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4 SAFETY BEHAVIOR INCREASES OBSESSION-RELATED COGNITIONS 97 Although hypochondria was not classified as an anxiety disorder in the DSM- IV, and OCD has been separated from the anxiety disorders in the DSM-5 (American Psychological Association, 2013), there appears to be quite some overlap between these disorders and anxiety disorders (Deacon & Abramowitz, 2008). Thus, despite the distinct characteristics of the safety behaviors associated with these disorders, the role that safety behaviors may play in the development of OCD and anxiety disorders is expected to be functionally equivalent (Rachman 2002; Telch & Lancaster, 2012). However, checking behavior, the most commonly observed safety behavior in patients with OCD (i.e., in 80% among those with lifetime OCD; Ruscio, Stein, Chiu & Kessler, 2010), has unique features that include rigidity and repetitiveness. The present study was therefore conducted to experimentally investigate whether this more rigid and ritualistic safety behavior (i.e., checking) contributes to the development of OCD symptoms. According to the self-perpetuating mechanism of compulsive checking (Rachman, 2002), the amount of checking behavior a person performs is determined by the sense of responsibility, probability of harm, and anticipated seriousness of the harmful outcome. Conversely, Rachman (2002) predicts that an increase in checking behavior will lead to an increase in the sense of responsibility, probability of harm, anticipated seriousness of the harmful outcome, and, additionally, a decrease in memory confidence. Since previous research has shown that people with OCD symptoms not only use checking behavior in response to their obsessions, but also have the tendency to display more checking behavior in mildly uncertain situations that are unrelated to obsessions (Toffolo, van den Hout, Engelhard, Hooge, & Cath, 2014; Toffolo, van den Hout, Hooge, Engelhard, & Cath, 2013), checking behavior itself may contribute to the development of the disorder. When people are habitually more inclined to use checking behavior, this may not only increase uncertainty levels (e.g., van den Hout & Kindt, 2003), but also have a direct effect on obsessional beliefs such as the perceived likelihood and severity of threat. Therefore, we conducted a study similar to the one by Olatunji et al. (2011), in which participants in the