Caitlin Pinciotti, PhD
@cmpinciotti.bsky.social
Clinical psychologist and researcher at Baylor College of Medicine. OCD, trauma, and LGBTQIA+ mental healthcare. Views my own. She/her.
www.cmpinciotti.com
www.cmpinciotti.com
…this Friday at 1pm Eastern! If you’re not sure how you’d answer the above question, register now for this 1hr, *free* CE talk at cme.sheppardpratt.org/content/co-o... /2
Co-Occurring OCD and PTSD: Implications for Assessment and Treatment | Sheppard Pratt
Trauma and PTSD are highly prevalent among individuals with OCD, yet remain underassessed and undertreated in specialty care programs. There are a myriad ways that trauma and PTSD can intersect with O...
cme.sheppardpratt.org
August 12, 2026 at 1:24 PM
…this Friday at 1pm Eastern! If you’re not sure how you’d answer the above question, register now for this 1hr, *free* CE talk at cme.sheppardpratt.org/content/co-o... /2
disseminate this study far and wide so we could recruit a large enough sample to ask the questions so many of us in this field have wondered but have never had the data to answer. Check out the full paper at www.sciencedirect.com/science/arti... and follow along for more in the future 🇺🇸 10/
https://sciencedirect.com/science/articl…
August 4, 2026 at 3:05 PM
disseminate this study far and wide so we could recruit a large enough sample to ask the questions so many of us in this field have wondered but have never had the data to answer. Check out the full paper at www.sciencedirect.com/science/arti... and follow along for more in the future 🇺🇸 10/
..fears of downward mobility and financial instability in a region characterized by economic inequality, emphasis on self-reliance, and weaker social safety nets. There is so much more to come from this work, and I want to thank the countless people who worked so hard to 9/
August 4, 2026 at 3:05 PM
..fears of downward mobility and financial instability in a region characterized by economic inequality, emphasis on self-reliance, and weaker social safety nets. There is so much more to come from this work, and I want to thank the countless people who worked so hard to 9/
..illness and psychological vulnerability where rigid social hierarchies & weaker public institutions are common (DS), and, conversely, greater pluralism and community orientation (ML). Finally, poverty obsessions were 70% more prevalent in the Deep South, perhaps reflecting 8/
August 4, 2026 at 3:05 PM
..illness and psychological vulnerability where rigid social hierarchies & weaker public institutions are common (DS), and, conversely, greater pluralism and community orientation (ML). Finally, poverty obsessions were 70% more prevalent in the Deep South, perhaps reflecting 8/
..values of financial security and social status, making aging less threatening. Disability/diagnostic status obsessions were 33% less prevalent in the Midlands, 31% less prevalent in Tidewater, and 38% more prevalent in the Deep South, perhaps reflecting stigma surrounding 7/
August 4, 2026 at 3:05 PM
..values of financial security and social status, making aging less threatening. Disability/diagnostic status obsessions were 33% less prevalent in the Midlands, 31% less prevalent in Tidewater, and 38% more prevalent in the Deep South, perhaps reflecting stigma surrounding 7/
Racism and aging obsessions showed weaker effects, with no region demonstrating moderate or greater differences in racism obsessions and only New Netherland showing a 32% decrease in aging obsessions - perhaps reflecting the ubiquitousness of these themes and the stronger NN 6/..
August 4, 2026 at 3:05 PM
Racism and aging obsessions showed weaker effects, with no region demonstrating moderate or greater differences in racism obsessions and only New Netherland showing a 32% decrease in aging obsessions - perhaps reflecting the ubiquitousness of these themes and the stronger NN 6/..
..and diverse yet unassimilated communities exposing individuals to a wide range of attitudes toward sexual orientation expression (NN). Gender identity obsessions were 76% less prevalent in New France, perhaps again reflecting the permissive attitude toward diversity in NF. 5/
August 4, 2026 at 3:05 PM
..and diverse yet unassimilated communities exposing individuals to a wide range of attitudes toward sexual orientation expression (NN). Gender identity obsessions were 76% less prevalent in New France, perhaps again reflecting the permissive attitude toward diversity in NF. 5/
Sexual orientation obsessions were 61% less prevalent in New France, 33% less prevalent in the Left Coast, and 45% more prevalent in New Netherland - perhaps reflecting norms of individual self-expression within socially integrated communities with low identity stigma (NF & LC)4/
August 4, 2026 at 3:05 PM
Sexual orientation obsessions were 61% less prevalent in New France, 33% less prevalent in the Left Coast, and 45% more prevalent in New Netherland - perhaps reflecting norms of individual self-expression within socially integrated communities with low identity stigma (NF & LC)4/
sexual orientation, gender identity, racism, aging, disability/diagnostic status, and poverty) were more or less likely in different regions based on those regions’ sociocultural and political identities. We found regional differences, but not always in the expected direction. 3/
August 4, 2026 at 3:05 PM
sexual orientation, gender identity, racism, aging, disability/diagnostic status, and poverty) were more or less likely in different regions based on those regions’ sociocultural and political identities. We found regional differences, but not always in the expected direction. 3/
This large scale, geographically representative study is rooted in the sociocultural framework developed by @colinwoodard.bsky.social differentiating 11 culturally distinct regions of the U.S. In this first paper, we wanted to see whether identity-based presentations (obsessions about 2/
August 4, 2026 at 3:05 PM
This large scale, geographically representative study is rooted in the sociocultural framework developed by @colinwoodard.bsky.social differentiating 11 culturally distinct regions of the U.S. In this first paper, we wanted to see whether identity-based presentations (obsessions about 2/
Future research should validate our proposed benchmarks with separate measures of impairment, but this represents an exciting first step in offering severity descriptors for the CAPS. The first 50 link clicks get free access: www.tandfonline.com/eprint/RXZAX... /4
Psychometric Evaluation of the English Clinician-Administered PTSD Scale for DSM-5–Child and Adolescent Version (CAPS-CA-5)
Despite its widespread use for diagnosing and assessing the severity of posttraumatic stress disorder (PTSD) among youth, psychometric evaluation of the Clinician-Administered PTSD Scale for Childr...
urldefense.com
July 20, 2026 at 9:24 PM
Future research should validate our proposed benchmarks with separate measures of impairment, but this represents an exciting first step in offering severity descriptors for the CAPS. The first 50 link clicks get free access: www.tandfonline.com/eprint/RXZAX... /4
.. to create severity/impairment benchmarks to assist with clinical interpretation of total CAPS-CA-5 scores. This is the first of any attempt to do so with any version of the CAPS. Our benchmarks varied by sex and age, though there was more overlap in benchmarks for males. /3
July 20, 2026 at 9:24 PM
.. to create severity/impairment benchmarks to assist with clinical interpretation of total CAPS-CA-5 scores. This is the first of any attempt to do so with any version of the CAPS. Our benchmarks varied by sex and age, though there was more overlap in benchmarks for males. /3
.. youth and young adults aged 8-20 across Texas. As expected, we found support for internal consistency, test-retest reliability, convergent & discriminant validity. Agreement on PTSD diagnosis with the MINI-KID was moderate (k=.56). Most exciting, however, was our attempt /2
July 20, 2026 at 9:24 PM
.. youth and young adults aged 8-20 across Texas. As expected, we found support for internal consistency, test-retest reliability, convergent & discriminant validity. Agreement on PTSD diagnosis with the MINI-KID was moderate (k=.56). Most exciting, however, was our attempt /2
I am so grateful for the push to really sit down and think through this proposed framework. I hope this work inspires more research to better understand why compulsions emerge and persist after trauma. Paper available for free for 50 days at www.sciencedirect.com/science/arti... /9.
“Shielding and Healing”: A Functional Framework for Conceptualizing Trauma-Related Compulsions in Obsessive-Compulsive Disorder
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www.sciencedirect.com
June 17, 2026 at 9:03 PM
I am so grateful for the push to really sit down and think through this proposed framework. I hope this work inspires more research to better understand why compulsions emerge and persist after trauma. Paper available for free for 50 days at www.sciencedirect.com/science/arti... /9.
..and differential diagnostic assessment via “Finding the Seam” between these trauma- and OCD-related pathways to inform a split-response prevention approach where OCD processes are resisted while trauma processes are gently processed and cognitively restructured. /8
June 17, 2026 at 9:03 PM
..and differential diagnostic assessment via “Finding the Seam” between these trauma- and OCD-related pathways to inform a split-response prevention approach where OCD processes are resisted while trauma processes are gently processed and cognitively restructured. /8
..safety and certainty through harm prevention (“shielding”) and regulation of trauma responses (“healing”). I review a variety of harm prevention, certainty seeking, emotion regulation, and moral absolution compulsions and end with clinical guidance for thorough functional /7
June 17, 2026 at 9:03 PM
..safety and certainty through harm prevention (“shielding”) and regulation of trauma responses (“healing”). I review a variety of harm prevention, certainty seeking, emotion regulation, and moral absolution compulsions and end with clinical guidance for thorough functional /7
..through negative reinforcement of short-term relief offered by compulsions and neural systems biased toward habit formation - one learns they are “certainly safe” and “safely certain” because of their compulsions! Thus, trauma-related compulsions represent efforts to achieve /6
June 17, 2026 at 9:03 PM
..through negative reinforcement of short-term relief offered by compulsions and neural systems biased toward habit formation - one learns they are “certainly safe” and “safely certain” because of their compulsions! Thus, trauma-related compulsions represent efforts to achieve /6
..distress and mitigate perceived threat and doubt then become compulsive through hyperactive CSTC circuitry creating a positive feedback loop of urges to ritualize strengthened by habitual responding, thereby increasing future urges. Altogether, fear and doubt persist.. /5
June 17, 2026 at 9:03 PM
..distress and mitigate perceived threat and doubt then become compulsive through hyperactive CSTC circuitry creating a positive feedback loop of urges to ritualize strengthened by habitual responding, thereby increasing future urges. Altogether, fear and doubt persist.. /5
..and errors where none exist. Trauma-related memory disturbance is further amplified by OCD-related executive dysfunction and impairments in visuospatial and nonverbal memory, increasing mistrust in memory and driving urgent efforts to obtain certainty. Attempts to regulate../4
June 17, 2026 at 9:03 PM
..and errors where none exist. Trauma-related memory disturbance is further amplified by OCD-related executive dysfunction and impairments in visuospatial and nonverbal memory, increasing mistrust in memory and driving urgent efforts to obtain certainty. Attempts to regulate../4
Threat endures both because of these trauma processes and also through OCD-related threat overestimation and inflated responsibility, impaired fear extinction learning, and hyperactive fear circuitry and performance and error monitoring that trigger excessive signals for harm…/3
June 17, 2026 at 9:03 PM
Threat endures both because of these trauma processes and also through OCD-related threat overestimation and inflated responsibility, impaired fear extinction learning, and hyperactive fear circuitry and performance and error monitoring that trigger excessive signals for harm…/3
Borrowing from Ehlers and Clark’s seminal cognitive model of PTSD, I propose that OCD-specific neurobiological and genetic vulnerabilities are activated by trauma exposure and compound trauma-related enduring threat caused by negative appraisals and memory disturbance. /2
June 17, 2026 at 9:03 PM
Borrowing from Ehlers and Clark’s seminal cognitive model of PTSD, I propose that OCD-specific neurobiological and genetic vulnerabilities are activated by trauma exposure and compound trauma-related enduring threat caused by negative appraisals and memory disturbance. /2