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Confirmatory factor analysis was used to examine the OCD+PTSD factor structure and the optimal solution subjected to network analysis. The best fitting factor solution, consistent with Pinciotti, Horvath, and colleagues (2022), included seven PTSD factors and two OCD factors. The strongest symptom-level associations were among: a) trauma-related intrusions and avoidance and b) obsessions and compulsions. Affective symptoms (e.g., dysphoric arousal) emerged as central bridge symptoms connecting obsessions\/compulsions to trauma-related intrusions\/avoidance symptoms. Findings converge with models suggesting these disorders are functionally related, albeit distinct, conditions.<\/jats:p>","DOI":"10.1521\/bumc.2026.90.3.187","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T17:17:23Z","timestamp":1789406243000},"page":"187-220","source":"Crossref","is-referenced-by-count":0,"title":["Understanding the co-occurrence of OCD and PTSD: A network approach"],"prefix":"10.1521","volume":"90","author":[{"given":"Samantha N.","family":"Hellberg","sequence":"first","affiliation":[{"name":"The University of North Carolina Chapel Hill, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi J.","family":"Ojalehto","sequence":"additional","affiliation":[{"name":"The University of North Carolina Chapel Hill, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin M.","family":"Pinciotti","sequence":"additional","affiliation":[{"name":"The Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel Van","family":"Kirk","sequence":"additional","affiliation":[{"name":"The OCD Institute at McLean Hospital, Belmont, Massachusetts, as well as Harvard Medical School, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan S.","family":"Abramowitz","sequence":"additional","affiliation":[{"name":"The University of North Carolina Chapel Hill, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"377","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2017.09.002"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-010-0337-5"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2014.10.012"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000167"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.150.11.1737"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1080\/15622975.2016.1181783"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1080\/15622975.2016.1190867"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177\/1073191116648209"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20375"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/s43586-021-00055-w"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1037\/h0101755"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1037\/met0000471"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cobeha.2015.11.018"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2021.101999"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s10519-007-9185-9"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2019.08.018"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-017-0773-y"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1017\/S0140525X09991567"},{"key":"ref20","first-page":"18","volume":"9","author":"Cukor J.","year":"2010","journal-title":"Journal of Anxiety Disorders, 24(8)"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21924"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1002\/da.23112"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3758\/s13428-017-0862-1"},{"issue":"1","key":"ref24","first-page":"1","volume":"48","author":"Epskamp S.","year":"2012","journal-title":"Journal of Statistical Software"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1037\/met0000167"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2010.05.005"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3109\/13651501.2013.777745"},{"key":"ref28","volume-title":"Structured Clinical Interview for DSM-5 Disorders","author":"First M. 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