Excessive Reassurance Seeking Research Articles

Fighting OCD together: An experimental study of the effectiveness and acceptability of seeking and receiving emotional support for OCD

Excessive reassurance-seeking in OCD has been linked to the maintenance of OCD, functioning as a type of checking ritual. Current treatments recommend the imposition of the extinction of seeking and providing reassurance; however, this is not well tolerated. Although it has been suggested that the provision of support may provide a more helpful alternative, there is no empirical evidence for this. In the present study, 36 participants with OCD engaged with two personalised semi-idiographic scenarios in which they imagined seeking and receiving reassurance and seeking and receiving emotional support in counterbalanced order. The primary outcome measure was anticipated urge to seek reassurance, which was found to significantly decrease in the imagined support condition relative to the imagined reassurance condition regardless of order of presentation. Emotional support was perceived as significantly more acceptable when compared to imagining reassurance in terms of higher ratings of perceived helpfulness in managing emotions, feelings of calmness and closeness, and the sense that they were fighting OCD together. These findings provide preliminary evidence for the value of encouraging the seeking and giving of emotional support as an alternative to reassurance. Implications for clinical work and further research are discussed.

Evidence that specific personal relationships help regulate depressive symptoms and related constructs among people with probable major depressive disorder

ABSTRACT Introduction Relational regulation theory describes how social network members (providers of regulation) help people (recipients of regulation) regulate their effect, actions and thoughts through mostly ordinary social interaction. Regulation is relational when the ability of a provider to regulate a recipient is an emergent property of the dyad and not a stable property of the provider or recipient. Research in predominantly well samples has found that dyads evoked affect and self-relevant thought in recipients. The present research examined whether such effects occurred among people with probable major depressive disorder (MDD). Methods A national, internet sample of 2058 US residents was screened for probable MDD. Depressed recipients (N = 152) rated their experience of depression-related constructs when with or thinking about specific providers. Results Recipients’ reports of affect and thought varied strongly depending on the dyad they were with or thinking about. These effects occurred for depressive symptoms, positive and negative affect, self-esteem, negative automatic thoughts, hopelessness, excessive reassurance-seeking, reappraisal and emotion suppression. Dyads that evoked depression-related experiences were seen by participants as unsupportive and as evoking conflict. Conclusion Relational regulation appears to occur among people with MDD which provides new insights about interpersonal processes in depression.

The influence of attachment style on support and feedback seeking and depression severity among mothers during the COVID-19 pandemic.

The ways that people seek support during times of stress influence their mental health outcomes, including depression. Insecure attachment is a risk factor for depression and may also interfere with adaptive support and feedback-seeking behaviour during stress. The purpose of the present study was to test theorized associations between insecure attachment, support and feedback seeking, and changes in depression symptoms over 1 year, in a sample of mothers of school-age children in the context of stress elicited by the COVID-19 pandemic. Participants (N = 70 mothers) completed self-report measures of anxious and avoidant attachment and depression severity at baseline in spring 2020 and then completed measures of past-year engagement in direct and indirect support seeking and excessive reassurance seeking (ERS), preference for negative feedback, and depression severity at a follow-up assessment in summer 2021. Greater attachment anxiety at baseline predicted more frequent direct support seeking, indirect support seeking, and ERS during the 1-year follow-up period. In turn, greater indirect support seeking predicted greater increases in depression from baseline to follow-up. Greater attachment avoidance at baseline predicted less direct support seeking during the 1-year follow-up period. Greater attachment avoidance at baseline also predicted depression severity at follow-up, particularly among mothers with moderate to high levels of attachment anxiety, although none of the examined support and feedback-seeking behaviours mediated this association. These results provide support for the role of activated attachment systems in determining support and feedback-seeking behaviour during stress, as well as the role of support and feedback-seeking behaviour in the maintenance and exacerbation of depression.

The Difficulties in Interpersonal Regulation of Emotions Scale (DIRE): Factor Structure and Measurement Invariance across Gender and Two Chinese Youth Samples.

Effective interpersonal emotion regulation (IER) strategies have been found to be meaningful predictors for positive psychological functioning. The Difficulties in Interpersonal Regulation of Emotions Scale (DIRE) is a measure developed to assess maladaptive IER strategies. This study aimed to examine the psychometric properties of the Chinese version of DIRE using two college student samples (Sample 1: n = 296; Sample 2: n = 419). The two-factor structure of DIRE (venting and excessive reassurance-seeking) was confirmed through an exploratory structure equation modeling approach. Our results demonstrated that the Chinese version of DIRE exhibits a similar factor structure (in both samples) as the original DIRE. Measurement invariance across gender and samples was also achieved. Latent mean analyses demonstrated that females more frequently reported excessive reassurance-seeking (in both samples) and venting (in Sample 1) than males. Furthermore, venting and excessive reassurance-seeking were significantly related to intrapersonal emotion regulation and well-being indicators. Although in Chinese culture DIRE performs somewhat differently from the original DIRE, the current findings suggest that DIRE is a reliable and valid scale with which to measure the IER strategies in Chinese culture and the use of this measure in clinical practice may allow for an accurate assessment of emotion regulation deficits in clients from other diverse cultures.

THE EFFECTS OF LATE-LIFE RELOCATION ON ANXIETY AND PERSONALITY TRAITS: EVIDENCE FROM CHINA AND EUROPE

Abstract Later-life relocation has been identified as an important life event that affects the living environment, social relationships, and daily routines of older adults with subsequent effects on mental health and personality. We explored the impact of relocation on anxiety and personality traits in older adults from China and Europe in two separate studies., In study 1, we administered the questionnaire to 301 Chinese older adults (Mage=69.51, SD=5.02) who experienced involuntary rural-urban relocation, with 61.8% of them reported severe to extremely severe anxiety. Excessive reassurance-seeking and concomitant negative information bias were processes that contributed to increased anxiety among relocated older adults, which was particularly detrimental for those adults who were otherwise resilient. In study 2, we investigated the differences in personality traits between older adults who moved to nursing homes and those who lived in private housing using data from Wave 7 of the European Health, Ageing and Retirement Survey (SHARE). Reports from a total of 4829 older people living in nursing homes (NNH= 360) and private housing (NPH=4469) were included in the finally analysis. Our results showed that older people who relocated to nursing homes had lower extraversion and conscientiousness, and higher neuroticism. Additionally, older adults’ age, gender, health problems, physical activity, community size, and national socio-economic status partly explained personality differences between older adults who relocated and who stayed in their homes. Our findings underscore the importance and necessity of studying advantageous and detrimental effects of late-life relocation, and provide new directions and ideas for future research.

Interpersonal stress generation among young adolescents: vulnerable and resilient interpersonal behaviors and the generation of negative and positive interpersonal events.

Theoretical and empirical studies on stress generation suggest four event generation processes: (1) vulnerability factors predict more negative interpersonal events; (2) vulnerability factors predict fewer positive interpersonal events; (3) resiliency factors predict fewer negative interpersonal events; and (4) resiliency factors predict more positive interpersonal events. However, few studies have examined these four processes simultaneously within a single analytic model. Therefore, it is unclear whether vulnerability and resiliency factors make unique and differential contributions to the occurrences of negative and positive interpersonal events. This study aimed to fill this important gap by examining whether social withdrawal and excessive reassurance-seeking (vulnerable interpersonal behaviors) and prosocial behaviors (a resilient interpersonal behavior) uniquely and differentially predict the occurrences of negative and positive peer events among young adolescents. This study also examined the sex differences in these relationships. One hundred and ninety-eight students (109 girls) were recruited from a public middle school in Japan. A multiple-group path analysis was conducted to examine possible sex differences. Social withdrawal uniquely predicted more negative peer events for boys and fewer positive peer events for boys and girls. Excessive reassurance-seeking uniquely predicted both more negative peer events and more positive peer events for boys and girls. Prosocial behavior uniquely predicted more positive peer events for boys and girls. This study underscores the unique and differential roles of vulnerable and resilient interpersonal behaviors in predicting negative and positive peer events among young adolescents. These findings not only advance our understanding of stress generation processes but also have broader implications for adolescent development and well-being.

Interpersonal Factors, Peer Relationship Stressors, and Gender Differences in Adolescent Depression.

Compared to boys, girls value close relationships more. Thus, heightened affiliative proclivities may serve as a particularly salient psychosocial risk factor for depression in adolescent girls. The purpose of this review is to examine whether the preponderance of depression in girls is because of gender differences in interpersonal vulnerabilities and peer relationship stressors and/or in the associations between these factors and depression. Girls (vs. boys) exhibit higher levels of co-rumination and affective empathy, but not excessive reassurance-seeking. The prevalence of different forms of peer relationship stressors (e.g., peer victimization) varies by gender depending on the specific type. Evidence is mixed regarding gender differences in the association between peer victimization and depression. Gender differences in the association between peer victimization and depression not only depend on peer victimization subtype but also on the country. Most studies were conducted in non-clinical samples, highlighting the need for future research to assess major depressive disorder (not just depressive symptoms). Future research should also assess interpersonal factors (e.g., co-rumination) and peer relationship stressors together.

Like Mother, Like Daughter: Excessive Reassurance Seeking Across Mother–Daughter and Romantic Relationships

Excessive reassurance seeking (ERS) is a maladaptive self-regulatory behavior whereby an individual persistently seeks reassurance that one is loveable and worthy (Joiner et al., 1992; Joiner et al., 1999). Despite research evidencing the negative consequences of ERS on relationships, little is known about how ERS presents across relationships. The present study evaluated the associations between mothers’ and daughters’ ERS across the parent–child relationship and across their respective romantic relationships. Sixty-seven mother–daughter dyads were recruited to separately complete measures of ERS in reference to their relationships with each other and their relationships with their romantic partners. Consistent with our hypotheses, mothers’ ERS directed toward their romantic partners correlated with mothers’ ERS directed toward their daughters, r(65) = .36, p = .003, and daughters’ ERS directed toward their mothers also correlated with daughters’ ERS directed toward daughters’ romantic partners, r(65) = .25, p = .04. These preliminary findings highlight the interpersonal nature of ERS and contribute to the understanding of the consistency of this maladaptive interpersonal behavior across relationships.

Therapists’ beliefs about excessive reassurance seeking and helping manage it: does experience play a role?

Abstract Excessive reassurance seeking (ERS) is believed to play an important role in maintaining mental health problems, in particular anxiety disorders such as obsessive-compulsive disorder and health anxiety. Despite this, therapists commonly give into patients’ requests for reassurance in clinical settings and are generally unsure how to handle the issue both in therapy itself and concerning advice to the patient’s loved ones. In order to increase our understanding of therapists’ perception of ERS and how interventions for ERS are managed, we examined therapists’ perception and understanding of ERS, including its function, which emotional problems therapists associate it with, and what treatment interventions they consider important for managing ERS. Qualified therapists (n=197) were benchmarked against international expert consensus (n=20) drawn from leading clinical researchers. There was evidence that clinical experience right up to the expert level may result in less reassurance giving within treatment settings. Still, there were enough inconsistencies between the experts and other clinicians to suggest that ERS remains poorly understood and is not consistently dealt with clinically. Results are discussed in terms of how current treatment interventions may be limited for treating ERS, highlighting the need to consider new approaches for dealing with this complicated interpersonal behaviour. Key learning aims (1) To describe the role of excessive reassurance seeking in checking behaviour, including its negative personal and interpersonal consequences. (2) To learn that therapists commonly report finding it difficult to manage reassurance seeking. (3) To learn that therapists’ beliefs about excessive reassurance seeking may play a key role in helping us understand how to tackle this complicated behaviour. (4) To consider what therapeutic interventions may be appropriate and helpful for treating excessive reassurance seeking.

Problematic behaviours associated with generalized anxiety disorder during pregnancy and the postpartum period: A thematic analysis.

Given that worry during the perinatal period is largely maternally focused, the objective of this study was to explore the accompanying behavioural features of GAD during pregnancy and the postpartum period. A qualitative study was conducted. Twenty-five pregnant (n=10) and postpartum (n=15) women were recruited through clinical referrals and the Hamilton community. Following the completion of a semistructured diagnostic interview and symptom measures, participants participated in one of seven focus groups to learn about behaviours utilized in response to their worries. A thematic analysis was conducted to identify behaviour themes and subthemes in pregnant and postpartum women. Five behaviour themes and 12 subthemes were identified. Specifically, participants endorsed engaging in excessive reassurance seeking, checking and repeating, overcontrol, overpreparation and avoidance behaviours. Our results confirm that perinatal women with GAD engage in comparable problematic behaviours to those with GAD in the general population, yet the presentation, frequency and focus of those behaviours differ. These findings have implications for theoretical formulations of GAD, and the clinical management of this disorder during the perinatal period.

The Contribution of Attachment Styles and Reassurance Seeking to Trust in Romantic Couples.

The current daily diary study examined the moderating impact of attachment style on the association between excessive reassurance seeking (ERS) behavior and trust in romantic dyads. A sample of 110 heterosexual couples completed measures of attachment, ERS, and relationship trust. In line with prior research, an anxious attachment style was associated with higher daily ERS, and an avoidant attachment style with lower daily ERS. Lower levels of trust were also associated with greater daily ERS. Moreover, analyses remained significant while controlling for symptoms of depression. This study extended the literature by demonstrating that for women with an anxious attachment style, and men with an avoidant attachment style, ERS was related to lower next day trust. In contrast, the partners of men with an avoidant attachment style, who also engaged in ERS, reported higher levels of next day trust. This study was also the first to examine how individual attachment styles influenced the perception of, and reactions to, ERS. Women with an anxious attachment style liked when their male partners engaged in ERS, as illustrated by higher levels of reported trust. These results support the idea that attachment styles play an important role in determining whether or not ERS leads to negative interpersonal consequences. They also suggest that it is the combination of relationship insecurities and ERS that leads to negative interpersonal consequences.

Excessive reassurance seeking versus compulsive checking in OCD: Comparing implicit motivators and mechanisms

Background and objectivesExcessive 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. MethodsCommunity 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. ResultsIn 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. LimitationsThe study was performed online due to Covid-19 restrictions and utilised non-clinical participants. ConclusionsLike checking, reassurance facilitates short-term threat re-appraisal and diffuses responsibility following obsessive threats. Differentiated responses to reassurance ambiguity disappear as OC symptoms increase.

Emotion regulation deficits and depression-related maladaptive interpersonal behaviours

ABSTRACT Coyne’s interpersonal theory of depression posits that those with depressive symptoms engage in maladaptive interpersonal behaviours that, although intended to assuage distress, push away social supports and increase depressive symptoms (Coyne, 1976). Excessive reassurance seeking, negative feedback seeking, and conversational self-focus are three behaviours implicated in Coyne’s theory, yet their correlates- apart from depressive symptoms- are poorly understood. The current study considered the potential role of intrapersonal emotion regulation deficits as an additional vulnerability factor for these behaviours. Mediation models further tested whether linkages between emotion regulation deficits and maladaptive interpersonal behaviours helped to explain short-term increases in depressive symptoms, as further suggested by theory. Older adolescents (N = 291, M age = 18.9) completed self-report measures of emotion regulation deficits, depressive symptoms, and the three maladaptive interpersonal behaviours during an initial lab visit and again four weeks later. A series of multiple regression models suggested that emotion regulation difficulties are uniquely associated with each of the behaviours over and above the impact of depressive symptoms. Mediation analyses suggested that only excessive reassurance seeking mediated the association between initial emotion regulation deficits and increased depressive symptoms over time. The clinical implications of these findings are discussed.

Selfie Appearance Investment and Peer Feedback Concern: Multi-Method Investigation of Adolescent Selfie Practices and Adjustment.

Sharing "selfies" on social media is common among adolescents. The frequency with which adolescents post selfies may be less important than behaviors and cognitions underlying selfie-posting, and these practices may differ by gender. This multi-method study explored selfie practices in a school-based sample of 639 adolescents (M age=17.6; 53.5% female). Participants completed self-report measures of selfie practices, body esteem, depressive symptoms, and peer behaviors. In addition, a subset of participants' social media pages (n = 245) were observationally-coded for numbers of selfies, followers, and likes. Factor analyses revealed two distinct selfie practices: selfie appearance investment and selfie peer feedback concern. Girls posted selfies more frequently, and reported greater levels of appearance investment and concern over peer feedback on selfies compared to boys. Multiple group structural equation models indicated that for boys and girls, selfie appearance investment was associated with depressive symptoms. For girls only, selfie peer feedback concern was associated with excessive reassurance-seeking and lower body esteem. No associations were revealed between observationally-coded measures of selfie-posting frequency and psychosocial outcomes. Overall, findings suggest that frequency of selfie-posting may be less relevant for understanding adolescent adjustment than investment in and concern over the selfie-posting experience.

Adolescent girls' stress responses as prospective predictors of self-injurious thoughts and behaviors: A person-centered, multilevel study.

Adolescent risk for self-injurious thoughts and behaviors (STBs) involves disturbance across multiple systems (e.g., affective valence, arousal regulatory, cognitive and social processes). However, research integrating information across these systems is lacking. Utilizing a multiple-levels-of-analysis approach, this person-centered study identified psychobiological stress response profiles and linked them to cognitive processes, interpersonal behaviors, and STBs. At baseline, adolescent girls (N = 241, Mage = 14.68 years, Range = 12-17) at risk for STBs completed the Trier Social Stress Test (TSST), questionnaires, and STB interviews. Positive affect (PA), negative affect (NA), and salivary cortisol (SC) were assessed before and after the TSST. STBs were assessed again during 3, 6, and 9 month follow-up interviews. Multitrajectory modeling of girls' PA, NA, and SC revealed four profiles, which were compared on cognitive and behavioral correlates as well as STB outcomes. Relative to normative, girls in the affective distress, hyperresponsive, and hyporesponsive subgroups were more likely to report negative cognitive style (all three groups) and excessive reassurance seeking (hyporesponsive only) at baseline, as well as nonsuicidal self-injury (all three groups) and suicidal ideation and attempt (hyporesponsive only) at follow-up. Girls' close friendship characteristics moderated several profile-STB links. A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.

Intrapersonal Emotion Regulation Difficulties and Maladaptive Interpersonal Behavior in Adolescence.

Although most research conceptualizes emotion regulation as an internal process (i.e., intrapersonal), emotions are frequently regulated in an interpersonal context. Adolescents may be particularly prone to turn to peers for assistance, given that honing emotion regulation abilities is a key task and peers become increasingly important at this stage. Adolescents each participated with a self-nominated same-gender friend (total N = 186; M age = 15.68years). All participants provided self-reports of their own emotion regulation difficulties and their engagement in interpersonal behaviors (excessive reassurance seeking, negative feedback seeking, conversational self-focus, self-disclosure) as well as their perceptions of their friends' engagement in excessive reassurance seeking and conversational self-focus. Using a cross-lagged panel model design, the current study tested associations between adolescents' intrapersonal emotion regulation difficulties and engagement in self- and friend-reported interpersonal emotion regulation behaviors at 3 time points over 6months. Gender and age group differences were considered. Results evidenced concurrent and longitudinal associations between emotion regulation difficulties and self-reported maladaptive (excessive reassurance seeking, conversational self-focus, negative feedback seeking), but not adaptive (self-disclosure), interpersonal regulatory behaviors. Friends' reports of adolescents' excessive reassurance seeking and conversational self-focus were associated concurrently, but not longitudinally, with self-reported emotion regulation difficulties. Implications for clinical intervention with adolescents struggling to regulate emotions are discussed.

NEGATIVE FEEDBACK SEEKING AND EXCESSIVE REASSURANCE SEEKING BEHAVIOR AND DEPRESSION: A META-ANALYTIC REVIEW

Introduction: Negative feedback seeking and excessive reassurance seeking behaviors in interpersonal relationships have been shown to frequently occur in conjunction with levels of depression.Method: We used meta-analysis to examine 102 studies (134 effects), relating depression with negative feedback seeking (k = 31) and/or excessive reassurance seeking (k = 103).Results: Depression had positive, moderate effect sizes with both negative feedback seeking (r = .26, 95% CI [.21, .32], p < .001, k = 31) and excessive reassurance seeking (r = .33, 95% CI [.31, .36] p < .001, k = 103). Subgroup analysis revealed the effect size for negative feedback seeking was smaller in romantic relationships compared to other relationship types. Effect sizes for excessive reassurance seeking did not differ for romantic and other relationships but were smaller in romantic relationships of a longer duration. Participant gender and symptom severity did not moderate effect sizes. Studies with child and adolescent samples had larger effects for negative feedback seeking and smaller effects for excessive reassurance seeking, relative to adult samples.Discussion: Longer closer relationships may protect against maladaptive interpersonal behaviors in individuals with depression.

Applying a Multicomponent Framework to Manage School Refusal: A Case Report

Abstract Introduction: This paper presents the rationale of applying a combined cognitive behavioral and dialectical approach with parent management strategies to a case of anxiety-based school refusal. School refusal is a serious concern that causes much subjective distress to the child, placing his/her parents under tremendous stress. It negatively impacts the child’s self-worth and psychological well-being, and also interferes with social and educational development. The condition is frequently co-morbid with emotional difficulties including depression and anxiety in children and adolescents. Method: The client in this study is a 17-year-old boy with an above average intelligence level presented with school refusal, along with symptoms of anxiety, obsessive worry and excessive reassurance seeking behaviors. Initial assessments using the Children’s Global Assessment Scale (CGAS) revealed moderate impairment in the social area and severe impairment in the academic area. The client showed clear difficulties in emotion regulation, in terms of a higher use of expressive suppression and lesser use of cognitive reappraisal, which were identified on the Emotion Regulation Questionnaire (ERQ). Psychotherapy involved weekly sessions of Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) techniques including facilitating exposure, cognitive restructuring, distress tolerance, effective goal setting, and interpersonal effectiveness skills in the family context. Changes were assessed at 6 months, 12 months and 18 months follow-up. Results: Results showed reductions in subjective anxiety and reassurance seeking behaviors, and an increase in distress tolerance, with a higher use of cognitive reappraisal. Improvements in interpersonal effectiveness in the family context were noted. The CGAS and ERQ ratings at 6 months, 12 months and 18 months follow-up showed steady improvement, with the client resuming regular schooling. Conclusion: A combined cognitive behavioral and dialectical behavioral approach can be useful in managing school refusal. This case report emphasizes the need for further research to understand the effectiveness of multicomponent approaches to school refusal.

Excessive-reassurance seeking and mental health: Interpersonal networks for emotion regulation

In the context of research on depression, previous studies have explained relationships between excessive-reassurance seeking and mental health from the perspective of interpersonal rejection by significant others. The present study examined the mechanisms underlying these relationships from the perspective of “emotionships”, which indicates the diversity of interpersonal networks for emotion regulation. We also examined how the most significant other’s interpersonal acceptance plays a role in processes that underlie the relationship between excessive-reassurance seeking and mental health as mediated through emotionships. 118 students completed three questionnaires. First, they completed measures of excessive-reassurance seeking, depression and well-being. Second, to assess emotionships, participants nominated individuals they seek in different emotion regulation scenarios. Third, participants selected the most significant other that they nominated previously and answered questions about this individual’s acceptance tendency. Moderated mediation analysis results indicated that in a case that the most significant other did not tend to accept others, those who engaged in excessive-reassurance seeking had fewer emotionships, and fewer emotionships predicted deterioration of well-being. In contrast, when the most significant other tended to accept others, these negative effects of ERS behavior on well-being via emotionships were not found. These findings suggest that maintaining interpersonal networks for emotion regulation and the most significant other’s interpersonal acceptance may be important for preventing deterioration of mental health among excessive-reassurance seekers.

Excessive reassurance seeking in depression versus obsessive-compulsive disorder: Cross-sectional and cognitive behavioural therapy treatment comparisons

Excessive reassurance seeking (ERS) has been hypothesized as an important maintenance factor in depression and obsessive compulsive disorder (OCD). The present study examined the types of ERS in depression and OCD, the effects of CBT on ERS, predictors of ERS reduction, and the relation between ERS reduction and symptom change. MethodTreatment-seeking participants diagnosed with a depressive disorder (N = 361) or OCD (N = 156) completed the Reassurance Seeking Scale (RSS) and symptom measures before and following CBT treatment. Measures of intolerance of uncertainty and distress tolerance were completed pre-treatment as potential predictors of ERS change. ResultsIndividuals with depression demonstrated higher pre-treatment ERS related to social attachment compared to those with OCD. ERS significantly decreased over treatment in both groups and change in ERS predicted symptom change among both OCD and depression groups. Higher pre-treatment intolerance of uncertainty significantly predicted less ERS change regardless of diagnosis. Distress tolerance was not associated with ERS changes. ConclusionERS is significantly related to symptom severity cross-sectionally as well as over treatment in depression and OCD, though types of ERS may differ. Higher intolerance of uncertainty may impede the reduction of ERS in CBT.