Obsessive-compulsive disorder and depression in university students: serial mediation of (intrusive and deliberate) rumination and social anxiety

Early non-clinical obsessive-compulsive symptoms often disrupt young people’s social life in different ways and make the onset of clinical conditions more likely. Evidence shows frequent comorbidity between obsessive-compulsive symptoms and depression, suggesting that the former can start before depressive symptoms appear. However, the mechanisms that make this association more likely are unclear. This cross-sectional study examines whether (intrusive and deliberate) rumination and social anxiety play a serial mediating role between subclinical conditions in university students. Participants were 266 university students (217 women and 49 men; Mage = 20; SDage = 2.8). They responded to different scales that measure obsessive-compulsive symptoms, (intrusive and deliberate) rumination, social anxiety, and depression. Serial mediation analysis was computed using macro program PROCESS 4.2. Mediation analysis supported a direct positive association between obsessive-compulsive symptoms and depression, as well as multiple serial mediations of the three mediators analyzed. However, while intrusive rumination and social anxiety were positively associated with depression, deliberate rumination was indirectly related to lower depression through the former’s link to lower social anxiety. Although longitudinal research is still required, this cross-sectional study suggests that obsessive-compulsive symptoms, intrusive rumination, and social anxiety were positively associated with depression, either separately or in combination. By contrast, deliberate rumination appears to be indirectly related to lower depression through its co-occurrence with lower social anxiety. This latter points to deliberate rumination as a potential target for intervention.