The effects of race and racial priming on self-report of contamination anxiety

Abstract

African Americans show unusually high endorsement rates on self-report measures of contamination anxiety. The purpose of this study was to replicate this finding in a nationally representative sample and conduct a randomized experiment to determine the effect of salience of race as a causal factor. Black and White participants were given contamination items from two popular measures of obsessive-compulsive disorder, half prior to being primed about ethnic identity and half after being primed, via the administration of an ethnic identity measure. The experiment took the form of a 2 (Black and White participant) X 2 (ethnicity salient and ethnicity non-salient) double-blind design, with ethnic saliency assigned at random by computer. Participants consisted of a geographically representative US sample of African Americans supplemented with a similar sample of European Americans (N=258). Black participants scored significantly higher than White participants on contamination scales. Participants from Southern states scored higher than those from other regions. Over-endorsements by Black participants were greater when awareness of ethnic and racial identification was increased. Clinical and research implications were discussed; these measures should be used with caution in African Americans.

Phenomenology and treatment outcomes in children and adolescents from ethnic minorities with obsessive–compulsive disorder

“…Contrary to some previous studies carried out in adults (Himle et al, 2008;Williams et al, 2005Williams et al, , 2008, our White and non-White samples did not differ substantially in their clinical presentation. Specifically, our minority children and adolescents did not display a later age of onset of the OCD and did not endorse more contamination concerns, as reported previously in African American and Asian American samples (Himle et al, 2008;Wheaton et al, 2013;Williams et al, 2005Williams et al, , 2008. Only three individual symptoms from the C-YBOCS-SC showed borderline significant between-group differences, and, of those, only the fear of not saying the right thing tended to be more prevalent among the non-White group.…”

“…Interestingly, this symptom was also found to be elevated in an adult sample of African Americans with OCD in the study by Williams, Elstein, Buckner, Abelson, and Himle (2012). The authors of that study suggested that the obsessive need to be perfectly understood could be connected to minority status; according to the authors, African Americans may exhibit fears of appearing unintelligent, resulting in stereotype compensation -an intentional effort to present one's self in a counter-stereotypical manner (Williams et al, 2008;Williams, Elstein, et al, 2012). It may be that certain, but not all, ethnic groups (e.g., African Americans) may differ in some respects.…”

“…Specifically, it has been reported that Black Americans may have a later age of onset (31.8 years vs. 19.5 years in the general population; Himle et al, 2008) and a different clinical presentation of the symptoms, such as greater contamination concerns (Wheaton, Berman, Fabricant, & Abramowitz, 2013;Williams, Abramowitz, & Olatunji, 2012;Williams, Turkheimer, Magee, & Guterbock, 2008;Williams, Turkheimer, Schmidt, & Oltmanns, 2005). Furthermore, it has been suggested that patients from ethnic minorities (mostly individuals from African-American backgrounds) with the most severe form of the disorder, especially those with uncommon symptoms, may be misdiagnosed as psychotic (Hollander & Cohen, 1994;Ninan & Shelton, 1993).…”

The relationship between contamination cognitions, anxiety, and disgust in two ethnic groups

“…For example, Williams, Turkheimer, Schmidt, and Oltmanns (2005) studied a large internet sample using the Padua Inventory (Sanavio, 1988), another self-report measure of OCD symptoms, and found a similar pattern of high African American endorsement of contamination items: non-clinical African American participants scored as highly as participants reporting a diagnosis of OCD. Extension of this research suggests that these differences are partially explained by cultural factors, including geography and whether the participants were primed with information that triggered thoughts about their ethnic identity before contamination measures were administered (Williams, Turkheimer, Magee, & Guterbock, 2008). Similarly, Williams and Turkheimer (2007) found that ethnic differences in contamination anxiety reflected varied cultural attitudes toward grooming and housekeeping as opposed to actual differences in the severity of psychopathology.…”

Anxiety psychopathology in African American adults: Literature review and development of an empirically informed sociocultural model.

“…R. Johnson et al, 2007;Monnier et al, 2002;Scott et al, 2002;M. T. Williams & Turkheimer, 2007;M. T. Williams et al, 2008), and treatment outcome (M. M. Carter et al, 2003;Friedman et al, 2003;Zoellner et al, 1999).…”