Disturbances in social cognitive processes such as the ability to infer others' mental states importantly contribute to social and functional impairments in psychiatric disorders. Yet, despite established social, emotional, and cognitive problems, the role of social cognition in obsessive-compulsive disorder is largely overlooked. The current review provides a first comprehensive overview of social (neuro)cognitive disturbances in adult patients with obsessive-compulsive disorder. Results of our review indicate various social cognitive alterations. Patients with obsessive-compulsive disorder show deficits in the recognition of affective social cues, specifically facial expressions of disgust, and more general deficits in theory of mind/mentalizing. Additionally, patients show heightened affective reactions and altered neural responding to emotions of self and others, as well as poor emotion regulation skills, which may contribute to poor social functioning of patients. However, the discrepancies in findings and scarcity of studies make it difficult to draw firm conclusions with regard to the specificity of social cognitive disturbances. The review offers directions for future research and highlights the need to investigate obsessive-compulsive disorder from an interactive social neurocognitive perspective in addition to the prevalent passive spectator perspective to advance our understanding of this intricate and burdensome disorder.

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Mistakes that affect others often are linked to increased feelings of responsibility and guilt. This especially holds for individuals high in obsessive-compulsive symptoms (OCS), who are characterized by inflated feelings of responsibility and a fear of causing harm to others. This event-related potential study investigated individual differences in OCS in social performance monitoring with a focus on the role of responsibility for other's harm and the error-related negativity (ERN). Healthy volunteers low (N = 27) or high (N = 24) in OCS performed a Flanker task in the presence of a gender-matched peer in three conditions. Mistakes could either have negative monetary consequences for 1) oneself, 2) the other, or 3) no one. Results showed enhanced ERNs for mistakes that harmed others instead of the self for individuals high in OCS, whereas individuals low in OCS showed decreased amplitudes specifically for mistakes affecting no one versus oneself. Amplitudes of the error positivity but not the ERN also were larger in the high OCS group. These findings indicate that high OCS are associated with enhanced performance monitoring in a social responsibility context, when mistakes harm others instead of the self, and demonstrate the importance of integrating the social context in performance monitoring research as a way to shed more light on obsessive-compulsive symptomatology.