Development of a computer-based behavioral assessment of checking behavior in obsessive-compulsive disorder

Objective: The goal of the current study was to develop and obtain preliminary psychometric data for a computer-based behavioral measure of compulsive checking behavior in a sample of patients with obsessive-compulsive disorder (OCD). Method: We examined performance on a novel behavioral measure in 30 patients with OCD and 27 matched healthy controls. In the computerized assessment, participants navigated through two virtual environments (home and office) using a joystick and head-mounted display. The experiment consisted of three phases: training, distraction, and the main task. After the training and distraction phases, participants were instructed to check the virtual environments freely as if they were in their natural environment. Primary dependent variables in the current study included several indices of frequency and duration of checking behaviors. We examined construct validity for the task by comparing the novel behavioral measures with standardized self-report and interviewer-rated measures. Results: Results indicated that (1) OCD patients demonstrated significantly greater problems with compulsive checking compared to controls, and (2) performance on the task was positively correlated with both self-reported symptoms and interviewer-rated measures associated with OCD. Conclusions: This study provides preliminary data to support the use of this task as a new possible behavioral measure of compulsive checking behavior in OCD. If we merge the traditional behavioral research with this novel and ecologically valid method, it could improve the assessment of OCD in both clinical and research setting.