The role of traumatic experiences in the genesis of obsessive-compulsive disorder

This paper discusses the role of traumatic stress in the genesis of obsessive-compulsive disorder. While the early classical conditioning theory of the onset of obsessive-compulsive disorder has only limited empirical support, authorities have always recognised the role of stress in precipitating this disorder, and in triggering relapse in those who have been successfully treated. Here, clinical cases are cited that show a causal link between severe trauma and the onset of obsessive-compulsive disorder. The nature of the traumatic reaction and the possible mechanisms by which it leads to frank obsessive compulsive disorder are discussed. The apparent links between this and posttraumatic stress disorder are also explored. Finally, implications for therapy are considered. (C) 1999 Elsevier Science Ltd. All rights reserved.