Testing the Efficacy of an Education-Based Training Tool to Improve Diagnostic Accuracy of Obsessive-Compulsive Disorder

Abstract

Objective: The study aimed to increase awareness of OCD symptomatology among doctoral students in clinical, counseling and school psychology through the implementation of a comprehensive OCD education-based training tool. Method: The program directors across all APA-accredited clinical, counseling, and school psychology doctoral graduate programs in the five boroughs of New York and Long Island were contacted via email and asked to participate in the study. Programs that provided consent were assigned to either the control or intervention condition. Three assessment sessions were conducted across both groups. Five distinct vignettes were randomized to each participant at each assessment point. A time-lagged design was used: The session in which the participants were shown the training tool varied depending on the condition (control vs. intervention). Participants provided a diagnostic impression(s) and treatment recommendation(s) for each vignette they received. Results: Eighty-two students, across seven doctoral programs participated in the study. All participants completed two assessment points; four participants were lost to follow-up resulting in 78 participants completing all three sessions. Prior to viewing the video, 18.5% of participants misidentified the OCD vignettes; following exposure to the intervention only 5.4% of participants misidentified the OCD vignettes. Misidentification rates for the pre-intervention OCD vignette assessments were greater for some manifestations of OCD over others: obsessions regarding homosexuality (33.3%), fear of saying things (25.5%), aggression (22.2%), pedophilia (22.2%), religion (20.0%), somatic concerns (17.6), contamination (6.3%) and need for symmetry (0.0%). The majority of participants (82.0%) reported being knowledgeable regarding OCD symptomatology (ranging from somewhat to very knowledgeable). However, in accordance with misidentification rates, participants reported less awareness (not at all aware or not very aware) of some obsessions [aggression (36.0%), homosexuality (29.0%), somatic concerns (22.3%), fear of saying certain things (19.7%), religion (17.1%), and sexual content (17.1%)] over others [need for symmetry (3.9%), and contamination (1.3%)]. Conclusions: While most participants reported being knowledgeable regarding OCD symptomatology, their knowledge and ability to successfully identify the diagnosis extended to symptoms of contamination and need for symmetry. Results showed widespread self-reported lack of awareness and greater misidentification rates of other symptoms of OCD. Non-contamination and non-need for symmetry vignettes were misidentified at elevated rates compared to the contamination and need for symmetry vignettes. The training video was effective in reducing the misidentification rates among the OCD vignettes. These findings support the notion that graduate students in the mental health field could benefit from targeted training on OCD.