highlighting their substantial impact on OCD development and persistence. Network Comparison Tests indicated no significant sex differences in network structure, global strength, or centrality.<b>Conclusions:</b> Emotional abuse and physical neglect appear to impact OCD symptomatology primarily through emotional dysfunction. These findings emphasise the need for incorporating emotion-focused strategies and trauma-informed interventions into OCD treatment protocols. Longitudinal studies are warranted to better understand the causal relationships between childhood trauma, emotional dysregulation, and OCD.