A Systematic Review of Public Stigma Attributes and Obsessive-Compulsive Disorder Symptom Subtypes

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.