COVID-19 and obsessive-compulsive symptoms in a large multi-site college sample

Abstract

The COVID-19 pandemic poses unique risks to college students' mental health, and specifically to symptoms of obsessive-compulsive disorder (OCD). To better understand the relationship between COVID-19 impact and OC symptoms in this population, six colleges from across the US administered a battery of questionnaires and an emotion differentiation paradigm to eligible students (N = 841). We examined whether degree of pandemic-related disruption was associated with OC severity, and if so, whether this relationship was explained by trait (poor emotion regulation and differentiation) and state risk factors (poor sleep quality, less exercise frequency, less social support, thwarted sense of belongingness, and greater loneliness). Results indicated that the positive relationship between COVID-19 impact and OC severity was mediated by trait emotion-related processes (e.g., emotion regulation and differentiation), but no state risk factors emerged as significant mediators. Our findings contribute to the literature demonstrating a significant relationship between COVID-19 impact and OC severity, and highlight that emotion regulation difficulties may help explain this association. Our findings can inform evidence-based interventions on college campuses; however, the cross-sectional design precludes causal inferences. Future research should evaluate these relationships longitudinally and incorporate other psychosocial factors that may operate as mechanisms.

Keywords: COVID-19; College; Emotion differentiation; Emotion regulation; OCD.

Fig. 1

Cross-sectional multiple mediation model examining the association between the COVID-19 Impact apprehension and social distress sub-scales and overall OC symptom severity (DOCS total scores), mediated by six potential mechanisms: thwarted belongingness, loneliness, perceived social support, difficulties in emotion regulation, sleep quality, and exercise frequency. Notes: Solid lines represent significant associations, dotted lines represent non-significant associations in the two multiple mediation models that use different COVID-19 Impact sub-scale scores as predictors. For the site effect, solid lines indicate that at least one site has a significantly different effect (p < .05) compared to the largest site (#4). Path estimates for specific models are presented in Table 2. Abbreviations: MSPSS = Multidimensional Scale of Perceived Social Support; DERS = Difficulties in Emotion Regulation Short Form; DOCS = Dimensional Obsessive-Compulsive Scale.

Fig. 2

Cross-sectional mediation model examining the association between the COVID-19 Impact apprehension or social distress sub-scales and overall OC symptom severity (DOCS total scores), mediated by negative emotion differentiation in the sub-sample with valid negative emotion differentiation scores (n = 610). Notes: Solid lines represent significant associations in at least one mediation model, dotted lines represent non-significant associations in both mediation models. For the site effect, solid lines indicate that at least one site has a significantly different effect (p < .05) compared to site 4 in at least one mediation model. Specific path estimates for each model are presented in Table 2. Abbreviation: DOCS = Dimensional Obsessive-Compulsive Scale.