Not All OCD Is Treated Equal: Differential Mental Health Stigma across OCD Symptom Subtypes In Latino Communities

Background and Purpose: Mental health stigma is a well-documented barrier to treatment access among Latino populations, yet the literature has largely treated stigma as a uniform construct applied consistently across diagnostic presentations. Obsessive-compulsive disorder (OCD) encompasses a heterogeneous range of symptom subtypes, including contamination, harm-related, and religious/scrupulosity obsessions that differ substantially in social visibility, perceived threat, and cultural meaning. Harm-related subtypes, involving intrusive thoughts about causing harm to oneself or others, may be especially susceptible to stigmatizing responses given cultural associations with moral failing or dangerousness. This study examined whether Latino adults assign differential levels of OCD-specific stigma to individuals presenting with distinct OCD symptom subtypes, and explored the role of multidimensional religiosity as a moderator of OCD-related stigma.

Methods: A randomized vignette experimental design was used with a community sample of Latino adults (N = 212) recruited through bilingual English/Spanish channels. Participants were randomly assigned to read one of three vignettes depicting a Latino/a individual presenting with contamination, harm-related, or religious/scrupulosity OCD symptoms. Participants then completed measures including a stigma scale, questions about receiving psychological help, and the Duke University Religion Index which assessed three dimensions of religiosity. MANOVA and moderated regression analyses tested for OCD-specific stigma differences across subtype conditions and examined religiosity as a moderator.

Results: Significant differences in OCD-specific stigma were found across subtype conditions. Harm-related OCD vignettes elicited significantly higher stigma scores compared to contamination and scrupulosity presentations. Organizational religiosity (participation in communal religious practices) was associated with greater stigmatizing responses toward individuals with OCD. In contrast, intrinsic/personal religiosity was associated with lower stigma toward individuals with OCD, suggesting that internalized religious values may perhaps function protectively against OCD-related stigmatizing attitudes. Patterns held after controlling for demographic variables.

Conclusions and Implications: OCD-specific stigma varies meaningfully by symptom subtype, with harm-related presentations generating the highest stigma among Latino adults. The divergent roles of organizational versus personal religiosity or spirituality have direct implications for understanding stigma within Latino communities: Latino clients with OCD who are embedded in communal religious contexts may encounter heightened stigma from community members, placing them at greater risk of shame, concealment, and delayed treatment engagement. Conversely, community members with stronger personal or intrinsic religiosity may hold less stigmatizing attitudes toward those with OCD, suggesting potential protective social environments for some Latino clients. Clinicians should assess both the nature and expression of religiosity or spirituality, not treat it as a monolithic construct, when working with Latino clients presenting with OCD. These findings further underscore the need for specialized training for OCD clinicians in culturally and religiously responsive care, as well as community-level outreach that engages religious institutions directly, reframing OCD as a medical condition requiring professional care rather than a spiritual failing. Given that stigma is a known predictor of delayed help-seeking, early community screening efforts targeting OCD presentations may help reduce the lag between symptom onset and treatment engagement, and family psychoeducation should be prioritized as a key intervention component given the central role of family and social networks in communal Latino communities.