(SSCP1-5) SSCP Submission: Postpartum Obsessive-compulsive and Anxiety Symptom Disparities Between Racial Groups

Background: Race, as a social construct, plays a crucial role in shaping individual experiences, making it important to examine racial disparities in mental health to understand and address the unique psychological impacts and challenges faced by different racial groups. Examining such disparities in the symptomatology of obsessive-compulsive disorder (OCD), particularly in the context of perinatal mental health, is an important, yet overlooked, area of research. While studies have established that OCD prevalence rates are consistent across various racial and ethnic groups, there is a gap in our understanding of OCD’s specific manifestation across racial groups. Black Americans, for example, are disproportionately impacted by higher discrimination levels, leading to a distinct presentation of OCD symptoms, particularly in the area of contamination (e.g., Wilson & Thayer, 2020). The present study sought to address this gap by examining perinatal OCD and anxiety symptoms across racial groups. Based on previous research, we hypothesized that while racial groups would not differ with respect to overall OCD severity, Black individuals, relative to Asian, White, and multiracial individuals, would evidence greater levels of contamination symptoms.

Method: Pregnant women completed a demographics form, along with the Obsessive-Compulsive Inventory-12 (OCI-12) and the Perinatal Anxiety and Stress Scale (PASS) at 20 weeks of pregnancy, 34 weeks of pregnancy, 6 weeks postpartum, and 6 months postpartum. The OCI-12 contains 4 subscales: (a) washing, (b) checking, (c) ordering, and (d) obsessing. The PASS includes four subscales: (a) Excessive worry and specific fears, (b) Perfectionism, control, and trauma, (c) Social anxiety, and (d) Acute Anxiety and adjustment.

Results: The sample includes 182 White, 37 Black, 18 Asian, and 14 multiracial women. A series of oneway ANOVAs were conducted to compare these groups on the outcomes mentioned previously at each time point. Results indicated that while OCI-12 total scores did not differ between groups during pregnancy, at both postpartum assessment points, Black participants had significantly greater OCI-12 total scores than did White participants (p < .05). Black participants showed significantly greater washing symptoms relative to White participants at both postpartum timepoints. Black participants also had significantly greater ordering scores relative to the other three groups at both 6 weeks and 6 months postpartum (all ps < .05). Moreover, at 6 months postpartum, Black participants evidenced higher scores on PASS-Social Anxiety relative to White and Asian participants, and greater scores on PASS-Perfectionism, Control, and Trauma relative to White participants (all ps < .05).

Conclusions: There are important racial disparities in the experience of postpartum OCD and anxiety symptoms, particularly among Black participants compared to White participants. These findings highlight the importance of considering race and cultural factors in addressing postpartum mental health and emphasize the need for culturally informed treatment approaches and further research to explore the underlying mechanisms and impact of these disparities on maternal and infant outcomes over time.