Potential Mediating Roles of Thought-Action Fusion and Schizotypal Traits in the Relationship Between Childhood Maltreatment and Obsessive-Compulsive Disorder

OBJECTIVE: Although the relationship between childhood maltreatment (CM) and obsessive-compulsive disorder (OCD) is well known, no studies to date have examined the potential mediating roles of thought-action fusion (TAF) and schizotypal traits in the relationship between CM and OCD. In this study, we investigated whether TAF and/or schizotypal traits mediate the association between CM subtypes and OCD. METHOD: This study was conducted in 83 patients (18-65 years) with OCD. Participants completed Yale Brown Obsessive-Compulsive Scale (YBOCS) Childhood Trauma Questionnaire-Short Form (CTQ-SF), Thought-Action Fusion Scale (TAFS), and Schizotypal Personality Questionnaire-Brief (SPQ-B). Descriptive, correlational, and mediation analyses were used to determine the extent of the relationship between CM and OCD. RESULTS: The YBOCS scores showed significant correlations with SPQ-B total and SPQ-B interpersonal traits. Positive correlations were found between the YBOCS scores and emotional abuse, physical abuse, and emotional neglect. Emotional abuse was associated with cognitive, perceptual, and disorganized traits and TAF subscales. Emotional neglect was significantly associated with SPQ-B total, interpersonal, and cognitive-perceptual traits, as well as TAF likelihood-self. The mediation analysis indicated that the SPQ-B total significantly mediated the relationship between emotional abuse and emotional neglect and the YBOCS total. CONCLUSIONS: Contrary to expectations, neither moral nor the likelihood dimensions of TAF were significantly associated with OCD severity. As hypothesized, the indirect effects of emotional abuse and emotional neglect on OCD through total schizotypy were significant. Clinicians treating individuals who develop new or worsening OCD following maltreatment exposure should consider the role of schizotypal traits for treatment.