Why now : a quantitative analysis of barriers influencing a delay in treatment-seeking behavior for adults with obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) disrupts daily life through intrusive obsessions and time-consuming compulsions. Although effective treatments exist, many individuals delay accessing care for years after diagnosis, worsening outcomes and increasing risks for comorbidities, functional impairment, and suicide. Despite increasing attention to mental health access, few quantitative studies have explored OCD-specific barriers in U.S. adults. This study aimed to identify the personal, structural, and stigma-related barriers that influence treatment-seeking behavior among adults with OCD. Guided by the capability, opportunity, motivation, and behavior model (Michie et al., 2011), I conducted a cross-sectional survey using the Barriers to Access to Care Evaluation scale (BACE; Clement et al., 2012). A total of 104 adults with a self-reported OCD diagnosis completed an anonymous online survey. Mood’s Median results showed no statistically significant difference in BACE v3 scores between those who sought treatment within one year of diagnosis and those who delayed treatment (p = .254), though participants who delayed treatment reported slightly higher median scores (Mdn = 1.83; range, 1.27–3.90). A logistic regression revealed that stigma (p = .027) and structural barriers (p = .010) statistically significantly predicted delayed treatment, while knowledge (p = .204) and attitude (p = .702) barriers did not. A point-biserial correlation revealed that knowledge barriers were significantly correlated with longer time to treatment (rpb = .306, p = .002). The Mann-Whitney U test found non-White participants reported higher overall BACE v3 scores (M = 2.02) than White participants (M = 1.70), but the difference was not statistically significant (p = .112). These findings suggest that stigma, structural obstacles, and knowledge deficits are key contributors to delays in OCD treatment, while personal attitudes may play a less prominent role. While non-White participants reported higher average barrier scores than White participants, this difference did not reach statistical significance, suggesting that racial or ethnic disparities in perceived barriers may exist but were not conclusively demonstrated in this sample. Professionals can utilize this data to screen for these barriers, provide targeted psychoeducation, and enhance care pathways. Policymakers and researchers should prioritize efforts to reduce systemic inequities and improve mental health literacy. This study offers an evidence-based foundation for designing interventions that promote earlier access to care and reduce disparities in OCD treatment.

Name thesis:degree_name

Ed.D.

Level thesis:degree_level

Doctoral

Grantor

Baylor University.

Year dc:date.issued

2025

Author dc:creator

• Cornell, Kerstin M., 1987-

Advisor dc:contributor.advisor

• Steketee, Anne.

• Knowledge barriers.
• Structural barriers.
• Barriers to Access to Care Evaluation scale, version three (BACE v3)
• Capability, opportunity, motivation, and behavior (COM-B) model.
• Obsessive-compulsive disorder (OCD)
• Mental health access.
• Stigma.
• Delayed treatment.

Statement dc:rights

• Baylor University works are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. Contact libraryquestions@baylor.edu for inquiries about permission.

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/2104/14099

OAI identifier oai:identifier

oai:baylor-ir.tdl.org:2104/14099