'Autism is the Arena and OCD is the Lion': Autistic adults' experiences of co-occurring obsessive-compulsive disorder and repetitive restricted behaviours and interests.
Hannah Long, Kate Cooper, Ailsa Russell
PMID 38727194WHAT IT FOUND
Autistic adults describe repetitive behaviours as intrinsic and soothing, while OCD feels like an unwanted intruder that exploits routines and interests.
This distinction helps therapists differentiate symptoms, but the study reports experiences, not treatment outcomes.
Key findings
01Participants described repetitive restricted behaviours and interests (RRBIs) as core to their identity and useful for managing anxiety, whereas OCD was experienced as incongruent with their self-concept.
02OCD was reported to 'hijack' existing routines and focused interests, intensifying repetition and turning neutral or positive activities into sources of distress.
03Masking both RRBIs and OCD symptoms was common, but motivations differed: RRBIs were often masked due to social stigma, while OCD behaviours were masked to avoid interrupting others.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study excluded individuals with intellectual disabilities, limiting generalisability to that population. Participants were recruited through charity networks, which may bias the sample towards those who align closely with specific diagnostic labels. The sample size was small (n=15), and findings are based on self-reported experiences rather than clinical observation or treatment outcomes. The interviewers were non-autistic clinical psychologists in training, which may influence the interpretation of cross-neurotype communication.
Declared interests
The authors declared no potential conflicts of interest. The study was funded by Health Education England as part of the first author's Doctorate in Clinical Psychology requirements.
The easy way to misread this
Do not interpret these themes as evidence that specific interventions for OCD or RRBI are effective. This is a qualitative study of patient experiences, not a trial of treatment outcomes.