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ViewAttendees 3

Symposia

LGBTQ+

Session: “Affectively” Understanding and Addressing Sexual and Gender Minority Mental Health Disparities: Implications from the Intersection of Emotion and Stigma Research

3 - (SYM 51) Comparing OCD Severity and Emotion Regulation Between Sexual Minority and Heterosexual Adults with OCD

Saturday, November 18, 2023
8:30 AM – 10:00 AM PST
Location: Skagit (603), Level 6

Background: Sexual minority (SM; e.g., lesbian, gay, bisexual) people are more likely to experience psychopathology compared to heterosexual people. Strikingly, SM people are nine times more likely to be diagnosed with or treated for obsessive-compulsive disorder (OCD) relative to heterosexual people. This increased rate of OCD among SM people may be attributable to their disproportionate exposure to stigma, which has been consistently associated with reduced emotion regulation (ER) processes implicated in OCD. Despite increased rates of OCD among SM people, there has been little research examining important clinical features in this population. To address this gap, we examined baseline and treatment outcome differences in measures of OCD symptom severity, ER, and distress tolerance (DT) among SM and heterosexual adults with OCD receiving exposure-based, partial hospital/residential treatment.

Methods: Participants (N=470) were adults (18+) in treatment for OCD, including 22% SM people: 6% gay or lesbian, 8% bi+ (i.e., bisexual, pansexual), 3% asexual, 2% queer, and 3% a sexual orientation that was not listed. The sample was mostly White (80%) and non-Hispanic (97%). We conducted a 2 (Group) x 2 (Time) ANOVA for each outcome, with follow up t-tests comparing groups at admission and discharge.

Results: At admission, SM (vs. heterosexual) people reported worse ER overall and in specific subdomains: difficulty implementing ER strategies perceived as effective, nonacceptance of distress, and DT. SM people also experienced marginally worse OCD severity. Despite these group differences at baseline, SM people endorsed similar levels of OCD symptom severity at discharge; however, DT and difficulty implementing ER strategies perceived as effect remained worse relative to heterosexual people at program discharge.

Conclusions: Results indicate that SM adults enter OCD treatment with less ER capacity, lower DT, and marginally more severe OCD symptoms compared to heterosexual adults. By the end of treatment, their clinical presentation is more similar, but SM people continue to report lower DT and difficulty implementing ER strategies perceived as effective. These findings suggest that evidence-based OCD treatment may be similarly efficacious at reducing OCD severity and some aspects of ER for SM and heterosexual people. However, treatment may need to be adapted to better address DT and difficulty implementing ER strategies perceived as effective among SM people.