Childhood Trauma is associated with Theory of Mind deficits in Obsessive-Compulsive Disorder - 15/07/25

Doi : 10.1016/j.ejtd.2025.100581

Tamini Soondrum ¹, Jie Fan ^1,^2,³, Feng Gao ^1,^2,³, Xiang Wang ^1,^2,³, Qian Liu ^1,², Yao Liu ¹, Jingjie Lu ¹, Quanhao Yu ^1,², Hongyu Du ^1,², Xiongzhao Zhu ^1,^2,^3,^⁎
¹ Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
² Medical Psychological Institute of Central South University, Changsha, China
³ National Clinical Research Center for Mental Health Disorders, Changsha, Hunan, China

^⁎Corresponding author: Xiongzhao Zhu, Medical Psychological Center, the Second Xiangya Hospital, Central South University, Renmin, Middle Road 139#, Furong District, Changsha 410011, Hunan, China, Tel: +86 135 7485 2322Medical Psychological Center, the Second Xiangya HospitalCentral South UniversityRenmin, Middle Road 139#, Furong DistrictChangshaHunan410011China

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Abstract

Background

Previous studies have shown that social impairments such as Theory of Mind (ToM) may be influenced by childhood trauma (CT), however the extent to which CT influence ToM ability, and whether OCD patients with CT are more vulnerable to ToM deficits than healthy controls (HC) have never been established. Therefore, this study attempts to understand the effect of CT on ToM ability in OCD.

Methods

81 OCD patients and 108 healthy controls were included in this study. ToM deficits were assessed on four dimensions, namely first and second order affective and cognitive ToM. The effect of CT on ToM deficits was assessed using the 2*2 Analysis of Covariance (ANCOVAs) and the hierarchical regression.

Results

Simple effect analysis revealed a positive effect of CT>No CT in OCD and effect of OCD>HC in CT for both affective and cognitive second-order ToM deficits. Within the OCD group, emotional abuse was found to have an effect on affective ToM deficits (p=0.028) and sexual abuse on cognitive ToM deficits (p=0.040).

Conclusions

Only OCD patients with CT showed deficits on second order cognitive and affective ToM and emotional and sexual abuse were the most influential CT subtypes on second-order ToM deficits in OCD.

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Keywords : obsessive-compulsive disorder, childhood trauma, theory of mind, social cognition