(PS9-C51) Personalized Networks of the Relationship Between Involuntary Thought and Reassurance in Obsessions and Worry

Involuntary distressing thoughts play a role in emotional disorders such as generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD).  These thoughts may result in attempts to reduce their negative emotional impact using various coping strategies including consulting trusted others (i.e., reassurance seeking). However, previous studies that have examined this relationship have involved retrospective self-reports. Thus, understanding the temporal relationships between intrusive thoughts and reassurance seeking measured in real time may result in improved intervention. Ecological Momentary Assessment (EMA) is one method that captures symptom and behavior fluctuation throughout daily life and may better represent both the average level and severity of an individual’s experiences. As a part of a larger study, we used EMA to ask participants (n = 277) to rate the severity (rated 0 to 100) of intrusive thoughts (i.e., “to what degree have you experienced involuntary thoughts, images, or memories?”) and reassurance seeking (i.e., “to what degree have you sought reassurance?”) five times a day, three hours apart using a smartphone app during a two-week period. Participants also completed the Obsessive-Compulsive Inventory (OCI) and the Pennsylvania State Worry Questionnaire (PSWQ) to measure symptoms of OCD and GAD. We then created personalized networks for each participant to examine the contemporaneous relationships between symptoms, while controlling for all other symptoms. Next, we selected individual networks that demonstrated a strong positive relationship (
r

> .40) between intrusive thoughts and reassurance seeking, after controlling for other symptoms (e.g., worry, anxiety). We compared these individuals to those who did not show this relationship and found individuals that report co-occurring intrusive thoughts and reassurance seeking also reported higher OCD and GAD symptoms as measured by the OCI and the PSWQ. Therefore, an increased tendency to use reassurance in response to intrusive thought may be a factor responsible for the maintenance of obsessions and worries. Attempts at targeting this relationship using interventions that may alter it, may result in the improvement of symptom severity for anxious individuals