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Introduction
Reassurance seeking (RS) is a behaviour recognized for its role in maintaining various mental disorders. Despite its prevalence (e.g. Starcevic et al., 2012), facets of RS are under-represented in existing measures. The aim of this paper is to present the development, validation and psychometric analyses of a novel measure of RS behaviour.
Individuals with mental disorders including obsessive-compulsive disorder (OCD), depression and anxiety disorders [e.g. generalized anxiety disorder (GAD); social anxiety disorder (SAD)] may seek reassurance in ways that become repetitive and detrimental (e.g. American Psychiatric Association, 2013; Beesdo-Baum et al., 2012; Coyne, 1976; Heerey and Kring, 2007; Parrish and Radomsky, 2010; Warwick and Salkovskis, 1985). Individuals with such disorders may have biases towards evaluating uncertainty as threatening, and previous research has demonstrated an association between ambiguity and RS (e.g. Boelen and Reijntjes, 2009; Carleton et al., 2012; Dugas et al., 1997; Parrish and Radomsky, 2011; Tolin et al., 2003). Across disorders, functions of RS appear largely the same (e.g. Rector et al., 2011). Specifically, RS reduces distress, perceived threat and/or responsibility – at least in the short-term; long-term, it prevents individuals from learning corrective information about perceived threats or their ability to cope (e.g. Coyne, 1976; Halldorsson and Salkovskis, 2017a,b; Parrish and Radomsky, 2010; Salkovskis, 1999). This can be problematic if covert, or subtle, safety-seeking behaviours are not identified and subsequently addressed. Furthermore, when RS becomes pervasive, it is associated with consequences including relationship disruption, reduced workplace productivity, and distress (e.g. Coyne, 1976; Kobori et al., 2012). Given its similarities across disorders, and considering significant co-morbidity rates, there is need for a measure that captures overlapping functions and consequences of RS behaviour (e.g. Kessler and Wang, 2008).
Conceptualizations of RS across disorders suggest that it is a repetitive safety-seeking behaviour following perceived general or social/relational threats, despite having received the information before (e.g. ‘Are you really sure the door is locked?’, ‘Are you sure you still love me?’; e.g. Beesdo-Baum et al., 2012; Coyne. 1976; Heerey and Kring, 2007; Parrish and Radomsky, 2010; Warwick and Salkovskis, 1985; see also Rachman, 2002). Notably, the examples above highlight overt, obviously noticeable RS, wherein someone seeks responses from a partner who is conscious of the question. However,...