1
|
Pickenhan L, Milton AL. Opening new vistas on obsessive-compulsive disorder with the observing response task. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024; 24:249-265. [PMID: 38316708 PMCID: PMC11039534 DOI: 10.3758/s13415-023-01153-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/07/2024]
Abstract
Obsessive-compulsive disorder (OCD), a highly prevalent and debilitating disorder, is incompletely understood in terms of underpinning behavioural, psychological, and neural mechanisms. This is attributable to high symptomatic heterogeneity; cardinal features comprise obsessions and compulsions, including clinical subcategories. While obsessive and intrusive thoughts are arguably unique to humans, dysfunctional behaviours analogous to those seen in clinical OCD have been examined in nonhuman animals. Genetic, ethological, pharmacological, and neurobehavioural approaches all contribute to understanding the emergence and persistence of compulsive behaviour. One behaviour of particular interest is maladaptive checking, whereby human patients excessively perform checking rituals despite these serving no purpose. Dysfunctional and excessive checking is the most common symptom associated with OCD and can be readily operationalised in rodents. This review considers animal models of OCD, the neural circuitries associated with impairments in habit-based and goal-directed behaviour, and how these may link to the compulsions observed in OCD. We further review the Observing Response Task (ORT), an appetitive instrumental learning procedure that distinguishes between functional and dysfunctional checking, with translational application in humans and rodents. By shedding light on the psychological and neural bases of compulsive-like checking, the ORT has potential to offer translational insights into the underlying mechanisms of OCD, in addition to being a platform for testing psychological and neurochemical treatment approaches.
Collapse
Affiliation(s)
- Luise Pickenhan
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
| | - Amy L Milton
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK.
| |
Collapse
|
2
|
Harkin B, Davies LE, Yates A. Contamination-Focussed Vignettes as an Analogue of Infectious Pandemics: An Experimental Validation using the State Disgust and Anxiety Responses in OCD. Psychol Rep 2024:332941241238208. [PMID: 38462961 DOI: 10.1177/00332941241238208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Despite infectious pandemics proving particularly detrimental to those with Obsessive-Compulsive Disorder (OCD), the investigation of analogous experimental paradigms is lacking. To address this gap, we conducted two studies employing vignettes that depicted contamination-related situations commonly experienced during a pandemic (e.g., Coughing into hands and failing to use hand sanitizer). We manipulated the salience of these vignettes across three levels: high contamination, low contamination, and a neutral control condition. Our examination of state anxiety and disgust responses in all participants revealed the successful manipulation of the vignettes' impact. Specifically, individuals with more severe OCD symptoms reported significantly higher levels of state disgust and anxiety for both high and low contamination vignettes, in contrast to the group with lower symptom severity. No significant differences were observed in the neutral vignette condition between the high- and low-scoring groups. Interestingly, for those with higher OCD symptoms, high salience contamination-focused vignettes resulted in similarly elevated state disgust and anxiety, regardless of whether the vignettes were situated in public (Study 1) or domestic (Study 2) settings. This suggests that the heightened sensitivity to contamination-related scenarios observed in individuals with OCD symptoms in the present study is not confined to a specific context. These findings support the use of contamination-focused vignettes as analogues for studying infectious pandemics and provide valuable insights into OCD models, interventions, and future research.
Collapse
Affiliation(s)
- Ben Harkin
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Lucy E Davies
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Alan Yates
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| |
Collapse
|
3
|
Dar R, Sarna N, Yardeni G, Lazarov A. Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis. Psychol Med 2022; 52:2404-2412. [PMID: 35848286 PMCID: PMC9647546 DOI: 10.1017/s0033291722001908] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 05/10/2022] [Accepted: 06/01/2022] [Indexed: 12/24/2022]
Abstract
People with obsessive-compulsive disorder (OCD) tend to distrust their memory, perception, and other cognitive functions, and many OCD symptoms can be traced to diminished confidence in one's cognitive processes. For example, poor confidence in recall accuracy can cause doubt about one's memory and motivate repeated checking. At the same time, people with OCD also display performance deficits in a variety of cognitive tasks, so their reduced confidence must be evaluated in relation to their actual performance. To that end, we conducted an exhaustive review and meta-analysis of studies in which OCD participants and non-clinical control participants performed cognitive tasks and reported their confidence in their performance. Our search resulted in 19 studies that met criteria for inclusion in the quantitative analysis, with all studies addressing either memory or perception. We found that both performance and reported confidence were lower in OCD than in control participants. Importantly, however, confidence was more impaired than performance in participants with OCD. These findings suggest that people with OCD are less confident in their memory and perception than they should be, indicating a genuine under-confidence in this population. We discuss potential mechanisms that might account for this finding and suggest avenues for further research into under-confidence and related meta-cognitive characteristics of OCD.
Collapse
Affiliation(s)
- Reuven Dar
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Noam Sarna
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Gal Yardeni
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| |
Collapse
|
4
|
Hoven M, de Boer NS, Goudriaan AE, Denys D, Lebreton M, van Holst RJ, Luigjes J. Metacognition and the effect of incentive motivation in two compulsive disorders: Gambling disorder and obsessive-compulsive disorder. Psychiatry Clin Neurosci 2022; 76:437-449. [PMID: 35674699 PMCID: PMC9541950 DOI: 10.1111/pcn.13434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/12/2022]
Abstract
AIMS Compulsivity is a common phenotype among psychiatric disorders, such as obsessive-compulsive disorder (OCD) and gambling disorder (GD). Deficiencies in metacognition, such as the inability to estimate one's performance via confidence judgments could contribute to pathological decision-making. Earlier research has shown that patients with OCD exhibit underconfidence, while patients with GD exhibit overconfidence. Moreover, it is known that motivational states (e.g. monetary incentives) influence metacognition, with gain (respectively loss) prospects increasing (respectively decreasing) confidence. Here, we reasoned that OCD and GD symptoms might correspond to an exacerbation of this interaction between metacognition and motivation. METHODS We hypothesized GD's overconfidence to be exaggerated during gain prospects, while OCD's underconfidence to be worsened in loss context, which we expected to see represented in ventromedial prefrontal cortex (VMPFC) blood-oxygen-level-dependent activity. We tested those hypotheses in a task-based functional magnetic resonance imaging (fMRI) design (27 patients with GD, 28 patients with OCD, 55 controls). The trial is registered in the Dutch Trial Register (NL6171). RESULTS We showed increased confidence for patients with GD versus patients with OCD, which could partly be explained by sex and IQ. Although our primary analyses did not support the hypothesized interaction between incentives and groups, exploratory analyses did show increased confidence in patients with GD specifically in gain context. fMRI analyses confirmed a central role for VMPFC in the processing of confidence and incentives, but no differences between the groups. CONCLUSION Patients with OCD and those with GD reside at opposite ends of the confidence spectrum, while no interaction with incentives was found, nor group differences in neuronal processing of confidence.
Collapse
Affiliation(s)
- Monja Hoven
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nina S de Boer
- Department of Philosophy, Radboud University, Nijmegen, The Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Arkin and Jellinek, Mental Health Care, and Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maël Lebreton
- Paris School of Economics, Paris, France.,Swiss Center for Affective Science, University of Geneva, Geneva, Switzerland.,Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Ruth J van Holst
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Judy Luigjes
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
5
|
Loosen AM, Hauser TU. Towards a computational psychiatry of juvenile obsessive-compulsive disorder. Neurosci Biobehav Rev 2020; 118:631-642. [PMID: 32942176 DOI: 10.1016/j.neubiorev.2020.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 01/22/2023]
Abstract
Obsessive-Compulsive Disorder (OCD) most often emerges during adolescence, but we know little about the aberrant neural and cognitive developmental mechanisms that underlie its emergence during this critical developmental period. To move towards a computational psychiatry of juvenile OCD, we review studies on the computational, neuropsychological and neural alterations in juvenile OCD and link these findings to the adult OCD and cognitive neuroscience literature. We find consistent difficulties in tasks entailing complex decision making and set shifting, but limited evidence in other areas that are altered in adult OCD, such as habit and confidence formation. Based on these findings, we establish a neurocomputational framework that illustrates how cognition can go awry and lead to symptoms of juvenile OCD. We link these possible aberrant neural processes to neuroimaging findings in juvenile OCD and show that juvenile OCD is mainly characterised by disruptions of complex reasoning systems.
Collapse
Affiliation(s)
- Alisa M Loosen
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, United Kingdom.
| | - Tobias U Hauser
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, United Kingdom.
| |
Collapse
|
6
|
Hoven M, Lebreton M, Engelmann JB, Denys D, Luigjes J, van Holst RJ. Abnormalities of confidence in psychiatry: an overview and future perspectives. Transl Psychiatry 2019; 9:268. [PMID: 31636252 PMCID: PMC6803712 DOI: 10.1038/s41398-019-0602-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/03/2019] [Accepted: 07/30/2019] [Indexed: 01/11/2023] Open
Abstract
Our behavior is constantly accompanied by a sense of confidence and its' precision is critical for adequate adaptation and survival. Importantly, abnormal confidence judgments that do not reflect reality may play a crucial role in pathological decision-making typically seen in psychiatric disorders. In this review, we propose abnormalities of confidence as a new model of interpreting psychiatric symptoms. We hypothesize a dysfunction of confidence at the root of psychiatric symptoms either expressed subclinically in the general population or clinically in the patient population. Our review reveals a robust association between confidence abnormalities and psychiatric symptomatology. Confidence abnormalities are present in subclinical/prodromal phases of psychiatric disorders, show a positive relationship with symptom severity, and appear to normalize after recovery. In the reviewed literature, the strongest evidence was found for a decline in confidence in (sub)clinical OCD, and for a decrease in confidence discrimination in (sub)clinical schizophrenia. We found suggestive evidence for increased/decreased confidence in addiction and depression/anxiety, respectively. Confidence abnormalities may help to understand underlying psychopathological substrates across disorders, and should thus be considered transdiagnostically. This review provides clear evidence for confidence abnormalities in different psychiatric disorders, identifies current knowledge gaps and supplies suggestions for future avenues. As such, it may guide future translational research into the underlying processes governing these abnormalities, as well as future interventions to restore them.
Collapse
Affiliation(s)
- Monja Hoven
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Maël Lebreton
- 0000 0001 2322 4988grid.8591.5Swiss Center for Affective Science (CISA), University of Geneva (UNIGE), Geneva, Switzerland ,0000 0001 2322 4988grid.8591.5Neurology and Imaging of Cognition (LabNIC), Department of Basic Neurosciences, University of Geneva (UNIGE), Geneva, Switzerland
| | - Jan B. Engelmann
- 0000000084992262grid.7177.6CREED, Amsterdam School of Economics (ASE), University of Amsterdam, Amsterdam, The Netherlands ,0000000084992262grid.7177.6Amsterdam Brain and Cognition (ABC), University of Amsterdam, Amsterdam, The Netherlands ,0000 0001 2353 4804grid.438706.eThe Tinbergen Institute, Amsterdam, The Netherlands
| | - Damiaan Denys
- 0000000084992262grid.7177.6Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ,0000 0001 2171 8263grid.419918.cNeuromodulation & Behavior, Netherlands Institute for Neuroscience, KNAW, Amsterdam, The Netherlands
| | - Judy Luigjes
- 0000000084992262grid.7177.6Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ruth J. van Holst
- 0000000084992262grid.7177.6Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
7
|
Ouimet AJ, Ashbaugh AR, Radomsky AS. Hoping for more: How cognitive science has and hasn't been helpful to the OCD clinician. Clin Psychol Rev 2019; 69:14-29. [DOI: 10.1016/j.cpr.2018.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 12/19/2022]
|
8
|
Decreased memory confidence in obsessive-compulsive disorder for scenarios high and low on responsibility: is low still too high? Eur Arch Psychiatry Clin Neurosci 2018; 268:291-299. [PMID: 28353028 DOI: 10.1007/s00406-017-0783-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
Previous research suggests that patients with obsessive-compulsive disorder (OCD), particularly checkers, display an inflated sense of responsibility. For the present study, we tested whether memory confidence in OCD is reduced under conditions of heightened responsibility and/or reflects poor memory vividness. A computerized task designed to modulate perceived responsibility was administered to 26 OCD patients (12 checkers) and 21 healthy controls. In the experimental condition (high responsibility), participants had to allocate daily medications to ten fictive patients in a hospital emergency ward, whereas in the control condition (low responsibility) participants had to allocate bath essences for ten hotel guests. Participants' response time and accuracy were recorded as well as their memory confidence, memory vividness, and subjective success. Irrespective of the condition, OCD patients performed as accurately as healthy controls, but appraised their performance as worse than that of controls. Memory confidence was decreased in patients, particularly checkers. No group differences emerged on vividness, and none of the effects were moderated by the condition (high versus low responsibility). The relationship between responsibility and OCD behavior is complex. Results suggest metamemory problems in OCD checkers, even when induced responsibility is low. The findings speak against "cold" memory deficits in OCD, as patients did not differ from controls on accuracy, reaction time, or vividness. Future research should focus on idiosyncratic beliefs and scenarios that inflate responsibility and elicit cognitive biases.
Collapse
|
9
|
Moritz S, Scheu F, Andreou C, Pfueller U, Weisbrod M, Roesch-Ely D. Reasoning in psychosis: risky but not necessarily hasty. Cogn Neuropsychiatry 2016; 21:91-106. [PMID: 26884221 DOI: 10.1080/13546805.2015.1136611] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION A liberal acceptance (LA) threshold for hypotheses has been put forward to explain the well-replicated "jumping to conclusions" (JTC) bias in psychosis, particularly in patients with paranoid symptoms. According to this account, schizophrenia patients rest their decisions on lower subjective probability estimates. The initial formulation of the LA account also predicts an absence of the JTC bias under high task ambiguity (i.e., if more than one response option surpasses the subjective acceptance threshold). METHODS Schizophrenia patients (n = 62) with current or former delusions and healthy controls (n = 30) were compared on six scenarios of a variant of the beads task paradigm. Decision-making was assessed under low and high task ambiguity. Along with decision judgments (optional), participants were required to provide probability estimates for each option in order to determine decision thresholds (i.e., the probability the individual deems sufficient for a decision). RESULTS In line with the LA account, schizophrenia patients showed a lowered decision threshold compared to controls (82% vs. 93%) which predicted both more errors and less draws to decisions. Group differences on thresholds were comparable across conditions. At the same time, patients did not show hasty decision-making, reflecting overall lowered probability estimates in patients. CONCLUSIONS Results confirm core predictions derived from the LA account. Our results may (partly) explain why hasty decision-making is sometimes aggravated and sometimes abolished in psychosis. The proneness to make risky decisions may contribute to the pathogenesis of psychosis. A revised LA account is put forward.
Collapse
Affiliation(s)
- Steffen Moritz
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Florian Scheu
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany
| | - Christina Andreou
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Ute Pfueller
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany.,c Department of Psychiatry , SRH Klinikum Karlsbad-Langensteinbach , Karlsbad , Germany
| | - Matthias Weisbrod
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany.,c Department of Psychiatry , SRH Klinikum Karlsbad-Langensteinbach , Karlsbad , Germany
| | - Daniela Roesch-Ely
- b Department of General Psychiatry , Center for Psychosocial Medicine , Heidelberg , Germany
| |
Collapse
|
10
|
The Termination of Checking and the Role of Just Right Feelings: A Study of Obsessional Checkers Compared with Anxious and Non-clinical Controls. Behav Cogn Psychother 2016; 45:139-155. [DOI: 10.1017/s135246581600031x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Repeated checking in OCD can be understood from a cognitive perspective as the motivated need to achieve certainty about the outcome of a potentially risky action, leading to the application of Elevated Evidence Requirements (EER) and overuse of subjective criteria. Method: Twenty-four obsessional checkers, 22 anxious controls, and 26 non-clinical controls were interviewed about and rated recent episodes where they felt (a) they needed to check and (b) checked mainly out of habit (i.e. not obsessionally). Results: Both subjective and objective criteria were rated as significantly more important in obsessional checkers than in controls; obsessional checkers also used more criteria overall for the termination of the check, and rated more criteria as “extremely important” than the control groups. The termination of the check was rated as more effortful for obsessional checkers than for the comparison groups. Analysis of the interview data was consistent with the ratings. Feelings of “rightness” were associated with the termination of a check for obsessional checkers but not for controls. Conclusion: Results were consistent with the proposal that the use of “just right feelings” to terminate checking are related to EER.
Collapse
|
11
|
Tumkaya S, Karadag F, Mueller ST, Ugurlu TT, Oguzhanoglu NK, Ozdel O, Atesci FC, Bayraktutan M. Situation awareness in obsessive-compulsive disorder. Psychiatry Res 2013; 209:579-88. [PMID: 23537845 DOI: 10.1016/j.psychres.2013.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 02/04/2013] [Accepted: 02/07/2013] [Indexed: 11/25/2022]
Abstract
Past studies have suggested that OCD patients suffer memory impairment on tasks using complex stimuli that require memory for combined elements to be maintained, but not for more simplistic memory tests. We tested this with 42 OCD patients and 42 healthy controls performed a computerized situation awareness task. In addition, participants completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Maudsley Obsessive-Compulsive Inventory (MOCI). The OCD patients had poorer accuracy in integration/comprehension and perception levels than controls. There were significant correlations between situational awareness scores (i.e., visuo-spatial monitoring and processing) and Y-BOCS obsession-compulsion and slowness and doubt scores of MOCI in OCD patients. In addition, there were also significant correlations between situational awareness and controlling, cleaning, slowness, rumination and total scores of MOCI in control group. Results indicated that (I) OCD patients have problems of perception, integration, and comprehension of complex visual perceptions; (II) situation awareness deficits associated with severity and prevalence of obsessions and compulsions.
Collapse
Affiliation(s)
- Selim Tumkaya
- Pamukkale University Medicine Faculty Psychiatry Department, Doktorlar Cd, 20100 Denizli, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Ben Shachar A, Lazarov A, Goldsmith M, Moran R, Dar R. Exploring metacognitive components of confidence and control in individuals with obsessive-compulsive tendencies. J Behav Ther Exp Psychiatry 2013; 44:255-61. [PMID: 23268236 DOI: 10.1016/j.jbtep.2012.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/22/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Obsessive-compulsive (OC) patients typically display reduced metacognitive confidence, but findings regarding the scope of this phenomenon and factors that mediate it have been inconsistent. This study aimed to further the understanding of reduced metacognitive confidence in obsessive-compulsive disorder (OCD) by exploring the relationship between metacognitive processes and OC tendencies. METHODS High and low OC participants answered a general-knowledge questionnaire, rated their confidence in each answer, and decided whether or not to report each answer. RESULTS High and low OC participants did not differ either in their performance (general knowledge) or in their subjective estimations or confidence regarding their performance. The two groups also did not differ in the effectiveness of their metacognitive monitoring or in the relationship between monitoring and report-control decisions (control sensitivity). However, the two groups did differ in response criterion, with high OC participants less willing to report answers held with low-to-medium levels of subjective confidence. LIMITATIONS The study was conducted with non-clinical participants, which limits generalization to OCD. CONCLUSIONS These results suggest that conservative response criterion among OC individuals might be the critical factor underlying feelings of doubt and uncertainty endemic in OCD.
Collapse
Affiliation(s)
- Advah Ben Shachar
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | | | | | | | | |
Collapse
|
13
|
Aardema F, O'Connor K. Dissolving the tenacity of obsessional doubt: implications for treatment outcome. J Behav Ther Exp Psychiatry 2012; 43:855-61. [PMID: 22217423 DOI: 10.1016/j.jbtep.2011.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 12/01/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Previous research has found that a high impact of possibility based information during reasoning prevents the resolution of doubt among those with Obsessive-Compulsive Disorder (OCD). It was expected that the ability of those with OCD to resolve obsessional doubt would improve following Inference Based Treatment (IBT). METHODS The ability to resolve doubt, including the relative impact of reality and possibility based information, was measured before and after treatment with the Inference Processes Task in a group of 35 participants diagnosed with OCD. RESULTS Results confirmed that IBT improved the participants' ability to resolve obsessional doubt. Those who improved their ability to resolve doubt showed a significantly better treatment outcome. Improvements appeared mostly due to a lowered impact of possibility based information following treatment. LIMITATIONS The study did not include a control condition although results clearly indicate that the ability to resolve obsessional is closely linked to the most relevant quantifiers of treatment outcome. In addition, relatively small sample sizes prevented more powerful multiple comparisons between groups. CONCLUSIONS Results suggest treatment implications and the relevance of dissolving the tenacity of obsessional doubt in OCD.
Collapse
Affiliation(s)
- Frederick Aardema
- University of Montreal, Fernand-Seguin Research Center, 7331 Hochelaga, Montréal, Québec H1N 3V2, Canada.
| | | |
Collapse
|
14
|
Sarig S, Dar R, Liberman N. Obsessive-compulsive tendencies are related to indecisiveness and reliance on feedback in a neutral color judgment task. J Behav Ther Exp Psychiatry 2012; 43:692-7. [PMID: 21983353 DOI: 10.1016/j.jbtep.2011.09.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 09/12/2011] [Accepted: 09/12/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The present study was designed to test whether OC tendencies are associated with indecisiveness and increased need for objective feedback in vague decision situations. This hypothesis was tested using a neutral color judgment task that places minimal demands on working memory. METHODS Sixty-one participants completed several measures of OC symptoms and tendencies. Indecisiveness was tested on a novel computerized task in which participants can move along a continuum marked by two colors at the extreme ends and are instructed to choose the color they judge to be the exact mid-point on the continuum. RESULTS OC scores were positively correlated with indecisiveness on the task, as assessed by the amount of time it took participants to complete the task and the extent of their search through the color continuum. This association was most pronounced when feedback for performance was not routinely provided. Requests for feedback were also positively correlated with OC scores. OC scores were not associated with actual performance on the task (accuracy levels) or with confidence ratings. LIMITATIONS The study relies on non-clinical participants and the extent to which these results would extend to OCD patients in unknown. Some effects may be confounded by the fixed order in which the task phases were administered. CONCLUSIONS The findings support the hypothesis that OC tendencies are associated with general indecisiveness and reliance on external feedback.
Collapse
Affiliation(s)
- Shelly Sarig
- Department of Psychology, Tel Aviv University, Tel Aviv 69978, Israel
| | | | | |
Collapse
|
15
|
Hinds AL, Woody EZ, Van Ameringen M, Schmidt LA, Szechtman H. When too much is not enough: obsessive-compulsive disorder as a pathology of stopping, rather than starting. PLoS One 2012; 7:e30586. [PMID: 22291994 PMCID: PMC3266914 DOI: 10.1371/journal.pone.0030586] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 12/22/2011] [Indexed: 11/18/2022] Open
Abstract
Background In obsessive-compulsive disorder (OCD), individuals feel compelled to repeatedly perform security-related behaviors, even though these behaviours seem excessive and unwarranted to them. The present research investigated two alternative ways of explaining such behavior: (1) a dysfunction of activation—a starting problem—in which the level of excitation in response to stimuli suggesting potential danger is abnormally strong; versus (2) a dysfunction of termination—a stopping problem—in which the satiety-like process for shutting down security-related thoughts and actions is abnormally weak. Method In two experiments, 70 patients with OCD (57 with washing compulsions, 13 with checking compulsions) and 72 controls were exposed to contamination cues—immersing a hand in wet diapers —and later allowed to wash their hands, first limited to 30 s and then for as long as desired. The intensity of activation of security motivation was measured objectively by change in respiratory sinus arrythmia. Subjective ratings (e.g., contamination) and behavioral measures (e.g., duration of hand washing) were also collected. Results Compared to controls, OCD patients with washing compulsions did not differ significantly in their levels of initial activation to the threat of contamination; however, they were significantly less able to reduce this activation by engaging in the corrective behavior of hand-washing. Further, the deactivating effect of hand-washing in OCD patients with checking compulsions was similar to that for controls, indicating that the dysfunction of termination in OCD is specific to the patient's symptom profile. Conclusions These results are the first to show that OCD is characterized by a reduced ability of security-related behavior to terminate motivation evoked by potential danger, rather than a heightened initial sensitivity to potential threat. They lend support to the security-motivation theory of OCD (Szechtman & Woody, 2004) and have important implications both for research into the biological mechanisms underlying OCD and for the development of new treatment approaches.
Collapse
Affiliation(s)
- Andrea L. Hinds
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Erik Z. Woody
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Michael Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Louis A. Schmidt
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Henry Szechtman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| |
Collapse
|
16
|
Moritz S, Rietschel L, Jelinek L, Bäuml KHT. Are patients with obsessive-compulsive disorder generally more doubtful? Doubt is warranted! Psychiatry Res 2011; 189:265-9. [PMID: 21840062 DOI: 10.1016/j.psychres.2011.07.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 07/07/2011] [Accepted: 07/11/2011] [Indexed: 11/26/2022]
Abstract
A number of neuropsychological models implicate disinhibition and a lack of response confidence in the pathogenesis of obsessive-compulsive disorder (OCD). To provide a fair test of the inhibition and confidence account, a variant of the directed forgetting (DF) paradigm with OCD-related and unrelated conditions was administered in 30 OCD patients and 20 healthy controls. First, 16 words were presented which the participant was subsequently instructed to forget. Then, 16 words were presented that should be memorized. After a short interval, patients were shown the to-be-forgotten and the to-be-remembered items along with new items in random order. The subjects were instructed to recollect both the to-be-remembered and the to-be-forgotten items. The subject was asked to grade responses according to confidence. In accordance with prior findings from our group, patients did not differ from controls on overall recollection, response confidence, and the recollection of to-be-forgotten (allegedly inhibited) information. Our study cannot refute the claim that disinhibition plays a role in OCD in view of the vast array of paradigms tapping different aspects of inhibition. Still, we deem a psychological understanding more fruitful that looks at dysfunctional coping strategies and false beliefs as mechanisms for the persistence and pervasiveness of obsessive thoughts.
Collapse
Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
| | | | | | | |
Collapse
|
17
|
Moritz S, Peters MJV, Larøi F, Lincoln TM. Metacognitive beliefs in obsessive-compulsive patients: a comparison with healthy and schizophrenia participants. Cogn Neuropsychiatry 2010; 15:531-48. [PMID: 20446128 DOI: 10.1080/13546801003783508] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Distorted metacognitive beliefs are increasingly considered in theoretical models of obsessive-compulsive disorder (OCD). However, so far no consensus has emerged regarding the specific metacognitive profile of OCD. METHODS Participants with OCD (n=55), schizophrenia (n=39), and nonclinical controls (n=49) were assessed with the Metacognitions Questionnaire (MCQ-30). RESULTS Except for positive beliefs about worry, both patient samples exceeded nonclinical controls on all MCQ subscales. The MCQ "need to control thoughts" and "negative beliefs about uncontrollability and danger" subscales showed strong correlations with obsessions, and scores in the former scale were elevated in hallucinators. In contrast to several prior studies, "cognitive confidence" was related neither to core OCD nor to schizophrenia symptomatology. CONCLUSIONS Notwithstanding large pathogenetic differences between OCD and schizophrenia, findings suggest that obsessions and hallucinations may share a common metacognitive pathway. Need to control thoughts and dysfunctional beliefs about the malleability of worries may represent critical prerequisites for the two phenomena to emerge.
Collapse
Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
| | | | | | | |
Collapse
|
18
|
Orhan Murat Koçak, Nalçacı E, Halise Devrimci Özgüven, Emel Güneş Nalçacı, Ergenç I. Evaluation of cognitive slowing in OCD by means of creating incongruence between lexicon and prosody. Psychiatry Res 2010; 179:306-11. [PMID: 20488555 DOI: 10.1016/j.psychres.2009.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Revised: 02/15/2009] [Accepted: 04/22/2009] [Indexed: 10/19/2022]
Abstract
Studies indicate that patients with obsessive-compulsive disorder (OCD) have slowing in cognitive processing, especially in the presence of a conflict. This study aimed to determine whether decision and motor times in OCD patients were affected by manipulating the congruence/incongruence of lexical and prosodic aspects of commands. An experimental paradigm was designed to simulate a situation that can trigger anxiety and obsessions in OCD patients. Commands with or without a conflict, that is, an incongruence between lexical and prosodic aspects, were given to the participants. Decision time, motor time and errors were the main parameters of the experiment. The control group had significantly faster decision times than the OCD group in response to both conflicting and non-conflicting commands. The OCD patients demonstrated higher trait anxiety, while Stroop interference and state anxiety were not significantly different between the groups. These results suggest that OCD patients experience slowing in their response times, regardless of whether the stimuli are conflicting or not.
Collapse
Affiliation(s)
- Orhan Murat Koçak
- Kırıkkale University, Department of Psychiatry, Süleyman Demirel Research and Education Hospital, Kırıkkale, 71100, Turkey.
| | | | | | | | | |
Collapse
|
19
|
Moritz S, Kloss M, Jelinek L. Negative priming (cognitive inhibition) in obsessive-compulsive disorder (OCD). J Behav Ther Exp Psychiatry 2010; 41:1-5. [PMID: 19716549 DOI: 10.1016/j.jbtep.2009.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 08/03/2009] [Accepted: 08/11/2009] [Indexed: 11/16/2022]
Abstract
Cognitive disinhibition has been implicated in the pathogenesis of obsessive-compulsive disorder (OCD). Negative priming (NP) is regarded to tap into this function. While early studies indeed found reduced negative priming in OCD, attempts to replicate are both scarce and equivocal. Moreover, several studies in favor of the disinhibition hypothesis are plagued by methodological limitations. For the present investigation, 18 participants with OCD and 28 healthy controls underwent a computerized NP experiment with varying response-stimulus intervals. In addition, a variant of the paradigm with concurrent item presentation was employed to rule out the confounding impact of memory. Negative priming was comparable between groups yielding small between-group effect sizes. The present study challenges broad claims of disinhibition in OCD. In our view, the disinhibition account faces theoretical problems. Instead, theories implicating cognitive biases as well as metacognitive problems may more parsimoniously explain the idiosyncratic nature of OCD symptoms.
Collapse
Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany.
| | | | | |
Collapse
|
20
|
Lind C, Boschen MJ. Intolerance of uncertainty mediates the relationship between responsibility beliefs and compulsive checking. J Anxiety Disord 2009; 23:1047-52. [PMID: 19656653 DOI: 10.1016/j.janxdis.2009.07.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 06/29/2009] [Accepted: 07/01/2009] [Indexed: 11/24/2022]
Abstract
Both responsibility beliefs and intolerance of uncertainty have been implicated in compulsive checking behavior. Despite this, the exact relationship of these two variables with compulsive checking behavior is yet to be determined. Using a mixed sample of individuals consisting of compulsive checkers as well as non-clinical participants, we assessed the validity of a mediation model in which the relationship between responsibility beliefs and compulsive checking was mediated by intolerance of uncertainty. Although both responsibility beliefs and intolerance of uncertainty were correlated with the frequency of compulsive checking, the relationship between responsibility and checking was fully mediated by intolerance of uncertainty. Implications for the understanding of the relationship between these constructs, as well for conceptualization of clinical checking problems are discussed.
Collapse
Affiliation(s)
- Christian Lind
- School of Psychology, Griffith University, Southport Qld, Australia
| | | |
Collapse
|
21
|
Bedard MJ, Joyal CC, Godbout L, Chantal S. Executive Functions and the Obsessive-Compulsive Disorder: On the Importance of Subclinical Symptoms and Other Concomitant Factors. Arch Clin Neuropsychol 2009; 24:585-98. [DOI: 10.1093/arclin/acp052] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
|
22
|
Cuttler C, Graf P. Checking-in on the memory deficit and meta-memory deficit theories of compulsive checking. Clin Psychol Rev 2009; 29:393-409. [DOI: 10.1016/j.cpr.2009.04.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 03/19/2009] [Accepted: 04/02/2009] [Indexed: 10/20/2022]
|
23
|
Moritz S, Kloss M, von Eckstaedt FV, Jelinek L. Comparable performance of patients with obsessive-compulsive disorder (OCD) and healthy controls for verbal and nonverbal memory accuracy and confidence: time to forget the forgetfulness hypothesis of OCD? Psychiatry Res 2009; 166:247-53. [PMID: 19285350 DOI: 10.1016/j.psychres.2008.02.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2007] [Revised: 11/01/2007] [Accepted: 02/11/2008] [Indexed: 11/27/2022]
Abstract
The memory deficit or forgetfulness hypothesis of obsessive-compulsive disorder (OCD) has received considerable attention and empirical effort over the past decades. The present study aimed to provide a fair test of its various formulations: (1) memory dysfunction in OCD is ubiquitous, that is, manifests irrespective of modality and material; (2) memory dysfunction is found for nonverbal but not verbal material, (3) memory dysfunction is secondary to executive impairment; and (4) memory dysfunction affects meta-memory rather than memory accuracy. Participants comprised 43 OCD patients and 46 healthy controls who were tested on the Picture Word Memory Test (PWMT), which provides several unconfounded parameters for nonverbal and verbal memory accuracy and confidence measures across different time-points. In addition, the Trail-Making Test B was administered to test assumption number 3. Replicating earlier work of our group, samples displayed similar performance on all indices. None of the different formulations of the memory deficit hypothesis were supported. In view of waning evidence for a global memory deficit in OCD, neuropsychological research on OCD should more thoroughly investigate moderators and triggers of occasional instances of impaired performance, particularly cognitive biases such as perfectionism and an inflated sense of responsibility.
Collapse
Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, 20246 Hamburg, Germany.
| | | | | | | |
Collapse
|
24
|
Moritz S, Jelinek L, Hottenrott B, Klinge R, Randjbar S. No evidence for object alternation impairment in obsessive-compulsive disorder (OCD). Brain Cogn 2009; 69:176-9. [DOI: 10.1016/j.bandc.2008.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 07/01/2008] [Accepted: 07/07/2008] [Indexed: 11/26/2022]
|
25
|
No deficits in nonverbal memory, metamemory and internal as well as external source memory in obsessive-compulsive disorder (OCD). Behav Res Ther 2009; 47:308-15. [PMID: 19208441 DOI: 10.1016/j.brat.2009.01.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 12/10/2008] [Accepted: 01/08/2009] [Indexed: 12/27/2022]
Abstract
A large body of literature suggests that some symptoms of obsessive-compulsive disorder (OCD) result from mnemonic dysfunctions. The present study tested various formulations of the memory deficit hypothesis considering important moderators, such as depression and response slowing. Thirty-two OCD patients and 32 healthy controls were presented verbal or nonverbal instructions for actions (e.g. simple gestures). These actions should either be performed or imagined. For recognition, previously presented as well as novel actions were displayed. Decisions had to be made whether an action was previously displayed (verbally vs. nonverbally) or not and whether an action was performed or imagined (internal source memory). Moreover, both judgments required confidence ratings. Groups did not differ in memory accuracy and metamemory for verbally presented material. Patients displayed some impairment for nonverbally presented material and imagined instructions, which, however, could be fully accounted for by response slowing and depressive symptoms. The study challenges the view that primary memory deficits underlie OCD or any of its subtypes. We claim that research should move forward from the mere study of objective impairment to the assessment of cognitive performance in conjunction with personality traits such as inflated responsibility.
Collapse
|
26
|
Moritz S, Wahl K, Ertle A, Jelinek L, Hauschildt M, Klinge R, Hand I. Neither saints nor wolves in disguise: ambivalent interpersonal attitudes and behaviors in obsessive-compulsive disorder. Behav Modif 2008; 33:274-92. [PMID: 19047487 DOI: 10.1177/0145445508327444] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inflated responsibility is ascribed a pivotal role in the pathogenesis of obsessive-compulsive disorder (OCD). The aim of the study was to assess interpersonal attitudes and behaviors contributing to enhanced responsibility in OCD. In particular, we tested the hypothesis that individuals diagnosed with OCD share stronger latent aggression toward others, resulting in a high degree of interpersonal ambivalence. A total of 176 participants with OCD, 42 participants with anxiety or depression as well as 42 healthy controls completed the Responsibility and Interpersonal Behaviors and Attitudes Questionnaire (RIBAQ). The factor analysis confirmed three factors: (1) inflated worry/responsibility, (2) latent aggression/calculating behavior and (3) suspiciousness/distrust. Whereas the psychiatric group displayed enhanced scores relative to healthy participants regarding responsibility and suspiciousness, OCD patients achieved significantly higher scores on the latent aggression dimension relative to both control groups. Results are consistent with the notion that participants with OCD show both inflated levels of (authentic) responsibility and latent aggression.
Collapse
Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
| | | | | | | | | | | | | |
Collapse
|
27
|
Cougle JR, Salkovskis PM, Thorpe SJ. "Perhaps you only imagined doing it": reality-monitoring in obsessive-compulsive checkers using semi-idiographic stimuli. J Behav Ther Exp Psychiatry 2008; 39:305-20. [PMID: 17884012 DOI: 10.1016/j.jbtep.2007.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2007] [Indexed: 12/28/2022]
Abstract
Memory failures reported by obsessive-compulsive (OC) checkers often seem to be errors of "reality-monitoring", or misremembering whether one performed or imagined performing an action. To examine these memory processes in the context in which such errors are said to occur, an in-home reality-monitoring experiment involving bothersome and non-bothersome actions was conducted with 21 OC checkers and 24 non-clinical controls. OC checkers reported poorer confidence in memory, but both groups performed similarly on tests of immediate and delayed free and prompted recall. Among OC checkers (but not controls), accuracy in recall and confidence in memory were correlated. Theoretical implications are discussed.
Collapse
Affiliation(s)
- Jesse R Cougle
- Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, UK.
| | | | | |
Collapse
|
28
|
Gloster AT, Richard DC, Himle J, Koch E, Anson H, Lokers L, Thornton J. Accuracy of retrospective memory and covariation estimation in patients with obsessive–compulsive disorder. Behav Res Ther 2008; 46:642-55. [DOI: 10.1016/j.brat.2008.02.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2007] [Revised: 02/27/2008] [Accepted: 02/27/2008] [Indexed: 11/28/2022]
|
29
|
Hermans D, Engelen U, Grouwels L, Joos E, Lemmens J, Pieters G. Cognitive confidence in obsessive-compulsive disorder: Distrusting perception, attention and memory. Behav Res Ther 2008; 46:98-113. [DOI: 10.1016/j.brat.2007.11.001] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 10/31/2007] [Accepted: 11/01/2007] [Indexed: 11/28/2022]
|