A cognitive theory of compulsive checking.

It is proposed that compulsive checking occurs when people who believe that they have a special, elevated responsibility for preventing harm, mainly to others, are unsure that the perceived threat has been reduced or removed. The intensity and duration of this checking is determined by three "multipliers": increased responsibility, probability of harm and anticipated seriousness of harm. The recurrency of the checking is promoted by a self-perpetuating mechanism, comprising four elements: paradoxical increases in responsibility and in perceived probability of harm, reduced confidence in memory and the absence of a certain end to the threat. The relation between compulsive checking and other anxiety disorders is examined and the successes and failures of past or present treatments re-considered. Experimental predictions are set out and the therapeutic implications of the construal are discussed.