Can Childhood Trauma Cause OCD?

There’s a lot that we don’t know about OCD. Specifically, experts haven’t identified exactly what causes OCD.

Experts believe that genetics might play a role. Some older research has suggested that people with certain personality traits, like neuroticism, are also more likely to develop OCD.

However, environmental factors can trigger the development of OCD in people who are already more susceptible to developing OCD. These triggers can include:

• a traumatic brain injury (TBI)
• pregnancy
• a bacterial or viral infection
• stress, including traumatic experiences

So, yes, childhood trauma can trigger OCD, but it’s not thought to directly cause OCD. There also isn’t sufficient research on whether childhood trauma is more likely to trigger OCD than trauma in adulthood.

Childhood trauma may not only trigger the onset of OCD but may also make OCD symptoms more severe. A 2011 study found that childhood trauma could increase the severity of OCD in children with attachment issues and emotional processing challenges.

A 2013 study also found that certain childhood traumas are more likely to increase the severity of OCD symptoms. These traumas include:

• emotional neglect
• sexual abuse
• physical abuse
• emotional abuse

More recently, a 2021 study found that people who experienced childhood maltreatment were more likely to exhibit worse OCD and depressive symptoms.

What’s the link between PTSD and OCD?

You can have both OCD and post-traumatic stress disorder (PTSD). Many people who have trauma-related OCD also experience PTSD.

One 2014 paper pointed out that there are many similarities between OCD and PTSD: both can appear after trauma, and both can involve upsetting, fear-inducing intrusive thoughts and attempts to get rid of them.

The symptoms of PTSD overlap with the symptoms of OCD. Only a mental health professional would be able to determine whether your symptoms are PTSD, OCD, or both.

There’s no established timeline for developing OCD after trauma: it’s not clear how long it will take before someone starts exhibiting OCD symptoms (if they do experience OCD, that is).

About 8 in 10 people who have OCD develop the condition before they turn 18. As such, people with OCD usually show signs in their childhood. In fact, even toddlers can have OCD.

Parents who are concerned about their children developing OCD can look out for early warning signs. However, if you think your child has OCD, or if they’ve experienced something traumatic, there’s no reason to wait for symptoms to appear: you can make an appointment with a child therapist right away.

Early signs of OCD include:

• asking for reassurance in excess (for example, asking adults repeatedly if they still love them, checking whether they’re ill/dying, reassuring them that they’re safe)
• displaying repetitive behaviors (including checking, counting, re-washing hands, repeating mantras)
• being very particular or perfectionistic about certain tasks
• becoming irritable or angry when they can’t carry out their rituals
• having difficulty executing certain tasks
• taking a longer-than-typical time to do certain tasks
• avoiding using certain items or going to certain places
• being preoccupied with order or symmetry

In pediatric OCD, a child’s obsessions and compulsions can focus on one or more “themes.” For example, they might be preoccupied with cleanliness or counting to a specific number. They might also have harm OCD, which is where they have unwanted thoughts about hurting themselves or others.

OCD is a treatable condition. Typically, pediatric OCD is treated with talk therapy. In some cases, your child might also benefit from prescription medication.

Although a few different kinds of talk therapy can successfully treat OCD, one of the most common kinds of therapy for OCD is a kind of cognitive behavioral therapy (CBT) called exposure and response prevention (ERP) therapy.

A 2014 review concluded that CBT could reduce OCD symptoms by 40% to 65% in children. It can be used to treat children as young as 3 years old.

In ERP, your child will be exposed to something that usually sets off their fears but they’ll be discouraged from carrying out their compulsion. For example, if they’re preoccupied with germs and cleanliness, they might touch a dirty item without washing their hands after. Over time, the anxiety will weaken and they’ll learn to cope better.

Family therapy can often be helpful for children with OCD. During family therapy, the child’s caregivers (and in some cases, siblings) will be educated about their condition. Family involvement can empower you to support your child with OCD.

In some cases, a doctor or psychiatrist will prescribe your child a serotonin selective reuptake inhibitor (SSRI), a kind of antidepressant.

You or your child might also benefit from attending support groups. Some support groups are specifically designed for children with OCD, while other support groups are tailored to parents and family members.

If you think your child has OCD, consider making an appointment with a child psychologist. This is a great first step in helping your child feel better.

Learn about choosing the right therapist for your child.

Although there isn’t thought to be one direct cause of OCD, trauma and stress, including in childhood, can play a role in triggering its onset and making symptoms more severe.

If your child has experienced something traumatic, whether they show signs of OCD or not, it’s worth making an appointment with a child therapist. Therapy can help your child process trauma and learn healthy coping skills.