Investigating the events that predispose vulnerable and feared self-concepts in obsessive-compulsive disorder: A qualitative analysis.

OBJECTIVES: The feared self-concept, the self that a person fears they may be or could become, has been increasingly shown to drive the development and maintenance of obsessive-compulsive disorder (OCD). It is proposed that the feared self develops from a vulnerable self-concept, which itself is a result of normative self-concept development being disrupted by negative early life experiences. However, it is currently unclear which experiences lead to the development of vulnerable self-concept in people with OCD. This study aimed to describe the events and life experiences that people with OCD report as influential in the development of their vulnerable and feared self-concepts. METHODS: Sixteen participants with OCD participated in semi-structured interviews. Reflexive thematic analysis was used to analyse interview transcripts. RESULTS: Traumatic experiences and rejection shaping self-concept were generated as major themes. Subthemes of traumatic experiences included early abuse informs the corrupted feared self, harassment fosters a feared self, and parental neglect informs the manifestation of the culpable feared self. Subthemes of rejection included interpersonal betrayal instigates self-doubt, not living up to parental expectations instigates self-doubt and parental neglect fosters vulnerable self-concept. These findings suggest that, for individuals with OCD, traumatic and rejection experiences were integrated into their self-concept resulting in its vulnerability and taking on feared aspects. CONCLUSIONS: These findings may be able to inform future research investigating prevention and treatment strategies that focus on the identification and treatment value of traumatic and rejection experiences.