Moving Beyond an Exclusive Focus on Harm Avoidance in Obsessive-Compulsive Disorder: Behavioral Validation for the Separability of Harm Avoidance and Incompleteness

There is increasing recognition that symptoms of obsessive-compulsive disorder (OCD) may be associated not only with harm avoidance, but also with sensations of things being incomplete or not “just right.” Although preliminary research supports the presence of both harm avoidance and incompleteness in OCD, their validity as separate constructs has not been tested beyond the use of self-report measures. Therefore, the aim of the current study was to behaviorally validate the separability of harm avoidance and incompleteness using an unselected student sample. Consistent with hypotheses, self-reported levels of incompleteness and harm avoidance uniquely predicted participants' ratings of their experiences while performing OCD-relevant behavioral tasks (e.g., washing dirty dishes, arranging books on a bookshelf). Results suggest that harm avoidance is associated with anxiety/nervousness and a desire to prevent harm, whereas incompleteness is linked to feelings of tension/discomfort and a desire to perform tasks perfectly or just right. Theoretical and clinical implications are discussed.