Confidence in memory and other cognitive processes in obsessive–compulsive disorder

Swin-PsyCHE Research Unit, Faculty of Life and Social Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Victoria, 3122, Australia.
Behaviour Research and Therapy (Impact Factor: 3.85). 01/2008; 45(12):2899-914. DOI: 10.1016/j.brat.2007.08.001
Source: PubMed


Previous studies have implicated beliefs about one's memory (i.e., meta-memory), in maintaining the symptoms of obsessive-compulsive disorder (OCD), particularly with respect to checking rituals. However, most research has focused on task- or situation-specific perceptions about memory performance. Expanding on this research, we undertook two studies with analogue and clinical cohorts to examine the relationship between general 'trait' beliefs about memory and related processes and OCD symptoms. Trait meta-memory as measured in the current study was conceptualised as a multi-dimensional construct encompassing a range of beliefs about memory and related processes including confidence in one's general memory abilities, decision-making abilities, concentration and attention, as well as perfectionistic standards regarding one's memory. Meta-memory factors were associated with OCD symptoms, predicting OCD symptoms over-and-above mood and other OCD-relevant cognitions. Meta-memory factors were found to be particularly relevant to checking symptoms. Implications for theory and research are discussed.

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    • "Participants rate items on a 5- point scale from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating lower confidence in memory. The CIMS has previously demonstrated excellent internal consistency and good test-retest reliability (Nedeljkovic and Kyrios, 2007), and also exhibited excellent internal consistency in the current study (a ¼ .96). "
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    ABSTRACT: Hoarding disorder (HD) is characterized by difficulty discarding, clutter, and frequently excessive acquiring. Theories have pointed to intense negative emotional reactions (e.g., sadness) as one factor that may play a critical role in HD's etiology. Preliminary work with an analogue sample indicated that more intense negative emotions following emotional films were linked with greater hoarding symptoms. Symptom provocation imaging studies with HD patients have also found evidence for excessive activation in brain regions implicated in processing emotions. The current study utilized a sample with self-reported serious hoarding difficulties to examine how hoarding symptoms related to both general and hoarding-related emotional reactivity, taking into account the specificity of these relationships. We also examined how two cognitive factors, fear of decision-making and confidence in memory, modified this relationship. 628 participants with self-identified hoarding difficulties completed questionnaires about general emotional reactivity, depression, anxiety, decision-making, and confidence in memory. To assess hoarding-related emotional reactivity, participants reported their emotional reactions when imagining discarding various items. Heightened general emotional reactivity and more intense emotional reactions to imagined discarding were associated with both difficulty discarding and acquisition, but not clutter, controlling for age, gender, and co-occurring mood and anxiety symptoms. Fear of decision-making and confidence in memory interacted with general emotional reactivity to predict hoarding symptoms. These findings provide support for cognitive-behavioral models of hoarding. Experimental research should be conducted to discover whether emotional reactivity increases vulnerability for HD. Future work should also examine whether emotional reactivity should be targeted in interventions for hoarding. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Feb 2015 · Journal of Psychiatric Research
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    • "Other research suggests that a decline in memory confidence may be especially pronounced under conditions of high responsibility and on tasks relevant to current goals (Boschen & Vuksanovic, 2007; Radomsky, Dugas, Alcolado, & Lavoie, 2014). At the same time a number of studies have found that individuals with OCD have less confidence in their memory, cognitive and sensory faculties overall than do individuals with another psychiatric diagnosis or individuals with no diagnosis (Hermans, Marten, De Cort, Pieters, & Eelen, 2003; Nedeljkovic & Kyrios, 2007; Nedeljkovic, Moulding, Kyrios, & Doron, 2009; van den Hout, Engelhard, de Boer, du Bois, & Dek, 2008), particularly when referencing OCD-relevant actions such as locking a door (Hermans et al., 2008). Confidence in memory, attention, and perception have also been found to predict greater self-reported checking symptoms over and above other OCD-relevant cognitions , such as increased responsibility and confidence in memory (Bucarelli & Purdon, 2009). "
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    ABSTRACT: Research on the persistence of compulsions has found that, when making the decision to stop a compulsion, people with OCD weigh sensory and memory information as more important than external criteria. At the same time, research has also found that repetition of behaviour has a deleterious effect on memory, sensory and cognitive confidence. These findings have important treatment implications but they are almost exclusively laboratory based. This study sought to examine compulsions as they occur in vivo using a structured diary format. 22 People with a principal diagnosis of OCD completed measures of memory, sensory and cognitive confidence and used a structured diary to report on three compulsive episodes a day for three days. Despite repetition, a sense of certainty or the "right" feeling was achieved in over half of the compulsive episodes. The outcome of compulsive episodes was not influenced by distress over the obsession, nor was distress associated with negative beliefs about obsessions. Episodes in which certainly was not achieved were characterized by greater repetitions, greater memory, cognitive and sensory doubt and less certainty that the compulsion had been done properly. The sample size was modest, checking compulsions were over-represented and data were based on retrospective self-report, albeit 2-h on average. Consistent with laboratory studies, repetition has insidious effects on the persistence of compulsions. However, compulsions yielded a sense of certainty half the time, despite repetitions. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jan 2015 · Journal of Behavior Therapy and Experimental Psychiatry
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    • "This type seems more general and occurs in a wide range of domains and ambiguous situations, which is displayed, for instance, by less confidence in one's memory (Tuna, Tekcan, & Topcuoglu, 2005), perception (Hermans et al., 2008), concentration abilities (Nedeljkovic & Kyrios, 2007), and general knowledge (Dar, Rish, Hermesh, Taub, & Fux, 2000). Researchers argued that this elevated level of subclinical, general uncertainty may precede clinical OCD by acting as a vulnerability factor for the disorder (Nedeljkovic & Kyrios, 2007; Toffolo et al., 2013). Subclinical uncertainty may tempt individuals to seek reassurance by repeated checking in response to normal doubts. "
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    ABSTRACT: Recently, Toffolo and colleagues (2013) showed that individuals with subclinical OCD (OC+) respond with more checking behavior to mildly uncertain situations than individuals with low OC tendencies (OC-). The present study aimed to replicate and extend these findings by measuring Intolerance of Uncertainty (IU), and including the whole range of OC tendencies in a correlation analysis. Participants filled out the Obsessive Compulsive Inventory Revised and Intolerance of Uncertainty Scale and performed a visual search task. This task contained 50 search displays, in which participants indicated whether a target was “present” or “absent”. Target-present trials were straight-forward, but target-absent trials were ambiguous, because participants had to rely on not having overlooked the target. Results revealed that target-absent trials induced more uncertainty than target-present trials. Furthermore, OC+ participants checked longer than OC- participants in target-absent but not target-present trials. This could not be explained by higher IU in OC+ participants. There were no differences in number of fixations in absent and present trials between the groups. Finally, when looking at the whole range of OC tendencies, there was a positive relation between OC tendencies and checking behavior. The findings (partly) replicated those of Toffolo, van den Hout, Hooge, Engelhard, and Cath (2013) and add to their robustness.
    Full-text · Article · Oct 2014 · Journal of Obsessive-Compulsive and Related Disorders
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