OCD Taboo Thoughts and Stigmatizing Attitudes in Clinicians

Steinberg, Daniel S.; Wetterneck, Chad T.

doi:10.1007/s10597-016-0055-x

Cited by 20 publications

(19 citation statements)

References 19 publications

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“…The studies conducted by Simonds and Thorpe (2003) and Cathey and Wetterneck (2013) unintentionally oversampled women undergraduate students and aimed to generalize conclusions to the lay public broadly. Alternatively, although other studies appeared to oversample women (Samari et al, 2018;Steinberg & Wetterneck, 2017), considerations about their population of interest (i.e., nursing students and clinical psychologists/graduate students) revealed appropriate sample characteristics to generalize conclusions.…”

Section: Methodological Evaluationsmentioning

confidence: 98%

A systematic review of public stigma attributes and obsessive–compulsive disorder symptom subtypes.

Ponzini¹,

Steinman²

2022

Stigma and Health

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Public stigma has significant, negative implications for those with obsessive-compulsive disorder (OCD). Yet, OCD symptoms and public stigma are multidimensional; individuals with different symptom presentations may encounter distinct attributes of public stigma. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the present systematic review aimed to elucidate the public stigma attributes associated with OCD symptom subtypes to direct future stigma interventions. Ten studies with 5,806 participants from 4 countries were identified. Studies reported on public stigma attributes (e.g., desire for social distance and perceived dangerousness) related to obsessions (harm/aggression, sexual, contamination, symmetry/just right, and scrupulosity) and compulsions (washing/cleaning and checking) presented via vignettes. Compared to other OCD symptom subtypes, harm/ aggression and sexual OCD were most associated with a desire for social distance. Harm/aggression was also associated with greater perceived dangerousness than symmetry/just right OCD. No conclusions can be drawn about the magnitude or public stigma attributes associated with other subtypes or disorders. The findings from this systematic review indicate harm/aggression and sexual OCD symptom subtypes may benefit from contact-based stigma-reduction programs. Conclusions are limited by the lack of assessments of anxiety-specific public stigma (e.g., personal weakness and histrionic tendencies) and focus on vignette studies. Future research should evaluate public stigma utilizing measures that mitigate social desirability, and assess the intersectionality between vignette characters' obsessional content, sociodemographic characteristics, and public stigma attributes.

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Section: Methodological Evaluationsmentioning

confidence: 98%

A systematic review of public stigma attributes and obsessive–compulsive disorder symptom subtypes.

Ponzini¹,

Steinman²

2022

Stigma and Health

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“…A differential diagnosis should be primarily made with pedophilia: the sexual arousal derived from recurrent fantasies, sexual urges or behaviours involving prepubescent children, that could, or not, involve the sexual abuse of children. 2 There are clinical distinctions between these entities [11][12][13][14] : the first is the ego-dystonic and marked suffering in patients with P-OCD, contrary to most pedophiles that present pleasure when imagining sexual acts with children. Besides, they enjoy being near children and experience sexual gratification when engaging in grooming activities.…”

Section: Discussionmentioning

confidence: 99%

“…15 Likewise, individuals with obsessive thoughts from different symptom dimensions might avoid the disclosure of sexual obsessions, even after disclosing other types of intrusive thoughts, because they are perceived as less acceptable: Cathey (2013) found that the disclosure of an intrusive thought relating to a sexual theme was associated with more social rejection than the disclosure of a contamination-related intrusive thought. 3 Thus, it is important that healthcare providers normalise these types of concerns when interviewing OCD patients: Steinberg, 14 in a study about stigmatising attitudes in clinicians, found that, when engaging with professionals with cognitive-behavioural backgrounds, participants were more likely to socially reject or be concerned about individuals with obsessions related with contamination, harming, and sexual obsessions than those with scrupulous obsessions, and that they would be less likely to reveal sexual obsessions to others if they were experiencing those rather than the other three types of obsessions.…”

Section: Discussionmentioning

confidence: 99%

Clinical Challenges in Pedophilia-Themed Obsessive-Compulsive Disorder

Ferreira

Pombo

et al. 2021

Acta Med Port

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In obsessive-compulsive disorder, pedophilia-themed obsessions-distressing intrusive thoughts about being sexually attracted to, or sexually abusing, children-are the most distressing for patients and the most misdiagnosed among healthcare professionals. Our aim is to present a case report highlighting the role stigma plays in delaying treatment, the clinical challenges in the diagnosis, and in the treatment of pedophilia-themed obsessive-compulsive disorder, in order to address the lack of literature on the subject. The case concerns a 33-year-old man with suicidal thoughts associated with the unbearable suffering caused by pedophilia-themed obsessions he had been having over the previous decade, without ever asking for help. This situation was highly disabling, leaving him mostly isolated in his bedroom. After the differential diagnosis was made, a treatment plan combining pharmacological and cognitive-behavioural therapy was implemented. After 18 months he showed a degree of remission that made it possible for him to apply for a job.

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“…Willingness‐to‐treat ratings were high overall, though willingness was lower for weapons‐related exposures, and for sexual exposures in youth. The lack of SNC and relatively high willingness‐to‐treat ratings are encouraging as unacceptable thought OCD symptoms are common (Fernández de la Cruz et al, 2013; Williams et al, 2011) and have been associated with greater stigma by therapists (Steinberg & Wetterneck, 2017).…”

Section: Discussionmentioning

confidence: 99%

Serious negative consequences associated with exposure and response prevention for obsessive‐compulsive disorder: A survey of therapist attitudes and experiences

et al. 2020

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Objective: Many therapists are reluctant to conduct exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD). Negative beliefs about the safety and tolerability of ERP are common, especially for harm-related OCD symptoms. The study examined the nature and frequency of ERP-related serious negative consequences (SNC) and therapist attitudes and experiences providing ERP for harm-related OCD. Methods: An anonymous survey was completed by 277 therapists with experience treating OCD using ERP. Questions assessed clinical experiences of harm-related exposures, the nature of SNC, and concerns and clinical considerations regarding ERP.Results: Therapist's willingness to treat harm-related OCD was high. SNCs were reported for 6 clients (per-client risk: adults 0.05%, youth 0.01%) and 13 therapists (per therapist risk 4.73%, therapist per-year risk 0.004%). Qualitative analysis identified themes relating to the conduct of treatment, specific exposure types, professional issues, and negative perceptions of ERP.Conclusion: SNC associated with ERP for OCD are rare and primarily represent unintended secondary consequences of OCD or misunderstandings regarding the process and rationale behind ERP. Improving access to ERP will require good communication with clients, families, and other professionals regarding the rationale and safety of ERP. K E Y W O R D S assessment/diagnosis, child/adolescent, cognitive behavioral therapy, dissemination/ implementation, obsessive-compulsive disorder

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OCD Taboo Thoughts and Stigmatizing Attitudes in Clinicians

Cited by 20 publications

References 19 publications

A systematic review of public stigma attributes and obsessive–compulsive disorder symptom subtypes.

A systematic review of public stigma attributes and obsessive–compulsive disorder symptom subtypes.

Clinical Challenges in Pedophilia-Themed Obsessive-Compulsive Disorder

Serious negative consequences associated with exposure and response prevention for obsessive‐compulsive disorder: A survey of therapist attitudes and experiences

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