An experimental study of hand washing in people with high and normative contamination fear

Abstract

Compulsions are the hall mark of obsessive-compulsive disorder (OCD) but there has been surprisingly little research on their phenomenology and persistence, and much of this work has focused on checking compulsions. The current study examined hand wash duration in participants (N = 235) with high or normative contamination fear who either “contaminated” their hands or not, under high vs. low responsibility/harm conditions. Key findings were: 1) those high in contamination fear only washed “excessively” when under contamination exposure/high responsibility conditions; 2) there was no insidious effect of hand wash duration on memory confidence nor certainty it had been done properly; 3) there was little evidence of behavioural repetition during the hand wash; 4) under contamination/high responsibility conditions hand wash goals were more likely to be impossible and unverifiable (e.g., “get rid of all the germs”). We concluded that contextual factors influence hand washing moreso than contamination fear, that repetition and its consequences may be less relevant for understanding excessive washing, and that when treating OCD there could be merit in reframing compulsion goals, and exposing people to uncertainty as to whether or not that goal was met by one performance of the compulsion.