"Autism is the Arena and OCD is the Lion": Autistic adults’ experiences of co-occurring OCD and Repetitive, Restricted Behaviours and Interests

Hannah Long, Kate Cooper, Ailsa Russell

Research output: Contribution to journalArticlepeer-review

Abstract

Obsessive-compulsive disorder (OCD) commonly co-occurs with autism. Research characterising the interplay between restricted, repetitive behaviours, activities and interests (RRBI) related to autism and OCD symptoms has used theory-driven, bottom-up methodology. This study aimed to interview autistic adults about the subjective experience of differentiating between these phenomena.

Semi-structured interviews were conducted with fifteen autistic adults experiencing OCD symptoms and RRBI. Transcripts were analysed using reflexive thematic analysis from a critical-realist, inductive orientation.

Three overarching themes are presented. Participants viewed RRBI as intrinsic to their identity, while OCD remained ego-dystonic and a perpetuator of anxiety. Conversely, RRBI was present across various emotions, often serving as a method to manage anxiety. Routinised behaviours and focused interests were considered by participants to be vulnerable to OCD exploitation. Although participants reported masking both phenomena, the methods and motivations to mask differed.

This research demonstrates the importance of delineating these experiences, with suggestions offered in how to explore this with autistic clients. Future research could explore narratives of masking OCD across autistic and non-autistic people and investigate simultaneous co-occurrence of OCD and RRBI; including how focused interests may influence OCD and how repetitive routines may be intensified by OCD.
Original languageEnglish
JournalAutism
Publication statusAcceptance date - 8 Apr 2024

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