Abstract
Individuals with obsessive-compulsive disorder often identify psychosocial stress as a factor that exacerbates their symptoms, and many trace the onset of symptoms to a stressful period of life or a discrete traumatic incident. However, the pathophysiological relationship between stress and obsessive-compulsive disorder remains poorly characterized: it is unclear whether trauma or stress is an independent cause of obsessive-compulsive disorder symptoms, a triggering factor that interacts with a preexisting diathesis, or simply a nonspecific factor that can exacerbate obsessive-compulsive disorder along with other aspects of psychiatric symptomatology. Nonetheless, preclinical research has demonstrated that stress has conspicuous effects on corticostriatal and limbic circuitry. Specifically, stress can lead to neuronal atrophy in frontal cortices (particularly the medial prefrontal cortex), the dorsomedial striatum (caudate), and the hippocampus. Stress can also result in neuronal hypertrophy in the dorsolateral striatum (putamen) and amygdala. These neurobiological effects mirror reported neural abnormalities in obsessive-compulsive disorder and may contribute to an imbalance between goal-directed and habitual behavior, an imbalance that is implicated in the pathogenesis and expression of obsessive-compulsive disorder symptomatology. The modulation of corticostriatal and limbic circuits by stress and the resultant imbalance between habit and goal-directed learning and behavior offers a framework for investigating how stress may exacerbate or trigger obsessive-compulsive disorder symptomatology.
Document Type
Review
Publication Date
3-4-2018
Digital Object Identifier (DOI)
https://doi.org/10.1177/2470547018758043
Funding Information
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The primary author was supported by NIMH awards 1K23MH111977 and 1L30MH111037.
Repository Citation
Adams, Thomas G.; Kelmendi, Benjamin; Brake, C. Alex; Gruner, Patricia; Badour, Christal L.; and Pittenger, Christopher, "The Role of Stress in the Pathogenesis and Maintenance of Obsessive-Compulsive Disorder" (2018). Psychology Faculty Publications. 145.
https://uknowledge.uky.edu/psychology_facpub/145
Included in
Behavior and Behavior Mechanisms Commons, Disorders of Environmental Origin Commons, Psychology Commons
Notes/Citation Information
Published in Chronic Stress, v. 2, p. 1-11.
© The Author(s) 2018
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).