Moderators and Mediators of the Relationship Between Social Support and Readiness to Change in OCD

Individuals with obsessive-compulsive disorder (OCD) often struggle to find willingness to engage in treatment; social support presents as a means of increasing willingness. We investigated the relationship between social support and readiness to change (RTC) in individuals with OCD, specifically examining the potential moderating effects of age, depression severity, and symptom subtypes. A sample of 104 adults with OCD (61% female, mean age = 30.9 years) completed measures assessing RTC, social support, depression, OCD symptoms, and internalized stigma. In the main effects model, age ( β = .21), depression severity ( β = .21), and the unacceptable thoughts symptom factor ( β = .89) predicted RTC. The interaction model revealed a significant main effect of social support on RTC ( β = .58), with symptom subtype moderating this relationship. Notably, both unacceptable thoughts ( β = -.65) and harm obsessions ( β = -.67) showed a strong negative interaction with social support. We conclude that social support is positively associated with readiness to change in OCD, but this relationship varies in the presence of unacceptable thoughts and harm obsessions. Further, depression, age, and unacceptable thoughts have a positive relationship with RTC, independent of social support, in those with OCD. These findings suggest that encouraging non-professional social support may be a valuable treatment adjunct, though it should be used with caution for certain OCD subtypes. Future research should use more advanced modeling techniques and employ randomized clinical trials to examine the causal relationship between social support and readiness to change.