Category: Obsessive Compulsive and Related Disorders

Symposium

Stigma of the Hoarding Phenotype and Its Association With Treatment Willingness

Friday, November 17
3:30 PM - 5:00 PM
Location: Aqua 310, Level 3, Aqua Level

Keywords: Hoarding | Stigma
Presentation Type: Symposium

Treatment ambivalence is so often associated with hoarding disorder (HD) that it could represent a core component of the phenotype. One possible factor contributing to this ambivalence is stigma. To date, there have been no studies of stigma of HD, nor investigations of how stigma may impact HD treatment willingness. To address this void, we used MTurk to recruit 442 adults (51% male, M[SD] age = 36.7 [11.24], 80% non-Hispanic White) who answered questions about stigma of HD, as well as other comparison groups with a history of negative public perception: severe mental illness (SMI; i.e., psychosis), those in jail, and substance use disorders (SUDs). SMI in particular is a useful comparison because research has uncovered a considerable negative public perception: those with SMI should be feared and avoided because they are violent; are irresponsible and cannot make decisions; and are childlike and cannot be self-sufficient. Participants endorsed multiple items measuring Difference, Disdain, and Blame, which arewell-studied proxies of public stigma. Participants also completed an HD severity measure, and if they scored in the clinical range, an additional question rated how much they would be willing to seek help for the HD symptoms.  Within-subject ANOVAs revealed significant differences across clinical conditions for all stigma items (Fs ranged from 18.49 to 247.68, all ps < .001, η2 range = .14 - .69). Follow-up tests of marginal means indicated that public stigma for HD is similar to levels for SMI, with the exception of responsibility—those with HD are seen as significantly more blameworthy for their condition compared to those with SMI, t(305) = 17.69, pdz = .84. Among those who endorsed clinically significant levels of HD (n = 18), more negative perception of HD (i.e., a proxy for self-stigma) was associated with a lower willingness to ask for help for HD symptoms, with moderate-to-large effect sizes (rs ranging from -.33 to -.56). Thus, stigma of HD, particularly self-stigma, may be an important component of treatment ambivalence. Stigma may therefore represent a fruitful target for reducing ambivalence and enhancing treatment engagement.

Greg Chasson

Illinois Institute of Technology

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