Experimental and Phenomenological Examinations of Nonverbal Reassurance Seeking in Association with Obsessive-Compulsive Disorder
Bibliographic record
Abstract
In obsessive-compulsive disorder (OCD), excessive reassurance seeking (RS) has been construed as overt direct questions and/or covert subtle statements which prompt information to allay obsessional doubts and/or fears. However, an exclusively verbal conceptualization of RS lacks theoretical justification and fails to explain the use of nonverbal actions (e.g., prolonged pauses) ostensibly to prompt reassurance following an experimental manipulation of responsibility (Leonhart & Radomsky, 2019b). Nonverbal RS (NVRS) may reinforce symptoms ‘under the radar’ of those with OCD, loved ones, and/or helping professionals. The lack of research into NVRS may limit the effectiveness of cognitive-behavioural therapy (CBT)–the treatment of choice for OCD. The present mixed-methods doctoral research was conducted to examine the manifestations and functions of NVRS in OCD. A checklist of NVRS behaviours was developed from observations and a review of the literature on RS and nonverbal communication. In Study 1, experimentally increased high ([HR] vs. decreased, low responsibility [LR]) resulted in more verbal RS (VRS) as reported by participants (N = 86) and a trained actor from whom reassurance was sought, and critically, in more NVRS according to the actor. As predicted, responsibility beliefs may have similar impacts on checking, VRS, and NVRS. Further, a significant condition × time × person interaction was observed, such that HR participants reported a smaller transfer of responsibility to the actor while LR participants reported a comparatively larger transfer to themselves following the RS opportunity. Study 2 was designed to learn if people with lived experience of seeking and providing reassurance endorsed similar and/or additional NVRS behaviour. Twelve pairs of people who met criteria for OCD and partners of their choosing (N = 24) were interviewed. Participants with OCD utilized several NVRS behaviours when given an opportunity to seek reassurance from their partners. Prominent behaviours were those which reportedly occurred during most interactions and were used at least daily to seek reassurance according to participant-partner pairs: close examination of others’ reactions, direct eye contact, pauses to allow for reassurance, and forehead wrinkling. NVRS, like VRS, may result in neutralized obsessions, but it may also have unique functions (e.g., avoided social consequences, better effectiveness). Unexpectedly, there was no clear evidence that people with OCD were unaware of their NVRS. Implications for cognitive-behavioural theories of and therapies for RS generally and NVRS specifically are discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".