Abstract
Obsessive-compulsive disorder (OCD) is a highly debilitating disorder that is prevalent in up to 2.3% of the population, yet mental health providers are not sufficiently equipped to diagnose or treat it. This study served to explore OCD misidentification rates in two different types of obsessions, diagnostic impact of misidentification on choosing empirically supported treatment, and possible attitudes that might mediate a clinicians’ decisions in a sample of 110 psychologists (79.1% clinical psychologists; mean age = 45.43). Results revealed that over one-third (35.0%) of participants incorrectly diagnosed two vignettes, representing symptoms of sexual orientation OCD (SO-OCD) and symmetry. Of those who correctly diagnosed the vignettes, about half of participants recommended Exposure and Response Prevention (ERP) therapy as first-line treatment (symmetry = 55.4%; SO-OCD = 47.1%). Participants who identified as having greater client empowerment were more likely to misdiagnose the SO-OCD vignette (n = 40, M = 1.49, SD = 0.45) but were not as likely to misdiagnose the symmetry vignette (n = 36, M = 1.30, SD = 0.39). Negative attitudes toward evidence-based practice were associated with choice of treatment other than ERP (n = 33, M = 1.90, SD = 0.52, p = 0.01). Elevated OCD misdiagnosis rates and its impact on treatment recommendations, as well as knowledge of factors contributing to misdiagnosis and mistreatment imply the need for greater education and training.