Hit-and-Run OCD

Hit-and-run Obsessive-Compulsive Disorder (OCD) or motor vehicle accident OCD (MVA OCD) is a common symptom type that we treat here at the Houston OCD Program. However, available resources on hit-and-run OCD are less developed, suggesting lower public awareness about this potentially debilitating subtype. We, among others, aim to increase awareness and especially help someone who is suffering from this perhaps in silence to understand that there is a name and treatment for what they are experiencing.

What is hit-and-run OCD? In this symptom subtype, the person experiences the intrusive thought that they have hit someone while they are driving. They fear that the person they have “hit” is dead or severely injured and, perhaps even worse, that they have just drove off and left this person at the scene of an accident. The person often then fears that they will now get caught and go to jail.

What are some of the more common compulsions of hit-and-run OCD?  Checking and more checking! A person with hit-and-run OCD might become stuck in a checking loop where they drive back to the place where they have allegedly hit someone, check that they have not indeed hit someone, and then continue driving. However, OCD is often called the doubting disorder for a reason. The person begins to doubt themselves and question whether or not they checked enough or perhaps they missed something. They may repeatedly drive back to check until they are absolutely certain that no one has been hit. The person might also check their rearview mirrors extensively for any signs of an accident or to observe other drivers reactions for evidence that a passerby was just hit. Other common compulsions include extensive reassurance seeking (reassuring themselves as well as asking for reassurance from others), monitoring the road for any bumps, and listening and looking for any emergency vehicles. A person might avoid certain areas (school zones) or even avoid driving all together. After the drive is completed, a person with hit-and-run OCD might check the news for any reports of a hit-and-run accident.

What are available treatments for hit-and-run OCD? The gold standard treatment for OCD, including hit-and-run OCD, is Exposure and Response Prevention (ERP). In this treatment, a person is gradually exposed to their fears while not engaging in any compulsions or avoidance behaviors.

More overview information about hit-and-run OCD is available on Dr. Steven’s Seay’s article available here.