What Are You Looking for? Psychometric and Experimental Analyses of Reassurance Seeking in Obsessive-compulsive Disorder

Study Overview
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Brief Summary
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This study evaluates the efficacy and acceptability of two cognitive-behavioural interventions for reassurance seeking behaviour in obsessive-compulsive disorder (OCD), a family accommodation reduction protocol vs. a novel support-seeking protocol. Half of participants will be randomly assigned to participate in the support-seeking intervention, whereas the other half will participate in the family accommodation reduction intervention.

Detailed Description
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An existing family accommodation reduction intervention to reduce reassurance seeking behaviour in OCD (which represents treatment as usual, or TAU) is being compared to a novel support-seeking intervention to determine which is more efficacious and acceptable to participants. The TAU protocol asks participants to make an agreement with their significant others to withhold reassurance when it is sought. It is believed that this behaviourally-based intervention encourages extinction of reassurance seeking over time by eliminating reinforcement of the behaviour by significant others. The support-seeking intervention asks participants to move towards adaptively seeking support from a significant other to manage anxiety or distress rather than seeking reassurance. Significant others are taught to provide support rather than reassurance. It is believed that support-seeking may reduce reassurance seeking behaviour because it helps participants manage the anxiety or distress that underlies the requests for reassurance without interfering with disconfirmatory learning.

Official Title
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What Are You Looking for? Psychometric and Experimental Analyses of Reassurance Seeking in Obsessive-compulsive Disorder

Conditions
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Obsessive-Compulsive Disorder

Intervention / Treatment
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* Other: Cognitive-behavioural therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of OCD Engaging in reassurance seeking more than once a day about the same thing Willingness to allow the experimenter to contact a significant other from whom the participant seeks reassurance regularly Ability to read, write, and communicate in English Exclusion Criteria: Current suicidal ideation/intent Current substance abuse Psychosis Diagnosis of bipolar disorder (I or II) If participants are on medication they must be on a stable dose (i.e., have maintained a consistent dose for at least three months) and agree not to change their medication regimen for the duration of the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Support-seeking intervention<br>Cognitive-behavioural therapy intervention that guides participants to seek support rather than reassurance; participants' significant others are asked to provide support rather than reassurance. | Other: Cognitive-behavioural therapy<br>* Empirically-supported psychological intervention for various mental health concerns including obsessive-compulsive disorder (OCD). Includes components to foster cognitive (i.e., thinking) and behavioural changes.<br>|
| Active Comparator: Family accommodation reduction intervention<br>Cognitive-behavioural therapy intervention that guides participants' significant others to withhold reassurance when it is requested; participants are asked to refrain from seeking reassurance. | Other: Cognitive-behavioural therapy<br>* Empirically-supported psychological intervention for various mental health concerns including obsessive-compulsive disorder (OCD). Includes components to foster cognitive (i.e., thinking) and behavioural changes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported reassurance seeking behaviour | Number of times participants self-report seeking reassurance per day | 5 weeks (baseline through 3 week follow-up) | 
| Self-reported support-seeking behaviour | Number of times participants in the support-seeking condition self-report seeking reassurance per day | 4 weeks (condition assignment through 3 week follow-up) | 
| Self-reported anxiety | Level of anxiety on average per day, self-rated from 0-100 | 5 weeks (baseline monitoring through 3 week follow-up) | 
| One-week follow-up: Treatment Acceptability and Adherence Scale (TAAS; Milosevic, Levy, Alcolado, & Radomsky, 2015) | Validated questionnaire assessing how acceptable participants find an intervention as well as ease of adherence. | One-week follow-up | 
| One-week follow-up: Endorsement and Discomfort Scales (EDS; Tarrier, Liversidge, & Gregg, 2006) | Validated questionnaire assessing acceptability of and discomfort caused by an intervention. | One-week follow-up | 
| Three-week follow-up: Treatment Acceptability and Adherence Scale (TAAS; Milosevic, Levy, Alcolado, & Radomsky, 2015) | Validated questionnaire assessing how acceptable participants find an intervention as well as ease of adherence. | Three-week follow-up | 
| Three-week follow-up: Endorsement and Discomfort Scales (EDS; Tarrier, Liversidge, & Gregg, 2006) | Validated questionnaire assessing acceptability of and discomfort caused by an intervention. | Three-week follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in self-reported reassurance-seeking | Pre-post assessment of change in the number of times per day that participants self-report reassurance seeking behaviour from the baseline monitoring week to the follow-up assessments. | Baseline to one-week follow-up and baseline to three-week follow-up | 
| Change in anxiety | Pre-post assessment of change in participants' self-reported anxiety ratings, as rated from 0-100 | Baseline (monitoring week 1) to end of reassurance provision week (monitoring week 2) |