How can we stop caregiver reassurance? Investigating predictors of family accommodation in obsessive-compulsive scenarios

Abstract

Excessively reassuring loved ones with OCD may prevent them from learning to tolerate uncertainty with negative consequences during psychotherapy. Researchers have yet to isolate the characteristics that predict OCD caregiver over-reassurance in real-life scenarios. The current study sought to identify the role of caregiver characteristics of empathy, consideration of future consequences (CFC) and experiential avoidance in willingness to reassure a hypothetical child with OCD symptoms against therapeutic advice. University community participants (N = 112) completed questionnaires assessing empathy, CFC, experiential avoidance, psychopathology, and beliefs about reassurance. Then, participants’ willingness to reassure the anxious child (against therapist advice) was observed during two interactive videos of simulated OCD checking and contamination scenarios. In the contamination scenario, multivariate regression analyses revealed the tendency to consider future consequences less and hold positive beliefs about accommodation each uniquely predicted willingness to reassure. No association was found between experiential avoidance or empathy and reassurance willingness. A similar pattern emerged following re-analysis without multivariate outliers, with the exception that elevated depression and anxiety symptoms increased willingness to reassure against therapeutic advice, and obsessive-compulsive symptoms and empathy decreased willingness to reassure against therapeutic advice. There were no significant associations between caregiver characteristics and reassurance in the checking scenario.