Self-as-Context and fear of self in autogenous and reactive obsessions: implications for OCD subtypes

Abstract

OCD is characterized by persistent obsessions and compulsions that impact daily functioning. A model distinguishing autogenous and reactive obsessions suggests the need for specific subtypes. This study examines whether these subtypes differ in terms of self, focusing on self-as-context and fear of self in the autogenous (AG) and reactive groups (RG). The sample included 30 AG and 30 RG patients based on their primary obsessions and 30 control group (CG) participants matched for gender, age, and education levels. An informed consent form, sociodemographic data form, Structured Clinical Interview for DSM-5, Vancouver Obsessive Compulsive Inventory (VOCI), Dimensional Obsessive Compulsive Scale (DOCS), Self-as-Context Scale (SACS), and Fear of Self Questionnaire-short form (FSQ-8) were applied to all participants. CG participants had higher SACS scores than both AG and RG (p = .001). However, significant differences were found only between AG and CG (p < .001). AG patients had higher FSQ-8 scores than RG, who scored higher than CG (p < .001). Significant differences were found between AG and RG (p = .002), and AG and CG (p < .001) only. Higher FSQ-8 scores predicted increased OCD risk (p = .002), while higher SACS scores predicted lower risk (p = .033). In AG, only FSQ-8 scores were significant for DOCS total (p = .006), while in RG, only SACS scores were significant (p = .008). Fear of self and self-as-context impact OCD severity differently across autogenous and reactive subtypes. Self-focused interventions tailored to these subtypes may improve treatment outcomes and aid in OCD recovery.