Interactions of Technology and Obsessive-Compulsive Disorder Symptomatology in Adults: Qualitative Interview Study.

Background: Obsessive-compulsive disorder (OCD) affects 1%-3% of the population and is marked by intrusive obsessions and compulsive behaviors that impair daily functioning. As digital technologies have become ubiquitous, their features may interact with OCD symptom dimensions in ways that both exacerbate and alleviate symptoms. While case reports and clinical anecdotes suggest such interactions, systematic investigation of patients' lived experiences with technology remains limited. Objective: This study aimed to explore how individuals with OCD perceive and navigate their interactions with modern technologies, and to identify how specific features of technology may contribute to, reinforce, or relieve obsessive-compulsive symptom cycles. Methods: We conducted semistructured interviews (n=24) with adults self-reporting a diagnosis of OCD, recruited through online OCD communities and advocacy networks. Interviews were conducted via the HIPAA (Health Insurance Portability and Accountability Act)-compliant platform Zoom (Zoom Communications) between May and December 2024 (median duration 51, IQR 6.5 minutes). Transcripts were coded in Dedoose (version 9.2.22; SocioCultural Research Consultants) using a constructivist grounded theory approach. Coding proceeded iteratively through open and focused coding, with theoretical saturation reached after 15 interviews. Constant comparison and analytic memoing guided the development of a conceptual framework linking technology features to OCD symptom dimensions. Results: Participants (median age 26, IQR 12.8, range 20-64 years; 67%, 16/24 women, 29%, 7/24 men, and 4%, 1/24 nonbinary) described technology as both a trigger for and a coping tool against OCD symptoms. Analysis produced four central technology-related categories: (1) information-provision platforms (eg, social media, search engines, large language models, etc) that triggered disturbing-thought obsessions and enabled compulsive checking and reassurance-seeking; (2) gamification and quantification features (eg, streaks, progress bars, and tracking metrics) that reinforced "not-just-right" and symmetry-based compulsions; (3) notifications that provoked urges to clear, check, and maintain control, spanning both disturbing-thought and symmetry domains; and (4) user interfaces whose complexity and customizability elicited compulsive ordering, avoidance behaviors, and digital overwhelm. Conclusions: This study characterizes how interactions between OCD and digital technologies manifest across established symptom domains, most notably disturbing-thought and "not-just-right" categories. Participants overwhelmingly experienced compulsive checking, reassurance-seeking, and ordering behaviors reinforced by features such as information-provision, gamification, notifications, and user interfaces. These findings highlight the clinical relevance of technology-related compulsions and suggest value in their systematic assessment, incorporation into psychoeducation, and consideration in digital design.