Stigma and Shame as Barriers to Treatment for Obsessive-Compulsive and Related Disorders

Abstract

Limited research has examined barriers to treatment for obsessive-compulsive disorder (OCD), and no known studies have addressed barriers to treatment for trichotillomania (TTM) or skin picking disorder (SPD). Additionally, existing literature does not examine differences in barriers to treatment based on the content and severity of OCD obsessions. Previous literature has shown that shame and stigma may be an important reason for avoiding psychological treatment. This study examined the potential role of stigma and shame surrounding attitudes about treatment initiation for individuals with OCD, TTM, or SPD. Participants were recruited from study links posted on professional mental health websites. Included in the analyses were those who met diagnostic screening criteria for OCD, TTM, or SPD (n=587). Across disorders, the most frequently endorsed barrier was being “ashamed of my problems.” Ethnic minorities endorsed more stigma/shame connected with family disapproval. Individuals with OCD were significantly more likely to report a fear of involuntary hospitalization. Content and severity of OCD obsessions impacted stigma/shame barriers, as those with high levels of unacceptable/taboo thoughts were at greater risk for experiencing stigma/shame. Implications of findings are discussed.