Compulsive Checking Research Articles

Are Compulsive Checkers Impaired in Memory? A Meta-Analytic Review

Are Compulsive Checkers Impaired in Memory? A Meta-Analytic Review

A Comparison of Checking-related Beliefs in Individuals with Obsessive Compulsive Disorder and Normal Controls

AbstractThe potential roles of perceived danger, responsibility, thought-action fusion, confidence in memory, intolerance of uncertainty and need to control one's thoughts in mediating compulsive checking were examined. Belief ratings were obtained from 21 individuals with compulsive checking concerns and 21 nonclinical controls about the most prominent checking concern of each individual with obsessive compulsive disorder (OCD), with controls being yoked to individuals with OCD on the basis of gender and age. If control participants and individuals with OCD have some similar beliefs regarding, for example, locking their front door, then it follows that those beliefs are unlikely to be mediating or driving the disorder. Large and significant differences were found between sufferers of OCD and nonclinical controls on ratings of beliefs concerning the probability and severity of harm, intolerance of uncertainty and the need to control thoughts. However, no differences were found between individuals with OCD checking concerns and nonclinical controls in ratings of beliefs concerning perceived personal responsibility, thought-action fusion (TAF) and confidence in memory. The findings concerning personal responsibility are of particular interest and suggest that perceptions of harm or a negative outcome may be a necessary precursor to perceptions of responsibility and the decision to act.

A cognitive theory of compulsive checking

It is proposed that compulsive checking occurs when people who believe that they have a special, elevated responsibility for preventing harm, mainly to others, are unsure that the perceived threat has been reduced or removed. The intensity and duration of this checking is determined by three “multipliers”: increased responsibility, probability of harm and anticipated seriousness of harm. The recurrency of the checking is promoted by a self-perpetuating mechanism, comprising four elements: paradoxical increases in responsibility and in perceived probability of harm, reduced confidence in memory and the absence of a certain end to the threat. The relation between compulsive checking and other anxiety disorders is examined and the successes and failures of past or present treatments re-considered. Experimental predictions are set out and the therapeutic implications of the construal are discussed.

Effect of nicotine on quinpirole-induced checking behavior in rats: implications for obsessive-compulsive disorder

Background: Rats treated chronically in a large, open field with the dopamine D 2/D 3 receptor agonist quinpirole (QNP) develop compulsive checking behavior as defined by a set of behavioral criteria. This paradigm has been suggested as an animal model of obsessive-compulsive disorder (OCD). Because nicotine blocks various behaviors induced by ontogenetic QNP administration, we asked whether nicotine could attenuate QNP-induced compulsive checking. Methods: Adult male Long-Evans rats ( n = 14/group) were treated twice weekly with saline (control), or with QNP (0.5 mg/kg) for 14–16 injections. On the last two injections, rats were pretreated in random order with an acute dose of nicotine (0.3 mg/kg base) or saline 10 min before administration of QNP or saline; and the effects on checking behavior was examined. The effects of chronic QNP treatment on nicotinic receptors in discrete brain regions were also determined. Results: Chronic QNP resulted in compulsive checking and increases in cerebellar α 4β 2 and α 7 nicotinic receptor densities. Nicotine pretreatment significantly reduced one of the three measures of compulsive checking behavior. Conclusions: Nicotine attenuates some symptoms of compulsive checking in a rat model of OCD; however, the mechanisms of this effect and therapeutic efficacy of nicotinic agonists in OCD require further study.

Are compulsive checkers impaired in memory? A meta-analytic review.

Researchers have hypothesized that compulsive checkers suffer from impairment in explicit memory (e.g., Sher, Frost, & Otto, 1983), low confidence in explicit memory (e.g., McNally & Kohlbeck, 1993), or both. However, empirical findings have been equivocal, possibly due to variability in effect sizes produced by small samples. Combining data across studies may yield more meaningful conclusions than can be surmised from a narrative review. Following a brief review of the literature on checking and memory, we present meta-analytic results suggesting that checkers are impaired on many types of memory tasks (e.g., verbal free recall, verbal cued recall, and recall of actions) and are less confident in recognition than noncheckers. We discuss implications of these findings, suggestions for future research, and limitations of this analysis.

Subjektives Gefühls- und Körpererleben bei Wasch- und Kontrollzwangshandlungen

Subjective Emotional and Physical Experience during Compulsive Washing and Checking Background: Contrary to its general acceptance, empirical evidence for the anxiety reduction hypothesis for compulsions has so far been insufficient. Furthermore, a number of arguments question its validity. For the development and maintenance of compulsive washing and checking – the two most important subgroups of obsessive- compulsive disorder – anxiety reduction could be of differential importance. Patients and Methods: The present study examined whether compulsive behavior also serves to intensify positively valent emotions apart from reducing negatively valent emotions and physical arousal and, moreover, whether positive reinforcement is dominating in compulsive checking in comparison to compulsive washing. Results: The study shows that compulsions are experienced as both reducing negative affectivity and intensifying positive affectivity, accompanied by a subjective physiological deactivation. Compulsive washing and checking do not differ herein. On the level of single emotions and physical sensations, significant changes of intensity could be shown for anxiety, relief, satisfaction, tension, inner agitation, and relaxation. The experience of disgust represents a particularly discriminating characteristic between washing and checking. Conclusion: The results suggests that the anxiety reduction hypothesis should also encompass the aspect of a possible ‘double reinforcement’ of compulsions.

The occurrence of panic and obsessive compulsive symptoms in women with postpartum dysphoria: a prospective study

Objective: This study investigated the prevalence of panic and obsessive compulsive symptoms in a sample of postpartum women who endorsed high levels of dysphoria on a self-report depression measure. Method: A community-based sample of 788 postpartum women with self-reported depressive symptomatology completed an interview assessing major depression, panic disorder, and obsessive compulsive disorder. Results: An estimated 11% of the sample reported difficulties with panic attacks, 8% reported difficulties with obsessions, and 9% reported difficulties with compulsions. The most common panic symptoms included heart palpitations, sweating, trembling, and parasthesis. The most common content areas of obsessive compulsive symptoms were concerns about imminent disaster, compulsive cleaning behavior, and compulsive checking behavior, which were often related to fears concerning the newborn child. Comorbid depression and panic disorder was diagnosed in 1% of this sample, and comorbid depression and obsessive compulsive disorder was diagnosed in 2.4% of this sample. Conclusion: Postpartum panic and obsessive compulsive symptoms are common experiences that should be considered in treatment planning for women reporting dysphoria after they give birth.

Mirror, mirror on the wall, who is the ugliest of them all? The psychopathology of mirror gazing in body dysmorphic disorder

Patients with Body Dysmorphic Disorder (BDD) may spend many hours in front of a mirror but little is known about the psychopathology or the factors that maintain the behaviour. A self-report mirror gazing questionnaire was used to elicit beliefs and behaviours in front of a mirror. Two groups were compared, which consisted of 55 controls and 52 BDD patients. Results: Prior to gazing, BDD patients are driven by the hope that they will look different; the desire to know exactly how they look; a belief that they will feel worse if they resist gazing and the desire to camouflage themselves. They were more likely to focus their attention on an internal impression or feeling (rather than their external reflection in the mirror) and on specific parts of their appearance. They were also more likely to practise showing the best face to pull in public or to use “mental cosmetic surgery” to change their body image than controls. BDD patients invariably felt worse after mirror gazing and were more likely to use ambiguous surfaces such as the backs of CDs or cutlery for a reflection. Conclusion: Mirror gazing in BDD consists of a series of complex safety behaviours. It does not follow a simple model of anxiety reduction that occurs in the compulsive checking of obsessive–compulsive disorder. The implications for treatment are discussed.

Compulsive checking and selective processing of threatening information.

Threatening stimuli are processed differently from neutral ones by anxious and obsessive-compulsive subjects. In the present research, processing of threatening words was compared with that of neutral words for two groups of Italian students, one with high mean and one with low mean score on Checking, a subscale of the Padua Inventory. Two tests were given, a computerized version of the emotional Stroop task and a later recognition test under incidental learning conditions. The expected interference effect on the Stroop task for those scoring high on Checking was confirmed. These results suggest an association between compulsive checking and bias in the first automatic stages of processing of threatening stimuli.

Memory bias, confidence and responsibility in compulsive checking

Recent research suggests that there is a positive memory bias for threatening information in compulsive cleaners. However, the relationship between OCD and memory is likely to be more complex when the compulsive behaviour is checking. Hence, we decided to explore this relationship in a clinical sample of people who check compulsively. Participants completed a diagnostic interview and were then asked to complete a standard ‘baseline’ check which normally causes distress/discomfort. Two additional checks were then completed—one under conditions of high responsibility and one under low responsibility. The order of responsibility manipulation was randomized across participants. After each check, participants completed a Memory and Confidence Interview which assessed memory for threat-relevant and threat-irrelevant aspects of the check, and also confidence in memory for the check. One week later, participants came into the laboratory to complete additional Memory and Confidence Interviews after watching a videotape of the checks completed earlier in their own homes. These videotaped checks were taken as conditions of ‘no responsibility’. Results show a positive memory bias for threat-relevant information. As responsibility was inflated, this positive memory bias was amplified. Under conditions of no responsibility, no memory bias was detectable. Also, responsibility appears to have had a greater impact on confidence in memory than on memory itself in OCD. The results are discussed in terms of the mnestic deficit theory of OCD and in terms of cognitive-behavioural approaches to understanding the disorder.

Compulsive checking behaviors in generalized anxiety disorder.

Recent evidence suggests that a relationship exists between worry, the central feature of generalized anxiety disorder (GAD), and compulsive behaviors, particularly compulsive checking. In this article we report the results from two studies. The first study assessed the frequency of obsessions and compulsions in 107 principally diagnosed GAD clients. The second study examined levels of alexithymia in analogue samples of GAD checkers (n = 31), GAD noncheckers (n = 30), and non-GAD nonchecking controls (n = 27) using the Toronto Alexithymia Scale-20 (Bagby, Parker, & Taylor, 1994). The results from these studies suggest that compulsive behaviors in the form of compulsive checking is more common in GAD than previously expected and that such behaviors in GAD may act as an additional mechanism by which affective experiences are avoided.

Compulsive checking behavior of quinpirole-sensitized rats as an animal model of Obsessive-Compulsive Disorder(OCD): form and control

BackgroundA previous report showed that the open field behavior of rats sensitized to the dopamine agonist quinpirole satisfies 5 performance criteria for compulsive checking behavior. In an effort to extend the parallel between the drug-induced phenomenon and human obsessive-compulsive disorder (OCD), the present study investigated whether the checking behavior of quinpirole rats is subject to interruption, which is an attribute characteristic of OCD compulsions. For this purpose, the rat's home-cage was placed into the open field at the beginning or the middle of a 2-hr test.ResultsIntroduction of the home-cage reduced checking behavior, as rats stayed inside the cage. After 40 min, checking resurfaced, as quinpirole rats exited the home-cage often. An unfamiliar cage had no such effects on quinpirole rats or saline controls.ConclusionsChecking behavior induced by quinpirole is not irrepressible but can be suspended. Results strengthen the quinpirole preparation as an animal model of OCD compulsive checking.

The relationship between schizotypal and obsessive-compulsive features in university students

Comorbid schizotypal personality disorder (SPD) is relatively common in patients with obsessive-compulsive disorder. Some have argued, however, that the severity of the primary disorder results in inflated estimates of personality disorder. The present investigation explored the possibility that schizotypal features are also significantly related to obsessive-compulsive features in a nonclinical sample. One-hundred and ninety-two student volunteers completed the Maudsley Obsessional-Compulsive Inventory (MOCI) and the Schizotypal Personality Questionnaire (SPQ), the latter being a self-report inventory designed to tap all nine features of DSM-III-R SPD. Correlations between schizotypal and obsessive-compulsive features were strongest for compulsive checking as opposed to compulsive washing, slowness or doubting. Regression analyses revealed that only the MOCI checking subscale was a significant independent predictor of the total SPQ schizotypal score. Findings indicate that schizotypal features are also found in association with nonclinical levels of obsessive-compulsive features, particularly checking behaviors. The influence of gender on these findings are discussed.

Cognitive and behavioural treatments of checking behaviours: an examination of individual cognitive change

Most tenants of cognitive models agree that the way OCD patients evaluate their intrusive thoughts leads them to use compulsions. In contrast, others have suggested that patients' cognitions would be post hocrationalizations for their irrational neutralizing. This study examined individual cognitive change during successful Cognitive Therapy (CT) of compulsive checking using Multivariate Time Series (MTS) analysis. We also verified whether similar cognitive changes occurred during a standard Exposure and response prevention Treatment (ET). Six OCD patients suffering from compulsive checking participated in the study. They rated daily four variables during treatment: (1) belief about responsibility, (2) perfectionistic tendency, (3) perceived severity of outcome if checking not performed and (4) Checking Interference. MTS analysis was carried out on the four variables for each patient to test whether the cognitive change preceded the decrease of Checking Interference. Results show that for 2/3 of patients in cognitive therapy and all patients in the exposure treatment, change on at least one cognitive variable preceded the decrease of checking interference. Moreover, for all but one patient, some change in symptoms also preceded cognitive change at some point during treatment. The present study suggests that at least one mechanism involved during both CT and ET for OCD would involve the precedence of belief change over symptoms. Results also provide some evidence for another mechanism, which would include the precedence of symptom change over cognitions. The question of whether one of these mechanisms occurs first then remains to be empirically demonstrated. Copyright © 2000 John Wiley & Sons, Ltd.

Distinguishing manifestations of anxiety: how do personality traits of compulsive checkers differ from other anxious individuals?

To better understand relations between personality and anxiety in general, and personality differences between compulsive checkers and nonchecking anxious individuals in particular, the current study was conducted. Participants included a nonclinical undergraduate sample of 36 compulsive checkers, 33 nonchecking anxious controls and 33 nonchecking nonanxious controls who were compared on five basic personality dimensions: emotional stability, extraversion, agreeableness, conscientiousness and intellect (Goldberg, 1992). Results indicated that a combined group of all anxious individuals was less extraverted and less emotionally stable than nonchecking/nonanxious controls. Results further indicated that compulsive checkers were less emotionally stable and more conscientious than nonchecking anxious controls. The implications of these findings, as well as the impact of the order of personality item presentation, are considered and discussed.

高不安者の脅威情報に対する処理バイアス : 確認強迫の高低による比較

先行研究により,不安の高い人は脅威情報を選択的に処理することが示されている.本研究は,高不安者のうち確認強迫傾向の高い者と低い者の脅威情報に対する選択的処理を比較した.強迫あり高不安群(n=16),強迫なし高不安群(n=14),統制群(n=16)の3群に対して,情動ストループテストが施行された.刺激語は中立語,不安語,強迫語である.各被験者にとって完全に閾下となる呈示時間及び閾値があらかじめ測定され,閾下,閾値,閾上の3条件で刺激語が呈示された.被験者は単語を無視して,単語の背景についている色の名前をできるだけ早く答えることが求められた.その結果,以下の点が明らかになった.1)強迫なし高不安群は統制群に比べ,不安語を自動的に処理しやすかった.2)強迫あり高不安群では統制群に比べ,意識が関与し始める段階で不安語の処理が制御された.3)強迫あり高不安群は強迫語に対して選択的処理バイアスを示さなかった.最後に,確認強迫傾向の高い者の情報処理パターンについて考察を行った.

The influence of obsessive-compulsive neurosis patients' premorbid personality on obsessive-compulsive symptoms and efficacy of medication.

We conducted a survey with the Lynfield obsessive-compulsive symptom questionnaire (revised version) on 48 obsessive-compulsive neurotic patients as the survey subjects. In the factor analysis five factors of obsessions, were identified: (i) the desire for perfection; (ii) compulsive checking; (iii) washing; (iv) feelings of uncleanliness; and (v) anthropophobia. High correlations were noted between these factors. We also investigated the premorbid personalities of obsessive-compulsive neurotic patients with a multidimensional personality scale and obtained an extroversion dimension and neuroticism dimension. The influence of these premorbid personality dimensions on obsessive-compulsive symptoms became clear; (i) neuroticism is related to the levels of obsession after onset, but not related to compulsive behaviors; and (ii) No differences in premorbid personality dimensions were noted between compulsive checking and compulsive washing behaviors. We also studied whether it was possible to predict the efficacy of pharmacotherapy upon obsessive-compulsive symptoms. It was elucidated that the obsessions of those whose premorbid personalities are emotionally stable and extroversive are susceptible to antidepressants. Based on these results, we discussed the usefulness of premorbid personalities in predicting diversity of obsessive-compulsive symptoms, as well as in prediction the efficacy of medication.

Quinpirole induces compulsive checking behavior in rats: a potential animal model of obsessive-compulsive disorder (OCD).

Rats treated chronically with the dopamine agonist quinpirole (0.5 mg/kg, twice weekly x 10) met 5 criteria for performance of compulsive checking. Specifically, in a large open-field with single small objects in 4 of 25 locales, quinpirole rats revisited two places/objects excessively often and rapidly, compared with other locations in the environment or saline controls. They performed a ritual-like set of behavioral acts at these two places/objects and stopped in relatively few locales before returning to the preferred places/objects. Finally, they shifted their behavior to a new location when the object was moved there. Clomipramine (10 mg/kg, daily) postponed but did not prevent the development of the quinpirole effect. Quinpirole-induced compulsive checking may be an exaggeration of normal checking of home site in rats. Results suggest an animal model of obsessive-compulsive disorder and a role for dopamine in this disorder.

Quinpirole induces compulsive checking behavior in rats: A potential animal model of obsessive-compulsive disorder (OCD).

Rats treated chronically with the dopamine agonist quinpirole (0.5 mg/kg, twice weekly x 10) met 5 criteria for performance of compulsive checking. Specifically, in a large open-field with single small objects in 4 of 25 locales, quinpirole rats revisited two places/objects excessively often and rapidly, compared with other locations in the environment or saline controls. They performed a ritual-like set of behavioral acts at these two places/objects and stopped in relatively few locales before returning to the preferred places/objects. Finally, they shifted their behavior to a new location when the object was moved there. Clomipramine (10 mg/kg, daily) postponed but did not prevent the development of the quinpirole effect. Quinpirole-induced compulsive checking may be an exaggeration of normal checking of home site in rats. Results suggest an animal model of obsessive-compulsive disorder and a role for dopamine in this disorder.

A plausible rat model of obsessive-compulsive disorder: Compulsive checking behavior is induced in rats chronically injected with quinpirole

A plausible rat model of obsessive-compulsive disorder: Compulsive checking behavior is induced in rats chronically injected with quinpirole