The Covert and Overt Reassurance Seeking Inventory (CORSI): Development, validation and psychometric analyses.

BACKGROUND: Reassurance seeking (RS) is motivated by perceived general and social/relational threats across disorders, yet is often under-recognized because it occurs in covert (i.e. subtle) and overt forms. Covert safety-seeking behaviour may maintain disorders by preventing corrective learning and is therefore important to identify effectively. AIMS: This study presents the validation and psychometric analyses of a novel measure of covert and overt, general and social/relational threat-related interpersonal RS. METHOD: An initial 30-item measure was administered to an undergraduate sample (N = 1626), as well as to samples of individuals diagnosed with obsessive compulsive disorder (OCD; n = 50), anxiety disorders (n = 60) and depression (n = 30). The data were subjected to exploratory and confirmatory factor analyses, and validation analyses. RESULTS: An exploratory factor analysis using principal axis factoring with oblique rotation yielded five interpretable factors, after removing four complex items. The resulting 26-item measure, the Covert and Overt Reassurance Seeking Inventory (CORSI), evidenced good convergent and divergent validity and accounted for 54.99% of the total variance after extraction. Factor correlations ranged from r = .268 to .736, suggesting that they may be tapping into unique facets of RS behaviour. In comparison with undergraduate participants, all clinical groups had significantly higher total scores [t (51.80-840) = 3.92-5.84, p < .001]. The CFA confirmed the five-factor model with good fit following the addition of four covariance terms (goodness of fit index = .897, comparative fit index = .918, Tucker-Lewis index = .907, root mean square error approximation = .061). CONCLUSION: The CORSI is a brief, yet comprehensive and psychometrically strong measure of problematic RS. With further validation, the CORSI has potential for use within clinical and research contexts.

What do you really need? Self- and partner-reported intervention preferences within cognitive behavioural therapy for reassurance seeking behaviour.

BACKGROUND: Reassurance seeking (RS) in obsessive compulsive disorder (OCD) is commonly addressed in cognitive behavioural therapy (CBT) using a technique called reducing accommodation. Reducing accommodation is a behaviourally based CBT intervention that may be effective; however, there is a lack of controlled research on its use and acceptability to clients/patients, and case studies suggest that it can be associated with negative emotional/behavioural consequences. Providing support to encourage coping with distress is a cognitively based CBT intervention that may be an effective alternative, but lacks evidence regarding its acceptability. AIMS: This study aimed to determine whether support provision may be a more acceptable/endorsed CBT intervention for RS than a strict reducing accommodation approach. METHOD: Participants and familiar partners (N = 179) read vignette descriptions of accommodation reduction and support interventions, and responded to measures of perceived intervention acceptability/adhereability and endorsement, before completing a forced-choice preference task. RESULTS: Overall, findings suggested that participants and partners gave significantly higher ratings for the support than the accommodation reduction intervention (partial η2 = .049 to .321). Participants and partners also both selected the support intervention more often than the traditional reducing accommodation intervention when given the choice. CONCLUSIONS: Support provision is perceived as an acceptable CBT intervention for RS by participants and their familiar partners. These results have implications for cognitive behavioural theory and practice related to RS.

An experimental investigation of contamination-related reassurance seeking: Familiar versus unfamiliar others.

BACKGROUND AND OBJECTIVES: Repeated reassurance seeking (RS) is a hallmark feature of obsessive-compulsive disorder (OCD). Research in related areas of psychopathology suggests that familiarity with a partner can influence symptom expression. We hypothesized that participants in the company of a familiar (vs. unfamiliar) partner would seek more reassurance following an ambiguous task involving contamination-related threat. METHODS: Participants completed an ambiguous dishwashing task in the company of a familiar or unfamiliar other, and were subsequently given an opportunity to seek reassurance. Participants and their assigned partners completed a measure of RS wherein they reported the number of times the participant sought reassurance; actual reassurance seeking was coded based on a recording of the interaction. RESULTS: Results demonstrated that participants sought more reassurance from familiar (vs. unfamiliar) others F(3, 86) = 9.20, p < .001, partial η(2) = .24); this effect was robust when partner-reported (F(1, 88) = 27.04, p < .001, partial η(2) = .24), a trend when participant-reported (F(1, 88) = 2.72, p = .10, partial η(2) = .03), but not significant when using objectively-coded data (F(1, 88) = 0.14, p = .71, partial η(2) = .00). LIMITATIONS: As this experiment was a preliminary attempt to examine RS in an interpersonal context, the study may not have captured compulsive or excessive RS. CONCLUSIONS: Overall, results suggest that RS may be perceived as more excessive by familiar (versus unfamiliar) others, which may contribute to the distress experienced by carers of individuals with OCD.