by Henry A. Willis, MA
Obsessive compulsive disorder (OCD) is understudied among African-American/Black youth and young adults (Williams & Jahn, 2016). Black youth are also grossly underrepresented in treatment centers, clinical trials, and published research focused on OCD (Williams et al., 2012). Research suggests that although OCD is a persistent problem for Black youth relative to their White American counterparts, we don’t know enough about the sociocultural factors unique to Black youth that may influence OCD symptoms (Williams & Jahn, 2016). “Sociocultural factors” refer to the common social and cultural experiences, patterns, and beliefs that influence the lives of a population group. A lack of understanding of the sociocultural factors that shape the development of OCD, combined with the underrepresentation of African Americans in research, are important problems because if not addressed, efforts to understand and treat OCD, and meet the needs of Black youth with OCD, will be misguided and uninformed.
Two critical sociocultural factors that may influence OCD symptom severity and distress are racial discrimination (being treated differently on the basis of one’s race (Jones, 2000)), which can be harmful or a “risk factor,” and racial identity (the meaning of race in one’s own ideas about themselves (i.e., Sellers et al., 1998)), which can be helpful or “protective.” Racial discrimination is a source of stress for African Americans and may further increase the frequency of OCD symptoms and distress. Racial identity beliefs (i.e., feeling proud about being Black or African American, having a strong sense of connection to your racial-ethnic group, etc.) are also an important protective factor against psychological distress among African Americans (Smith & Silva, 2011), and they may protect against the development/severity of OCD among this group.
In light of these gaps in knowledge, researchers at the University of North Carolina, Chapel Hill*, led by Henry A. Willis, have been conducting a study that assesses OCD symptoms, along with sociocultural risk and protective factors (e.g., racial discrimination experiences and racial identity beliefs), during the transition to adulthood within a diverse sample of Black young adults. This study is following participants over a one-year period to explore how OCD changes over time as a result of these factors, and will also be exploring the impact of stress related to COVID-19. More importantly, this study is investigating how racial identity beliefs contribute to resiliency among Black youth, specifically by measuring how racial identity beliefs protect against the development of OCD symptoms, the mental health effects of experiencing racial discrimination, and other stressors. Our early data and previous studies (i.e., Willis & Neblett, 2018) suggest that distress from obsessive-compulsive (OC) symptoms increases as a result of racial discrimination, and that certain patterns of racial identity beliefs protect against racial discrimination and are linked to lower OC symptom distress as a result.
This project has so far recruited a nationally representative sample of over 400 Black youth and young adults between the ages of 18 and 25. The team is in the early stages of analyzing data and plans to present our early results at a variety of upcoming academic conferences, while also using the findings to improve the field’s understanding of OCD development and treatment among Black populations. The findings from this project have the potential to be a first step toward making psychotherapy for OCD more culturally aware and relevant for African Americans. For instance, by learning how racial identity beliefs are protective against the development of OCD symptoms, future treatments could target these beliefs to improve outcomes for Black OCD sufferers. Finally, the results of this study have the potential to improve commonly-used tools for detecting, diagnosing, and measuring the severity of OCD symptoms within African Americans by incorporating the evaluation of sociocultural factors like racial identity beliefs and racial discrimination experiences when assessing for the disorder among Black youth and young adults.
- As described in the theoretical model put forth by Williams and Jahn, 2016
*Note: Research team includes Enrique W. Neblett, Jonathan S. Abramowitz, Jennifer L. Buchholz, and undergraduate research assistants.
Jones, C. P. (2000). Levels of Racism: A Theoretic Framework and a Gardener’s Tale. American Journal of Public Health, 90(8), 1212–1215. http://doi.org/10.2105/AJPH.90.8.1212
Sellers, R. M., Smith, M. A, Shelton, J. N., Rowley, S. J., & Chavous, T. M. (1998). Multidimensional model of racial identity: A Reconceptualization of African American racial identity. Personality and Social Psychology Review, 2(1), 18–39. http://doi.org/10.1207/s15327957pspr0201
Smith, T. B., & Silva, L. (2011). Ethnic identity and personal well-being of people of color: a meta-analysis. Journal of Counseling Psychology, 58(1), 42. http://doi.org/10.1037/a0021528
Williams, M. T., & Jahn, M. E. (2016). Obsessive – Compulsive Disorder in African American Children and Adolescents : Risks , Resiliency, and Barriers to Treatment. American Journal of Orthopsychiatry, 87(3), 291.
Williams, M. T., Proetto, D., Casiano, D., & Franklin, M. E. (2012). Recruitment of a hidden population: African Americans with obsessive–compulsive disorder. Contemporary Clinical Trials, 33(1), 67-75.
Willis, H.A. & Neblett, E.W., Jr. (2018) OCD in African American young adults: The associations between racial discrimination, racial identity, and obsessive-compulsive symptoms. Journal of Obsessive-Compulsive Disorders, 19, 105-115.