Developing image sets for inducing obsessive-compulsive checking symptoms

Helena Brooks, Stephen A. Kichuk, Thomas G. Adams, William N. Koller, H. Nur Eken, Mariela Rance, Shelby Monahan, Suzanne Wasylink, Benjamin Kelmendi, Christopher Pittenger, Patricia Gruner, Michelle Hampson

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Visual stimuli are often used for obsessive-compulsive (OC) symptom provocation in research studies. We tested the induction of anxiety and OC checking symptoms across different types of checking provocation stimuli in three populations: individuals with obsessive compulsive disorder (OCD), individuals with checking symptoms but without a diagnosis of OCD, and control individuals with neither checking symptoms nor a clinical diagnosis. One set of provocative images depicted objects that are commonly associated with checking anxiety. Another set (‘enhanced provocative images’) depicted similar objects but also included contextual cues suggesting a specific harmful scenario that could occur. As expected, the enhanced provocative images were more effective at inducing anxiety and OC symptoms than the standard provocative images. Future studies requiring checking symptom provocation should therefore consider incorporating similarly suggestive images. Individuals with clinical OCD reported the greatest provocation in response to these images, followed by those with nonclinical checking, followed by control individuals. Thus, these stimuli are able to provoke OC checking symptoms and anxiety differentially across groups, with the intensity of provocation reflecting diagnostic status. All groups demonstrated a similar qualitative pattern of provocation across images. Finally, in all groups, reported anxiety closely tracked intrusive thoughts and checking urges.

Original languageEnglish
Pages (from-to)249-255
Number of pages7
JournalPsychiatry Research
StatePublished - Jul 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier B.V.


  • Anxiety [F01.470.132]
  • Compulsive Behavior [F01-145-527-100]
  • Obsessive Behavior [F01.145.126.950]
  • Obsessive-Compulsive Disorder [F03-080-600]

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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