{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:48:38Z","timestamp":1792054118509,"version":"4.4.0"},"reference-count":47,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100022883","name":"National Alliance on Mental Illness","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022883","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006924","name":"International OCD Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006924","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Research"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.psychres.2026.117285","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:19:08Z","timestamp":1781626748000},"page":"117285","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Prevalence and regional patterns of identity-related OCD across the United States: Findings from The National OCD Survey"],"prefix":"10.1016","volume":"364","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6481-3348","authenticated-orcid":false,"given":"Caitlin M.","family":"Pinciotti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Foshee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4464-7035","authenticated-orcid":false,"given":"Blake","family":"Upshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel D.","family":"Spencer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Hershfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin E.","family":"Franklin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7631-3703","authenticated-orcid":false,"given":"Eric A.","family":"Storch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.psychres.2026.117285_bib0014","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2021.644114","article-title":"Case report: doubts and pre-occupations about being transgender: questioning one\u2019s gender identity or a case of obsessive-compulsive disorder?","volume":"12","author":"Aboujaoude","year":"2021","journal-title":"Front. Psychiatry"},{"key":"10.1016\/j.psychres.2026.117285_bib0041","series-title":"Categorical Data Analysis","author":"Agresti","year":"2008"},{"key":"10.1016\/j.psychres.2026.117285_bib0009","doi-asserted-by":"crossref","DOI":"10.1016\/j.psychres.2024.116198","article-title":"A systematic scoping review of the literature on sexual orientation obsessive compulsive disorder (SOOCD): important clinical considerations and recommendations","volume":"342","author":"Allely","year":"2024","journal-title":"Psychiatry Res."},{"key":"10.1016\/j.psychres.2026.117285_bib0002","series-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-5\u2122","first-page":"947","year":"2013"},{"key":"10.1016\/j.psychres.2026.117285_bib0030","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.pcad.2023.07.002","article-title":"The geographic distribution of unhealthy living characteristics according to the American Nations model: cultural factors warranting attention","volume":"79","author":"Arena","year":"2023","journal-title":"Prog. Cardiovasc. Dis."},{"issue":"9","key":"10.1016\/j.psychres.2026.117285_bib0028","doi-asserted-by":"crossref","DOI":"10.1016\/j.cpcardiol.2024.102728","article-title":"The lifestyle health index in the context of COVID-19 mortality and vaccination in the United States: a syndemic not to be repeated","volume":"49","author":"Arena","year":"2024","journal-title":"Curr. Probl. Cardiol."},{"issue":"1","key":"10.1016\/j.psychres.2026.117285_bib0032","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1097\/HCR.0000000000000839","article-title":"Identifying the disability belt and epicenters in the American Nations","volume":"44","author":"Arena","year":"2024","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"issue":"3","key":"10.1016\/j.psychres.2026.117285_bib0026","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s11187-016-9787-9","article-title":"A new perspective on entrepreneurial regions: linking cultural identity with latent and manifest entrepreneurship","volume":"48","author":"Audretsch","year":"2017","journal-title":"Small Bus. Econ."},{"issue":"14","key":"10.1016\/j.psychres.2026.117285_bib0013","doi-asserted-by":"crossref","first-page":"3267","DOI":"10.1017\/S0033291720005437","article-title":"Towards a definitive symptom structure of obsessive\u2212compulsive disorder: a factor and network analysis of 87 distinct symptoms in 1366 individuals","volume":"52","author":"Cervin","year":"2022","journal-title":"Psychol. Med."},{"issue":"4","key":"10.1016\/j.psychres.2026.117285_bib0039","doi-asserted-by":"crossref","DOI":"10.1002\/ajmg.b.32962","article-title":"Latin American trans-ancestry initiative for OCD genomics (LATINO): study protocol","volume":"195","author":"Crowley","year":"2024","journal-title":"Am. J. Med. Genet. B Neuropsychiatr. Genet."},{"key":"10.1016\/j.psychres.2026.117285_bib0046","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.psychres.2018.11.042","article-title":"Examining the factor structure of the self-report yale-brown obsessive compulsive scale symptom checklist","volume":"271","author":"Du Mortier","year":"2019","journal-title":"Psychiatry Res."},{"issue":"6","key":"10.1016\/j.psychres.2026.117285_bib0033","doi-asserted-by":"crossref","DOI":"10.1016\/j.cpcardiol.2024.102558","article-title":"Unhealthy dietary patterns in the American Nations: a crisis with cultural distinctions","volume":"49","author":"Laddu","year":"2024","journal-title":"Curr. Probl. Cardiol."},{"issue":"1","key":"10.1016\/j.psychres.2026.117285_bib0024","article-title":"The personality of American nations: an exploratory study","volume":"3","author":"Lanning","year":"2022","journal-title":"Personal. Sci."},{"key":"10.1016\/j.psychres.2026.117285_bib0044","unstructured":"Long S., McCarthy J. Two in three Americans support racial justice protests. Gallup.Com. July 28, 2020. Accessed May 12, 2026. https:\/\/news.gallup.com\/poll\/316106\/two-three-americans-support-racial-justice-protests.aspx."},{"issue":"2","key":"10.1016\/j.psychres.2026.117285_bib0004","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.beth.2021.11.001","article-title":"Call to action: recommendations for justice-based treatment of obsessive-compulsive disorder with sexual orientation and gender themes","volume":"53","author":"Pinciotti","year":"2022","journal-title":"Behav. Ther."},{"issue":"4","key":"10.1016\/j.psychres.2026.117285_bib0005","first-page":"466","article-title":"Justice-based treatment considerations for identity-related obsessive\u2013compulsive disorder","volume":"31","author":"Pinciotti","year":"2024","journal-title":"Clin. Psychol.: Sci. Pract."},{"issue":"6","key":"10.1016\/j.psychres.2026.117285_bib0037","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/PRA.0000000000000823","article-title":"Psychometric properties of the yale-brown obsessive compulsive scale-II self-report","volume":"30","author":"Pinciotti","year":"2024","journal-title":"J. Psychiatr. Pract."},{"issue":"4","key":"10.1016\/j.psychres.2026.117285_bib0006","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.beth.2024.12.001","article-title":"Preferences for justice-based exposure and response prevention among individuals with identity-related obsessive-compulsive disorder","volume":"56","author":"Pinciotti","year":"2025","journal-title":"Behav. Ther."},{"key":"10.1016\/j.psychres.2026.117285_bib0038","doi-asserted-by":"crossref","DOI":"10.1016\/j.jad.2025.119719","article-title":"Benchmarking empirical severity for the yale-brown obsessive compulsive scale-second edition","volume":"390","author":"Pinciotti","year":"2025","journal-title":"J. Affect. Disord."},{"issue":"1","key":"10.1016\/j.psychres.2026.117285_bib0003","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.psychres.2007.07.010","article-title":"Further development of YBOCS dimensions in the OCD collaborative genetics study: symptoms vs categories","volume":"160","author":"Pinto","year":"2008","journal-title":"Psychiatry Res."},{"issue":"1","key":"10.1016\/j.psychres.2026.117285_bib0031","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s44167-023-00043-3","article-title":"Regional cultures and insufficient sleep in the United States","volume":"3","author":"Pronk","year":"2024","journal-title":"JASSB"},{"key":"10.1016\/j.psychres.2026.117285_bib0018","unstructured":"Quick S. Fear of aging. NOCD. November 15, 2022. Accessed December 4, 2025. https:\/\/www.treatmyocd.com\/what-is-ocd\/common-fears\/fear-of-aging-ocd."},{"key":"10.1016\/j.psychres.2026.117285_bib0020","unstructured":"Quick S. Fears about becoming homeless. NOCD. January 30, 2023. Accessed December 4, 2025. https:\/\/www.treatmyocd.com\/what-is-ocd\/common-fears\/fear-of-being-homeless-ocd."},{"key":"10.1016\/j.psychres.2026.117285_bib0019","unstructured":"Quinlan K. Living with the fear of \u2018going crazy\u2019 (a common OCD theme). KimberleyQuinlan-LMFT.Com. June 23, 2023. Accessed December 4, 2025. https:\/\/kimberleyquinlan-lmft.com\/fear-of-going-crazy-ocd\/."},{"key":"10.1016\/j.psychres.2026.117285_bib0010","series-title":"Fear of Being Straight","author":"Ricci","year":"2022"},{"issue":"5","key":"10.1016\/j.psychres.2026.117285_bib0011","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/sj.mp.4001798","article-title":"The dimensional yale\u2013brown obsessive\u2013compulsive scale (DY-BOCS): an instrument for assessing obsessive\u2013compulsive symptom dimensions","volume":"11","author":"Rosario-Campos","year":"2006","journal-title":"Mol. Psychiatry"},{"key":"10.1016\/j.psychres.2026.117285_bib0042","series-title":"Flexible Imputation of Missing Data, Second Edition","article-title":"Multiple imputation","author":"Rubin","year":"2018"},{"issue":"1","key":"10.1016\/j.psychres.2026.117285_bib0001","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1038\/mp.2008.94","article-title":"The epidemiology of obsessive-compulsive disorder in the national comorbidity survey replication","volume":"15","author":"Ruscio","year":"2010","journal-title":"Mol. Psychiatry"},{"issue":"3","key":"10.1016\/j.psychres.2026.117285_bib0015","first-page":"e268","article-title":"Obsessive-compulsive disorder presenting as gender dysphoria\/gender incongruence: a case report and literature review","volume":"2","author":"Safer","year":"2016","journal-title":"AACe Clin. Case Rep."},{"issue":"8","key":"10.1016\/j.psychres.2026.117285_bib0047","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/0005-7967(96)00036-8","article-title":"The yale-brown obsessive compulsive scale: interview versus self-report","volume":"34","author":"Steketee","year":"1996","journal-title":"Behav. Res. Ther."},{"issue":"2","key":"10.1016\/j.psychres.2026.117285_bib0035","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1037\/a0018492","article-title":"Development and psychometric evaluation of the yale\u2013brown obsessive-compulsive scale\u2014second edition","volume":"22","author":"Storch","year":"2010","journal-title":"Psychol. Assess."},{"issue":"6","key":"10.1016\/j.psychres.2026.117285_bib0036","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.janxdis.2010.04.010","article-title":"Psychometric analysis of the yale-brown obsessive-compulsive scale second edition symptom checklist","volume":"24","author":"Storch","year":"2010","journal-title":"J. Anxiety Disord."},{"issue":"1","key":"10.1016\/j.psychres.2026.117285_bib0025","first-page":"92","article-title":"Determining the development status of United States counties based on comparative and spatial analyses of multivariate criteria using geographic information systems","volume":"8","author":"Wheeler","year":"2019","journal-title":"Int. J. Hydrog. Energy"},{"issue":"1\u20132","key":"10.1016\/j.psychres.2026.117285_bib0007","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.psychres.2010.10.019","article-title":"Sexual orientation obsessions in obsessive-compulsive disorder: prevalence and correlates","volume":"187","author":"Williams","year":"2011","journal-title":"Psychiatry Res."},{"issue":"3","key":"10.1016\/j.psychres.2026.117285_bib0008","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s10508-014-0421-0","article-title":"Domains of distress among people with sexual orientation obsessions","volume":"44","author":"Williams","year":"2015","journal-title":"Arch. Sex. Behav."},{"key":"10.1016\/j.psychres.2026.117285_bib0021","series-title":"The Wiley Handbook of Obsessive Compulsive Disorders","first-page":"56","article-title":"Cross-cultural phenomenology of obsessive-compulsive disorder","author":"Williams","year":"2017"},{"issue":"3","key":"10.1016\/j.psychres.2026.117285_bib0040","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1002\/ajmgb.70002","article-title":"Black equality in OCD neurogenomics (BELONG): study protocol","volume":"201","author":"Williams","year":"2026","journal-title":"Am. J. Med. Genet. B Neuropsychiatr. Genet."},{"key":"10.1016\/j.psychres.2026.117285_bib0043","unstructured":"Williams M.T. Homosexuality anxiety: a misunderstood form of OCD. In: Sebeki LV, ed. leading-edge health education issues. 2008:195\u2013205."},{"key":"10.1016\/j.psychres.2026.117285_bib0016","article-title":"The intrusive, unwelcome thoughts of racism-themed OCD","author":"Williams","year":"2020","journal-title":"Psychol. Today"},{"key":"10.1016\/j.psychres.2026.117285_bib0029","series-title":"Exploring the Power of County-Level Regional Classifications on Predicting Sex-Specific All-Cause Mortality in the United States","author":"Wolf","year":"2017"},{"key":"10.1016\/j.psychres.2026.117285_bib0045","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.pcad.2025.03.014","article-title":"The American Nations model: an analytical tool for understanding the influence of U.S. regional cultures on health and the social and political determinants of health","volume":"90","author":"Woodard","year":"2025","journal-title":"Prog. Cardiovasc. Dis."},{"key":"10.1016\/j.psychres.2026.117285_bib0023","series-title":"American Nations: A History of the Eleven Rival Regional Cultures of North America","author":"Woodard","year":"2012"},{"key":"10.1016\/j.psychres.2026.117285_bib0027","series-title":"How Colin Woodard\u2019s \u201cAmerican Nations\u201d Explains the 2016 Presidential Election","author":"Woodard","year":"2017"},{"key":"10.1016\/j.psychres.2026.117285_bib0034","unstructured":"Woodard C. Nations apart: how clashing regional cultures shattered America. Viking; 2025. Accessed January 28, 2026. https:\/\/www.amazon.com\/Nations-Apart-Clashing-Regional-Shattered\/dp\/0593833406."},{"key":"10.1016\/j.psychres.2026.117285_bib0017","unstructured":"Woodrow S. Transgender OCD: a new theme following a familiar pattern. ADAA. April 6, 2020. Accessed December 3, 2025. https:\/\/adaa.org\/learn-from-us\/from-the-experts\/blog-posts\/professional\/transgender-ocd-new-theme-following-familiar."},{"key":"10.1016\/j.psychres.2026.117285_bib0022","series-title":"The Cultural Geography of the United States","author":"Zelinsky","year":"1992"},{"issue":"6","key":"10.1016\/j.psychres.2026.117285_bib0012","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1002\/cpp.1987","article-title":"Development and validation of the morphing fear questionnaire (MFQ)","volume":"23","author":"Zysk","year":"2016","journal-title":"Clin. Psychol. PsychOther"}],"container-title":["Psychiatry Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165178126003458?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165178126003458?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:22:49Z","timestamp":1792052569000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0165178126003458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":47,"alternative-id":["S0165178126003458"],"URL":"https:\/\/doi.org\/10.1016\/j.psychres.2026.117285","relation":{},"ISSN":["0165-1781"],"issn-type":[{"value":"0165-1781","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Prevalence and regional patterns of identity-related OCD across the United States: Findings from The National OCD Survey","name":"articletitle","label":"Article Title"},{"value":"Psychiatry Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.psychres.2026.117285","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"117285"}}