Background and objectives

Excessive reassurance seeking (ERS) in OCD increases following scenarios with high threat and personal responsibility, but the mechanism via which ERS addresses these concerns is unclear. We investigated whether reassurance following OCD-related threats facilitated temporary threat re-appraisal and/or transferred responsibility to others. We also examined the ‘checking by proxy’ theory of OCD ERS by comparing the functional mechanisms of reassurance and checking behaviour.

Methods

Community participants (N = 398) were recruited through MTurk and randomised to one of four conditions: ambiguous object-derived (checking) information, ambiguous person-derived (reassurance) information, unambiguous object-derived information and unambiguous person-derived information. Participants read scenarios that conveyed a risk of harm or contamination before imagining receiving reassurance or checking information as per their condition. Ratings of personal and external responsibility, threat likelihood and uncertainty were made before and after receiving the information.

Results

In support of a checking by proxy hypothesis of ERS, participants in the unambiguous information conditions reported decreased uncertainty, decreased estimated threat likelihood and increased responsibility of others, regardless of whether they imagined checking or receiving reassurance. Those in the ambiguous conditions reported no changes in threat estimation or responsibility beliefs. OCD symptom level moderated responses to ambiguity: unlike low OCD, high OCD participants did not respond differentially to ambiguous versus unambiguous reassurance.

Limitations

The study was performed online due to Covid-19 restrictions and utilised non-clinical participants.

Conclusions

Like checking, reassurance facilitates short-term threat re-appraisal and diffuses responsibility following obsessive threats. Differentiated responses to reassurance ambiguity disappear as OC symptoms increase.

中文翻译：

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强迫症中过度寻求安慰与强迫检查：比较内隐动机和机制

背景和目标

在具有高威胁和个人责任的情况下，强迫症患者过度寻求保证 (ERS) 会增加，但 ERS ​​解决这些问题的机制尚不清楚。我们调查了强迫症相关威胁后的再保证是否有助于临时威胁重新评估和/或将责任转移给他人。我们还通过比较再保证和检查行为的功能机制来检验 OCD ERS ​​的“代理检查”理论。

方法

社区参与者 ( N  = 398) 通过 MTurk 招募并随机分配到以下四种条件之一：模糊的对象衍生（检查）信息、模糊的人衍生（保证）信息、明确的对象衍生信息和明确的人衍生信息。参与者在想象根据自己的情况获得保证或检查信息之前，先阅读传达了伤害或污染风险的场景。在收到信息之前和之后对个人和外部责任、威胁可能性和不确定性进行了评级。

结果

为了支持 ERS ​​的代理检查假设，在明确信息条件下的参与者报告说，不确定性降低、估计威胁可能性降低和他人责任增加，无论他们是否想象检查或得到保证。那些处于模棱两可的条件下的人报告说威胁估计或责任信念没有变化。强迫症症状水平缓和了对模糊性的反应：与低强迫症不同，高强迫症参与者对模糊性和明确性的保证没有不同的反应。

限制

由于 Covid-19 的限制，该研究是在线进行的，并使用了非临床参与者。

结论

与检查一样，再保证有助于对短期威胁进行重新评估，并在强迫性威胁之后分散责任。随着 OC 症状的增加，对再保证模棱两可的差异化反应消失。