Autism and obsessive-compulsive disorder (OCD) share clinical and behavioural similarities, including engagement in repetitive behaviours. Due to their high co-occurrence and similarities in observable behaviours, it can be challenging to differentiate between the restricted and repetitive behaviours and interests (RRBIs) characteristic of autism and the compulsive behaviours attributable to OCD. This study explored the lived experiences of repetitive behaviours in autism and OCD to improve differential diagnosis and inform appropriate supports. Semi-structured interviews were conducted with 21 participants: 7 autistic adults, 7 adults with OCD, and 7 with both diagnoses. Participants discussed the motivations and functions of their repetitive behaviours and, for participants with both diagnoses, how they differentiated between autism-related RRBIs and OCD-related compulsions. Thematic analysis identified three key differences: (1) ego-syntonic versus ego-dystonic experiences, (2) the differing role of anxiety, and (3) differences in the urgency associated with the behaviour. Autistic individuals viewed RRBIs as enjoyable and stress-relieving, while those with OCD found compulsions distressing and anxiety-inducing. Autistic participants could manage the discomfort of suppressing RRBIs, but OCD sufferers found the urge to complete compulsions overwhelming. These findings underscore the importance of understanding and distinguishing between different forms of repetitive behaviour to support accurate diagnosis and tailored intervention.
O’Loghlen et al. (Thu,) studied this question.