Excerpt from Psychology Today - Culturally Speaking Blog written by Monnica Williams, PhD
Discrimination can create confusing symptoms in Black people with OCD.
There are many barriers people of color face when it comes to getting help for obsessive-compulsive disorder (OCD), and several are anchored in racism.
OCD is found in roughly the same proportion among all demographics. However, in North America, people of color are more likely to be misdiagnosed and undertreated for the disorder, according to a new study published in Clinical and Experimental Psychology by experts at the Houston OCD Program, the Baylor College of Medicine, the Menninger Clinic, and Harvard Mclean Hospital (Katz et al., 2020).
The researchers found that even though all ethnic and racial groups experienced equivalent average levels of severity, Black, Indigenous and other People of Color (BIPOC) with more severe anxiety symptoms were not receiving treatment at the same rates. Compared to White patients, BIPOC were much less likely to receive counseling, exposure and ritual prevention (the gold-standard treatment for OCD), or medication (not a cure but still helpful). Thus, it is clear that the gap between receiving the right diagnosis and therapy for people of color persists in mental health care, creating barriers to alleviating suffering.
Unfortunately, racism limits what we know about OCD in people of color. Racism also makes existing OCD symptoms worse, influences symptom presentation, and limits access to mental health care. Research published in the last few years is starting to show the importance of cultural considerations in understanding OCD, but the serious impact of racism is far from solved.
Racism Makes Existing OCD Symptoms Worse
Numerous studies have shown that among African Americans, Hispanic people, and members of other marginalized groups, racial discrimination is a risk factor for poorer mental and physical health overall (Lewis, Cogburn, & Williams, 2015). One way that racial discrimination can lead to poor health is through ongoing social stress, whereby chronically elevated cortisol levels worsen existing conditions and increase susceptibility to mental disorders. Stress due to discrimination may trigger dysfunctional coping behaviors, such as smoking or overeating, and cause difficulties, such as poor sleep, that directly contribute to health problems as well.
Using data from the National Survey of American Life (NSAL), our lab examined OCD symptoms in Black Americans across the U.S. and found that experiences of racial discrimination were associated with increases in nearly every OCD symptom dimension examined (Williams et al., 2017).
Among racialized groups, OCD symptoms may be influenced by negative racial stereotypes. When stereotypes and prejudices are salient, affected group members tend to decrease behaviors that might confirm the stereotypes. For example, research has found that contamination avoidance and aversion by African Americans was greater when stereotype cues (Jim Crow segregation photos) were shown to study participants (Olatunji, Tomarken, & Zhao, 2014). This suggests that greater concerns about the importance of cleanliness among Black Americans may function to compensate for negative stereotypes, which may in turn pose a barrier to the disclosure of OCD contamination symptoms to mental health professionals.
Reference: Psychology Today - Culturally Speaking Blog (2021)
Find the remainder of the article at https://www.psychologytoday.com/us/blog/culturally-speaking/202009/the-ocd-racism-connection-and-impact-people-color