Exploring the nature of obsessive compulsive checking

While people with Obsessive Compulsive Disorder (OCD) may present with a range of obsessions and compulsions, for many, excessive, ritualised, time consuming checking behaviours and related obsessions are dominant expressions of the condition (e.g. Fullana et al., 2009; Samuels et al., 2006). Sub-typing by predominant symptom presentation has been suggested to be important since qualitative differences between OCD subtypes mean that when conducting research into the origin, nature and treatment of OCD, findings may not be generalisable across the different subtypes (McKay et al., 2004). In this study we investigated the nature of Obsessive-Compulsive Checking (OC-Ch) by examining the type and frequency of obsessions and compulsions experienced in a large sample of people diagnosed with this subtype. As part of a comprehensive pre-treatment assessment the Yale-Brown Obsessive Compulsive Scale and checklist (Goodman et al., 1989) were administered to 50 people with OC-Ch subtype. Additionally, exploration into the nature of these phenomena was made by examining the prevalence of features such as pathological doubting, indecisiveness, avoidance behaviours, insight and pervasive slowness. The results of this phenomenological exploration are described and presented. Overall, participants met criteria for severe OCD that was causing a moderate to severe level of interference in most areas of their lives. All participants reported experiencing checking compulsions and aggressive obsessions, with high levels of endorsement for all checking compulsions and fears and obsessions about harm to self or others. Other features prominent in this group were avoidance, obsessional slowness, doubting and indecision. It is argued that enhancing our knowledge of the nature of specific OCD subtypes, such as OC-Ch may assist in determining disorder related pathogenesis, maintaining factors, prognosis and treatment. Identifying the underlying variables that mediate the concerns experienced by people with OC-Ch subtype could enable the development of treatment strategies to address these most frequently reported concerns and features.