Overcoming the forbidden: Identification and stigma of unacceptable thoughts in obsessive–compulsive disorder

Obsessive–compulsive disorder (OCD) is a heterogeneous condition, with lesser known symptom presentations not met with the same acceptance or media/educational focus as contamination or symmetry. Distressing, unwanted, and ego-dystonic thoughts with sexual, aggressive, or religious themes (unacceptable thought OCD; UT-OCD) have been found to be especially misidentified by professionals and the general public alike. The present study explores misidentification of—and stigma toward—UT-OCD through an online survey. Students ( n = 335) and community members ( n = 77) were given vignettes describing an individual with religious, aggressive, sexual (child or nonchild focused), or contamination obsessions, followed by a Diagnostic and Attribution Questionnaire. UT-OCD vignettes were significantly more likely to be misdiagnosed (59.9%) and stigmatized than those presenting with contamination OCD (27.1%). People may be less likely to offer help to those with UT-OCD and express more fear if OCD symptom content involves a perceived threat of harm toward others. These findings suggest that not all OCD symptoms are identified or perceived equally. Stigma can be reduced if OCD symptoms are correctly identified. Therefore, education and awareness campaigns should highlight the broad range of prevailing OCD symptom presentations. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Source: journal abstract)