Excessive Reassurance Seeking and Cognitive Confidence in Obsessive-Compulsive Disorder

Repeatedly questioning others about perceived threats, or excessive reassurance seeking (ERS), occurs across various psychiatric disorders, including obsessive-compulsive disorder (OCD; Parrish 2009). Three ERS domains have been consistently identified: ERS in response to general, decision-related, and social threats. We sought to examine whether (1) specific ERS domains are common in OCD, (2) ERS correlates with OCD symptom severity, (3) ERS levels impact the likelihood of having primary checking compulsions, and (4) ERS correlates with cognitive confidence. Participants were OCD patients (n = 35) and non-psychiatric controls (n = 34) who completed diagnostic and/or self-report measures. OCD patients reported significantly greater ERS than controls across all domains. ERS correlated positively with symptom severity. High decision-related ERS was found to increase the likelihood of checking as a primary symptom. Decision-related ERS correlated negatively with decision-making confidence and overall cognitive confidence. These findings greatly enhance our understanding of ERS in OCD. Implications for psychological interventions are discussed.