Semester

Spring

Date of Graduation

2023

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Shari Steinman

Committee Co-Chair

Elizabeth Claydon

Committee Member

Christina Duncan

Committee Member

Christa Lilly

Committee Member

Barry Edelstein

Abstract

Public stigma has detrimental impacts on those with obsessive compulsive disorder (OCD). Yet, stereotypes associated with OCD are poorly understood. Given the heterogeneity of OCD symptom presentations, a conceptualization of stereotypes associated with symptom subtypes is warranted to inform stigma reduction efforts.

In Study 1 (N = 60), participants read one of five vignettes on OCD subtypes (Symmetry/Just Right, Contamination, Sexual, Harm/Aggression, or Scrupulous) prior to responding to Internet-delivered open-ended questions. Study 1 methods followed the qualitative description framework, such that data were derived from participant responses and findings were presented using participant language. Prior to final coding and theme evaluation, all qualitative codes were validated by a subset (n = 23) of participants (i.e., Study 1 member check). An inductive content analysis was used to allow qualitative themes to emerge from Study 1 data. These methods followed the systematic, empirical approach of the postpositivist conceptual framework.

In Study 2, (N = 698) participants completed an Internet-delivered quantitative survey in which they were randomized to read one of seven vignettes (OCD subtypes, Generalized Anxiety Disorder, Schizophrenia) prior to completing previously established stigma measures and an OCD stigma measure developed from Study 1 themes.

In Study 1, a total of fifteen themes and two subthemes emerged across conditions. Stereotypes associated with anxiety-relevant stigma (e.g., trivial symptoms, social awkwardness) most commonly emerged for Symmetry/Just Right and Contamination, while stereotypes associated with serious mental illness stigma (SMI; e.g., dangerous, disturbed) emerged for Harm/Aggression and Sexual Vignettes. The Scrupulous vignette was associated with both anxiety-relevant and SMI stereotypes. Additionally, unique themes (e.g., odd, nuisance, and withdrawn) that are not typically associated with anxiety or SMI-stigma also emerged.

For Study 2, data suggested that the Sexual and Harm/Aggression vignettes appeared to be associated with the greatest stigma across measures compared to all other vignettes. However, the Scrupulous vignette was associated with the greatest stigma on the anxiety-relevant subscale of the OCD stigma measure. Across measures, the Sexual, Harm/Aggression, and Schizophrenia vignettes demonstrated similar stigma endorsements, which were often greater than the Symmetry/Just Right, Contamination, and GAD vignettes. Like Study 1, the Scrupulous vignette was associated with both groupings; that is, of autogenous (i.e., repugnant/unacceptable thoughts; Sexual and Harm/Aggression) and reactive obsessions (i.e., thought content perceived as rational; Contamination and Symmetry/Just Right). Further, and aligned with hypotheses, prior mental health treatment and more frequent contact with symptomatic individuals were associated with lower stigma across assessments.

Across studies, results suggested that OCD stigma shares stereotypes with anxiety-relevant and SMI stigma. Though stereotypes emerged for specific OCD subtypes (e.g., withdrawn, nuisance), these do not appear to be unique to OCD (given their shared occurrence for Schizophrenia and GAD on the OCD stigma measure). In general, these studies support groupings of autogenous and reactive obsessions with regards to their SMI and anxiety-relevant stigma endorsement. However, the Scrupulous vignette appears to be strongly associated with both SMI and anxiety-relevant stigma (and thus, both autogenous and reactive groupings).

Stigma reduction interventions for OCD should focus on macro-level stereotypes (i.e., stereotypes that exist across symptom groupings, such as perceptions of blame or a social outcast). Moreover, interventions should include psychoeducation about obsessional content and be targeted to address contextual factors (e.g., sociodemographic characteristics, cultural considerations, symptom presentations) relevant to the population of interest to allow for frequent contact, and thus, stigma reduction.

Download

Share

COinS