Severity of obsessive-compulsive symptoms is related to self-directedness character trait in obsessive-compulsive disorder

Personalized exposure and experience sampling method feedback versus exposure as usual for obsessive-compulsive disorder: a study protocol for a randomized controlled trial

BACKGROUND

Patients with obsessive-compulsive disorder (OCD) suffer from repetitive fearful intrusions which they try to neutralize by performing compulsions. OCD is considered to be the most resistant anxiety disorder with a remission rate of only 53% after a year of an evidence-based treatment. Therefore, it remains an obligation to develop and investigate more effective treatment interventions. This study aims to compare personalized exposure with response prevention (ERP) using experience sampling methodology-based feedback to ERP as usual in patients with OCD. Personalized exposure will be provided screen-to-screen in an ecologically valid (real time and real place) context by means of a smartphone application. This app will also be used to collect both objective and subjective data by means of experience sampling methodology (ESM). This ESM data will be used to identify triggers and protective factors for symptom severity, provide personalized feedback and optimize the effect of ERP. The primary goal of this RCT is to compare the effectiveness of personalized ERP to ERP as usual in the traditional context of a therapist's room in patients with OCD in OCD symptom severity, as well as differences in quality of life, depressive symptoms and anxiety states. Since both self-efficacy and experiential avoidance are known to influence symptom severity in OCS, a secondary goal is to examine if a possible treatment effect is mediated by self-efficacy or experiential avoidance.

METHODS

This study involves a randomized controlled trial with 20 weekly sessions by 2 groups (ERP as usual versus personalized ERP), repeated measurements at baseline (T0), 5 weeks of treatment (T1), 10 weeks of treatment (T2), 15 weeks of treatment (T3), posttest at 20 weeks (T4), 6 weeks follow-up (T5), 3 months follow-up (T6), 6 months follow-up (T7) and a year follow-up (T8). A hundred and sixty patients with an OCD diagnosis according to DSM-5 criteria will participate. Half of the group will receive exposure with response prevention as usual, the other half will receive personalized exposure with response prevention with a smartphone application and personalized feedback sessions based on experience sampling data. Multilevel mixed modelling analysis will be used to investigate differences in treatment effect, as well as differences in quality of life, depressive symptoms and anxiety states. We will use the macro of Preacher and Hayes and apply bootstrapping methods to assess the possible mediating effect of changes in self-efficacy and experiential avoidance on subsequent treatment effects.

DISCUSSION

This randomized controlled trial is the first to assess the influence of delivering ERP through video-calling and the use of an ESM intervention on the symptom severity of OCD. Since the global pandemic COVID-19, the use of video-calling to deliver psychological treatments has become more common, increasing the relevance of this study.

TRIAL REGISTRATION

ICTRP Trial NL8254. Registered on 2019-12-24.

Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation model

Reinforcement Sensitivity Theory (RST) posits that individual differences in reward and punishment processing predict differences in cognition, behavior, and psychopathology. We performed a quantitative review of the relationships between reinforcement sensitivity, depression and anxiety, in two separate sets of analyses. First, we reviewed 204 studies that reported either correlations between reinforcement sensitivity and self-reported symptom severity or differences in reinforcement sensitivity between diagnosed and healthy participants, yielding 483 effect sizes. Both depression (Hedges' g = .99) and anxiety (g = 1.21) were found to be high on punishment sensitivity. Reward sensitivity negatively predicted only depressive disorders (g = -.21). More severe clinical states (e.g., acute vs remission) predicted larger effect sizes for depression but not anxiety. Next, we reviewed an additional 39 studies that reported correlations between reinforcement sensitivity and both depression and anxiety, yielding 156 effect sizes. We then performed meta-analytic structural equation modeling to simultaneously estimate all covariances and control for comorbidity. Again we found punishment sensitivity to predict depression (β = .37) and anxiety (β = .35), with reward sensitivity only predicting depression (β = -.07). The transdiagnostic role of punishment sensitivity and the discriminatory role of reward sensitivity support a hierarchical approach to RST and psychopathology.

People behind unhealthy obsession to healthy food: the personality profile of tendency to orthorexia nervosa

PURPOSE

Our aim was to measure the personality profile of people with high orthorexic tendency using an assessment method which is acknowledged in the research of the classical eating disorders (anorexia nervosa, bulimia nervosa) and obsessive-compulsive disorder (OCD).

METHODS

In our research, 739 participants completed a self-administered, online questionnaire consisting of two measures: Temperament and Character Inventory-56 (TCI-56) and Ortho-11-Hu.

RESULTS

The orthorexia nervosa (ON) grouping variable has a significant effect on three factors of TCI: MANOVA revealed higher harm avoidance (F (2, 736) = 19.01, p < 0.001, η² = 0.05), lower self-directedness (F (2, 736) = 22.55, p < 0.001, η² = 0.06), and higher transcendence (F (2, 736) = 3.05, p = 0.048, η² = 0.01) in the higher ON group, compared to the lower ON group, regardless of the effect of the risk groups.

CONCLUSIONS

According to earlier studies, high harm avoidance and low self-directedness are relevant factors of anorexia nervosa, bulimia nervosa, and OCD, but now it also seems to be an important parameter of orthorexia. Nevertheless, higher transcendence may be a unique feature, which suggests that orthorexia seems to be an independent phenomenon.

LEVEL OF EVIDENCE

V, descriptive cross-sectional study.

New evidence for a pain personality? A critical review of the last 120 years of pain and personality

BACKGROUND

Personality traits may influence development and adjustment to ongoing pain. Over the past 120 years, there has been considerable research into the relationship between pain and personality. This paper presents new evidence for common personality traits found amongst chronic pain sufferers. In particular, it evaluates evidence for Cloninger's biopsychosocial model of personality in distinguishing typical personality features of chronic pain sufferers. It evaluates this evidence in the context of the past 120 years of research including psychodynamic formulations, MMPI studies, personality disorder investigations, and the influence of neuroticism on chronic pain.

METHODS

A literature search was conducted using PubMed, Medline, PsycINFO, SCOPUS and Cochrane library. Search terms included chronic pain, pain, personality, neuroticism, harm avoidance, self-directedness, attachment, Temperament and Character Inventory (TCI-R), MMPI, MMPI-2, NEO-PI, EPI, Millon Clinical Multiaxial Inventory, Millon Behavioral Health Inventory, Millon Behavioral Medicine Diagnostic, the Personality Assessment Inventory, the Locus of Control Construct and different combinations of these terms.

CONCLUSIONS

Recent descriptive studies using Cloninger's Temperament and Character Inventory (TCI-R) suggest that higher harm avoidance and lower self-directedness may be the most distinguishing personality features of chronic pain sufferers. High harm avoidance refers to a tendency to be fearful, pessimistic, sensitive to criticism, and requiring high levels of re-assurance. Low self-directedness often manifests as difficulty with defining and setting meaningful goals, low motivation, and problems with adaptive coping. Evidence for this personality profile is found across a wide variety of chronic pain conditions including fibromyalgia, headache and migraine, temporomandibular disorder, trigeminal neuropathy, musculo-skeletal disorders and heterogeneous pain groups. Limitations are also discussed. For example, high harm avoidance is also found in those suffering anxiety and depression. While many studies control for such factors, some do not and thus future research should address such confounds carefully. The evidence is also evaluated within the context of past research into the existence of 'a pain personality'. Psychodynamic formulations are found to be deficient in objective scientific methods. MMPI studies lack sufficient evidence to support 'a pain personality' and may be confounded by somatic items in the instrument. More recent neuroticism studies suggest a relationship between neuroticism and pain, particularly for adjustment to chronic pain. Personality disorders are more prevalent in chronic pain populations than non-pain samples.

CLINICAL IMPLICATIONS

Because harm avoidance reflects a tendency to developed conditioned fear responses, we suggest that higher harm avoidance may create more vulnerability to developing a fear-avoidance response to chronic pain. Furthermore, lower self-directedness may contribute to keeping a sufferer within this vicious cycle of fear, avoidance and suffering. Moreover, we suggest that harm avoidance and self-directedness are broader and more complex constructs than current clinical targets of CBT such as fear-avoidance and self-efficacy. Thus, assessing such personality traits may help to address the complexity of chronic pain presentations. For example, it may help to identify and treat sufferers more resistant to treatment, more prone to comorbidity and more vulnerable to entering the vicious cycle of chronic pain, suffering and disability.

Obsessive-compulsive disorders and anxiety disorders: A comparison of personality and emotionality patterns

Even though obsessive-compulsive disorders (OCD) and anxiety disorders (AD) have been separated in the taxonomy adopted by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, many issues remain concerning the physiopathological similarities and differences between those categories. Our objective was therefore to explore and compare their personality and emotional features, with the assumption that the distinction of two independent spectrums should imply the existence of two partially distinct temperamental profiles. We used the Temperament and Character Inventory (TCI-R) and the Positive and Negative Emotionality (PNE) scale to compare two groups of patients with OCD (n=227) or AD (n=827). The latter group included patients with social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder. Most temperament, character and emotionality measures showed no significant differences between both groups. In the personality measures results, only the self-directedness score (TCI-R) was significantly lower in OCD patients but this difference was not significant when the comparison was adjusted for the depressive scale score and age. Only lower PNE positive affects scores were obtained in OCD patients in the adjusted comparisons. These findings suggest that OCD and AD are not really distinguishable from the point of view of associated personality traits.

Pain and Personality: Do Individuals with Different Forms of Chronic Pain Exhibit a Mutual Personality?

The role of personality in the experience of chronic pain is a growing field, with endless debate regarding the existence of a "pain personality". This study aims to compare different chronic pain types and consolidate the existence of a common personality. Thirty-two females with chronic orofacial pain and 37 age-matched healthy females were assessed with the Temperament and Character Inventory-Revised. Chronic pain subjects had either trigeminal neuropathy (neuropathic pain) or temporomandibular disorders (nociceptive pain). This study revealed that individuals with different chronic pain types exhibit a mutual personality profile encompassing significantly higher scores in Harm Avoidance and significantly lower scores in Self-Directedness when compared to healthy subjects. In fact, this combination is associated with Cluster C personality disorders. In conclusion, our study reveals that irrespective of type, chronic pain may be associated with Cluster C personality disorders. Indeed, there has never been empirical evidence in the past to suggest that chronic pain as an overall concept is associated with any particular personality disorders. Therefore, a potential future avenue of chronic pain treatment may lie in targeting particular personality aspects and shift the target of pain-relieving treatments from sensory and psychologically state focused to psychologically trait focused.

The sense of incompleteness as a motivator of obsessive-compulsive symptoms: an empirical analysis of concepts and correlates

Contemporary models of obsessive-compulsive disorder emphasize the importance of harm avoidance (HA) and related dysfunctional beliefs as motivators of obsessive-compulsive (OC) symptoms. Recently, there has been a resurgence of interest in Janet's (1908) concept of incompleteness (INC) as another potentially important motivator. Contemporary investigators define INC as the sense that one's actions, intentions, or experiences have not been properly achieved. Janet defined INC more broadly to include alexithymia, depersonalization, derealization, and impaired psychological mindedness. We conducted two studies to address four issues: (a) the clinical correlates of INC; (b) whether INC and HA are distinguishable constructs; (c) whether INC predicts OC symptoms after controlling for HA; and (d) the relative merits of broad versus narrow conceptualizations of INC. Study 1 was a meta-analysis of the clinical correlates of narrowly defined INC (16 studies, N=5,940). INC was correlated with all types of OC symptoms, and was more strongly correlated with OC symptoms than with general distress. Study 2 (N=534 nonclinical participants) showed that (a) INC and HA were strongly correlated but factor analytically distinguishable; (b) INC statistically predicted all types of OC symptoms even after controlling for HA; and (c) narrow INC was most strongly correlated with OC symptoms whereas broad INC was most strongly correlated with general distress. Although the findings are limited by being correlational in nature, they support the hypothesis that INC, especially in its narrow form, is a motivator of OC symptoms.

Clinical correlates of tobacco smoking in OCD: A UK, case-controlled, exploratory analysis

Background Obsessive-compulsive disorder (OCD) is a biologically heterogeneous neuropsychiatric disorder. It is associated with impulsive as well as compulsive neurocognitive mechanisms. Cigarette smoking is common among most psychiatric patients; however, OCD patients are thought to show reduced rates. OCD smokers may thus represent a relatively uncommon OCD subtype, characterised by increased impulsivity. In this study, we aim to establish the prevalence of smoking in a large, well-defined OCD cohort. We investigate whether smokers with OCD differ from non-smokers with OCD on clinical measures of behavioural impulsivity and domains of personality and temperament, including reward-dependence and novelty-seeking. Method 183 of 200 outpatients with DSM-IV OCD were interviewed to determine smoking status. A sub-sample of 10 smokers was compared with 10 non-smokers, pair wise matched for age and gender. Patients were assessed for DSM co-morbidity, symptom profile, OCD severity, behavioural impulsivity and personality dimensions. Results Only 10 individuals (5.46%; five males) were smokers. Compared to OCD non-smokers, OCD smokers scored significantly higher on the Barratt Impulsiveness Scale (p < 0.001). They also scored significantly higher on TCI measures of novelty seeking (p < 0.001) and reward dependence (p < 0.001) and significantly lower on measures of harm avoidance (p < 0.001). Conclusions Tobacco smoking is rare in OCD. Significantly higher levels of behavioural impulsivity and temperamental factors associated with reward driven impulsivity are seen in OCD smokers compared to non-smokers. Tobacco smoking may indicate a possible source of neurocognitive heterogeneity in OCD.

Relations between childhood traumatic experiences, dissociation, and cognitive models in obsessive compulsive disorder

OBJECTIVE

Previous studies have indicated that obsessive compulsive disorder (OCD) is associated with childhood traumatic experiences and higher levels of dissociation. Dissociative tendency may arise when individual attempt to incorporate adverse experiences into cognitive schema.

METHODS

We investigated the possible links among childhood trauma, dissociation, and cognitive processes. We evaluated 95 patients with OCD using the Beck Depression Inventory (BDI), Thought-Action Fusion Scale (TAFS), Metacognitions Questionnaire (MCQ-30), White Bear Suppression Inventory (WBSI), Dissociative Experiences Scale (DES), and Childhood Trauma Questionnaire (CTQ-28).

RESULTS

The CTQ-28 total scores were not associated with Y-BOCS total, Y-BOCS insight, BDI, TAFS, MCQ-30, and WBSI scores. The TAFS Total, MCQ-30, WBSI, and BDI scores were significantly associated with DES scores. Regression analysis revealed that MCQ-30 and WBSI scores significantly predicted the DES scores.

CONCLUSIONS

These results suggest that in spite of pathological connotation of dissociative experiences, dissociation may primarily constitute a cognitive trait which is strongly associated with cognitive processes.

A meta-analysis of temperament in axis I psychiatric disorders

This article reports on a meta-analysis of Cloninger's temperament dimensions (novelty seeking, harm avoidance, reward dependence, and persistence) in individuals with lifetime psychiatric disorders compared with controls and on interdisorder comparisons between these disorders. Nine disorders from 75 studies were included in the meta-analyses. The most consistent feature was elevated harm avoidance: compared with the controls, harm avoidance was higher in all diagnostic groups studied except for those with alcohol use disorders. The increase in effect sizes in harm avoidance scores varied from a very large (d = 2.66) in social phobia to a small effect (effect size, d = 0.29) in alcohol use disorders. In other dimensions, differences between cases and controls were relatively small. However, in pairwise comparisons, notable differences also in other dimensions emerged: in novelty seeking, the lowest scores were in social phobia (d = -0.87) and the highest in bulimia nervosa (d = 0.33); in reward dependence, the lowest scores were in schizophrenia (d = -0.36) and the highest in social phobia (d = 0.12); and in persistence, the lowest scores were in social phobia (d = -0.30) and the highest in anorexia nervosa (d = 0.49). The provided data should be taken into account in the future studies on suggestive vulnerability markers for psychiatric morbidity.

Childhood trauma in obsessive compulsive disorder: the roles of alexithymia and attachment

OBJECTIVE

The aim of this study was to investigate the interrelationships between childhood trauma, attachment, alexithymia, and the severity of obsessive compulsive disorder (OCD) in a cohort of participants with OCD.

RATIONALE

There is a growing body of research linking traumatic experiences in childhood with the development of OCD. The mechanisms involved in this association are not yet clear.

METHODS

The sample was comprised of 82 people with OCD and 92 comparison participants. A cross-sectional design was used, utilizing internet-mediated administration of the Childhood Trauma Questionnaire - revised (CTQ-R); the Yale-Brown Obsessive Compulsive Scale - Self-Report (Y-BOCS-SR); the Experiences in Close Relationships Scale (ECR); and Toronto Alexithymia Scale (TAS-20). Partial least squares (PLS) analysis was used to determine significant paths between the constructs.

RESULTS

Results of PLS analysis supported all of the hypotheses made: there was a significant positive correlation between childhood trauma and attachment avoidance, which in turn was significantly positively associated with alexithymia. Alexithymia was significantly associated with the severity of OCD symptoms and the number of OCD symptoms. Mediational analysis showed that alexithymia significantly carried an influence from attachment avoidance to the severity of obsessions and the number of obsession symptoms.

CONCLUSIONS

There is a relationship between childhood trauma and OCD, however this relationship is not direct in nature but is influenced by peoples' past experiences with significant others and associated difficulties in emotional processing.

Personality traits in bipolar disorder type I: a sib-pair analysis

OBJECTIVE

The aim of this study was to compare temperament and character traits among patients with bipolar disorder (BD), their siblings, and healthy controls (HCs) in order to examine whether personality traits are related to the genetic vulnerability to develop BD.

METHODS

Using the Temperament and Character Inventory, we assessed 204 subjects: 67 euthymic outpatients with bipolar disorder type I, 67 siblings without BD, and 70 HCs.

RESULTS

Scores on harm avoidance, novelty seeking, and self-transcendence were significantly higher among patients with BD than among HCs, whereas those on self-directedness and cooperativeness were significantly lower. Siblings showed higher scores on harm avoidance and lower scores on self-directedness than did HCs. As some of the siblings presented at least one lifetime psychiatric disorder other than BD (n = 35), we examined the subset of siblings who had no lifetime psychiatric disorder (n = 32). This group showed statistically higher harm avoidance scores than HCs.

CONCLUSIONS

Our results suggest that the harm avoidance temperament trait and, to a lesser extent, the self-directedness character trait may represent vulnerability factors for BD.

Promotion of Well-Being in Person-Centered Mental Health Care

An understanding of the mechanisms of personality development provides a systematic way to promote health as an integrated state of physical, mental, social, and spiritual well-being. Individual differences in personality are causal antecedents of the full range of psychopathology. The maturation with integration of personality appears to be an important mechanism by which diverse modalities of treatment promote wellness and reduce illness. First, the authors review the relationship between personality and a wide range of psychiatric disorders. Second, the authors evaluate the impact of character structure on a wide range of measures of well-being, including positive emotions, negative emotions, life satisfaction, perceived social support, and perceived health. Third, the authors describe a practical and inexpensive clinical method for facilitating the maturation and integration of personality based on an understanding of the processes of human thought, which underlie changes in personality and well-being.

Overview of genetics and obsessive-compulsive disorder

This paper reviews the current state of research into the genetics of obsessive-compulsive disorder (OCD). Heredity has a major role in OCD etiology. This evidence comes from several methodological approaches such as family, twin, and segregation analysis studies. A major single gene effect as well as a polygenic hypothesis has been suggested based on segregation studies. In addition, candidate gene association and linkage analyses have shown not only one gene, but a few interesting genes and areas of the genome that may be relevant in OCD. In this search for genes, new definitions of the OCD phenotype have emerged, and some of them may be considered intermediate phenotypes between the gene effect and OCD-DSM-IV diagnosis. The phenotypic and genetic heterogeneity of OCD magnifies the challenge of locating susceptibility genes; at the same time, the identification of vulnerability genes will elucidate the identification of subtypes or dimensions of the disorder. Therefore research strategies that take advantage of clinical subtyping and that redefine the OCD phenotype in the context of genetic studies may potentially contribute to the nosology of OCD and ultimately pathophysiology. There is a lack of understanding about how genes and environment interact in OCD. However, there are some reports that will be discussed, which have attempted to evaluate how the environment contributes to OCD.

Temperament and character in subjects with obsessive-compulsive disorder

BACKGROUND

The aims of this study were to evaluate the differences between personality traits of patients with obsessive-compulsive disorder (OCD) and normal controls using the Temperament and Character Inventory (TCI) and to examine the relationship of personality traits and the severity of obsessive-compulsive (OC) symptoms. We also aimed to examine the influence a particular personality trait might have on the 5 factor-analyzed symptom dimension scores of OCD.

METHOD

We recruited 130 patients with OCD and 185 age- and sex-matched normal controls. All subjects completed the TCI. Patients with OCD were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Depression Rating Scale, and the factor-analyzed symptom dimension scores from the Y-BOCS checklist.

RESULTS

Patients with OCD had higher harm avoidance scores and lower self-directedness (SD), reward dependence (RD), and cooperativeness (C) scores than the controls. Lower SD scores and lower C scores were associated with OC symptom severity measured by the Y-BOCS after adjusting for age and depression severity. Hoarding dimension of OC symptoms was associated with lower SD scores and higher persistence (P) scores after adjusting for age, OC symptom severity, and depression severity.

CONCLUSIONS

There were significant differences in TCI subscales between patients with OCD and controls. Particular personality traits may have an influence on the severity and the dimensions of OC symptoms.

Personality traits and treatment outcome in obsessive-compulsive disorder

OBJECTIVE

Comorbidity with personality disorders in obsessive-compulsive patients has been widely reported. About 40% of obsessive-compulsive patients do not respond to first line treatments. Nevertheless, there are no direct comparisons of personality traits between treatment-responsive and non-responsive patients. This study investigates differences in personality traits based on Cloninger's Temperament and Character Inventory scores between two groups of obsessive-compulsive patients classified according to treatment outcome: responders and non-responders.

METHOD

Forty-four responsive and forty-five non-responsive obsessive-compulsive patients were selected. Subjects were considered treatment-responsive (responder group) if, after having received treatment with any conventional therapy, they had presented at least a 40% decrease in the initial Yale-Brown Obsessive Compulsive Scale score, had rated "better" or "much better" on the Clinical Global Impressions scale; and had maintained improvement for at least one year. Non-responders were patients who did not achieve at least a 25% reduction in Yale-Brown Obsessive Compulsive Scale scores and had less than minimal improvement on the Clinical Global Impressions scale after having received treatment with at least three selective serotonin reuptake inhibitors (including clomipramine), and at least 20 hours of cognitive behavioral therapy. Personality traits were assessed using Temperament and Character Inventory.

RESULTS

Non-responders scored lower in self-directedness and showed a trend to score higher in persistence than responders did.

CONCLUSION

This study suggests that personality traits, especially self-directedness, are associated with poor treatment response in obsessive-compulsive patients.

Alexithymia, temperament and character as predictors of psychopathology in patients with major depression

The study investigated the capacity of alexithymic personality features, in combination with temperament and character traits, age and gender, to predict psychopathological symptoms in patients with major depression. Consecutive patients (n=339) were investigated using the Toronto Alexithymia Scale-20 (TAS-20), the Temperament and Character Inventory (TCI), the Symptom Checklist-90-R (SCL-90-R), and the Hamilton Depression and Anxiety Rating Scales (HDRS, HARS). The amount of variance in SCL-90-R subscales and Hamilton scales predicted by TAS-20, TCI, age and gender was calculated by linear regression analyses. The 'difficulties identifying feeling' facet of alexithymia appeared to be a significant predictor of all dimensions of psychopathology. Among TCI scales harm avoidance was the strongest predictor for somatization, phobic anxiety, and anxiety (SCL-90-R, HARS); low self-directedness was the strongest predictor for obsessionality, depression (SCL-90-R, HDRS), interpersonal sensitivity and psychoticism; and low cooperativeness was the strongest predictor for hostility and paranoia. In conclusion, many psychopathological symptoms in major depression are associated with difficulties in the identification of emotions. Relative to alexithymia, Cloninger's psychobiological model of personality could predict psychopathological symptoms in a distinct and meaningful manner. The TAS-20 and the TCI are useful questionnaires for a better understanding of the relationship between psychopathology and personality in major depression.

History of trauma and dissociative symptoms among patients with obsessive-compulsive disorder and social anxiety disorder

We aimed to compare the history of trauma and the profile and severity of dissociative symptoms of patients with obsessive-compulsive disorder (OCD) to those of patients with social anxiety disorder (SAD). Patients with OCD (n = 34) and patients with SAD (n = 30) were examined with the following instruments: Trauma History Questionnaire (THQ), Dissociative Experience Scale (DES), Obsessive-Compulsive Inventory (OCI), Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Patients with OCD reported significantly lower rates of exposure to traumatic events. Nevertheless, the severity of dissociative symptoms was not significantly different between the groups. Regression analyses showed that, while the OCI scores better predicted the variance on DES scores in the OCD sample, the LSAS and the BAI better predicted the variance on the DES among patients with SAD. Patients with OCD are probably less vulnerable to some types of traumatic experiences. Dissociative symptoms may cut across different anxiety disorders.