Professional and student understanding of harm obsessive-compulsive disorder: a vignette study

Abstract

Obsessive compulsive-disorder (OCD) is characterized by obsessions and compulsions that differ significantly across patients. Lesser-known, Harm-related obsessions (i.e., fears of harming others or oneself; Harm OCD) can present in varying ways and are often misidentified – even by professionals – compared to more “prototypical” Contamination obsessions. However, research had not yet tested a vignette design specific to differing presentations of Harm OCD across a sample of professionals and students, particularly medical students. This study surveyed a sample of professionals (registered psychologists, general practitioners; n = 73), doctoral psychology students (n = 92), and medical students (n = 143), gathering diagnostic impressions and risk judgements for one of several Harm OCD vignettes (i.e., fears of harming one’s infant, of smothering one’s partner, of blurting an insult, or of completing suicide) or a social anxiety (control) vignette as compared to a Contamination OCD vignette. Harm OCD was significantly less likely to be identified (76%) than Contamination OCD (97%) through open-ended identification, and social anxiety when using ranked identification methods. Further, professionals and doctoral psychology students were significantly better able to identify Harm OCD than M.D. students, and characters with Harm OCD were perceived as more likely to harm others compared to those with Contamination OCD . The current findings support the need for accurate media representation of the varying OCD presentations, as well as improvement in OCD medical education.