Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada.
University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada; Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
J Anxiety Disord. 2020 Oct;75:102280. doi: 10.1016/j.janxdis.2020.102280. Epub 2020 Jul 31.
Excessive reassurance seeking (ERS) has been hypothesized as an important maintenance factor in depression and obsessive compulsive disorder (OCD). The present study examined the types of ERS in depression and OCD, the effects of CBT on ERS, predictors of ERS reduction, and the relation between ERS reduction and symptom change.
Treatment-seeking participants diagnosed with a depressive disorder (N = 361) or OCD (N = 156) completed the Reassurance Seeking Scale (RSS) and symptom measures before and following CBT treatment. Measures of intolerance of uncertainty and distress tolerance were completed pre-treatment as potential predictors of ERS change.
Individuals with depression demonstrated higher pre-treatment ERS related to social attachment compared to those with OCD. ERS significantly decreased over treatment in both groups and change in ERS predicted symptom change among both OCD and depression groups. Higher pre-treatment intolerance of uncertainty significantly predicted less ERS change regardless of diagnosis. Distress tolerance was not associated with ERS changes.
ERS is significantly related to symptom severity cross-sectionally as well as over treatment in depression and OCD, though types of ERS may differ. Higher intolerance of uncertainty may impede the reduction of ERS in CBT.
过度寻求保证(ERS)被假设为抑郁症和强迫症(OCD)的一个重要维持因素。本研究检查了抑郁症和 OCD 中的 ERS 类型、CBT 对 ERS 的影响、ERS 减少的预测因素,以及 ERS 减少与症状变化之间的关系。
接受治疗的患有抑郁症(N=361)或强迫症(N=156)的参与者在接受 CBT 治疗前后完成了寻求保证量表(RSS)和症状测量。在治疗前完成了不确定耐受力和痛苦耐受力的测量,作为 ERS 变化的潜在预测指标。
与强迫症患者相比,患有抑郁症的个体在与社会联系相关的治疗前 ERS 更高。在两组中,ERS 在治疗过程中显著降低,ERS 的变化预测了 OCD 和抑郁症组的症状变化。较高的不确定耐受力预示着 ERS 变化较小,无论诊断如何。痛苦耐受力与 ERS 的变化无关。
ERS 与抑郁和强迫症的症状严重程度在横断面上以及在治疗过程中都有显著的相关性,尽管 ERS 的类型可能不同。较高的不确定耐受力可能会阻碍 CBT 中 ERS 的减少。