Excessive reassurance seeking and anxiety pathology: Tests of incremental associations and directionality

Excessive reassurance-seeking (ERS) is hypothesized to play a key role in emotional disorders but has been studied mostly in relation to depression. Study 1 reports a new measure of reassurance seeking that assessed ERS related to general and evaluative threats in a non-clinical student sample, and its factor structure was further examined in Study 2. In Study 3, the scale, along with other symptom-related measures and an existing measure of depressive ERS, was administered to an undergraduate sample at two different time points, one month apart. Greater ERS was associated with greater symptoms of social anxiety, generalized anxiety disorder, and obsessive–compulsive disorder (OCD), even after controlling for trait anxiety, depression, and intolerance of uncertainty. Among OCD symptoms, only thoughts of harm were uniquely related to ERS, a finding consistent with emerging literature. ERS involving general threats also predicted changes in social anxiety and GAD symptoms one month later. Overall, the findings implicate an important role for ERS across anxiety disorders.

► Excessive reassurance seeking (ERS) may be related to multiple anxiety disorders.
► A measure of threat-related ERS was predictive of social anxiety, generalized anxiety, and OCD symptoms.
► Associations were not accounted for by negative affect or intolerance of uncertainty.
► Among OCD symptoms, ERS was specifically related to thoughts of harm.
► ERS prospectively predicted changes in generalized anxiety and social anxiety symptoms.