A check on the memory deficit hypothesis of obsessive–compulsive checking

Abstract

A number of recent studies have challenged the hypothesis that patients with obsessive-compulsive disorder (OCD) display global memory deficits. An alleviated form of the memory deficit hypothesis posits that OCD patients share deficits to vividly recall memory episodes. According to the latter view, checking rituals can be understood as counter-productive coping strategies to "enrich" memory episodes in order to make them more distinctive. A source memory task was administered to 27 OCD (17 checkers) and 51 healthy participants. Along with confidence judgments, a remember-know procedure was employed to assess whether OCD patients display problems with conscious/vivid recollection. Patients with or without checking compulsions did not exhibit differences to controls on source memory accuracy and meta-memory. Patients forgot more self-generated items, which, however, was related to comorbid depressive but not OCD symptoms. Findings challenge the ubiquity of memory deficits in OCD. To account for the inconclusive pattern of results in the literature, it is suggested that patients mistrust their memories and adopt checking rituals only when perceived responsibility is inflated.

Metacognitive impairments extend perceptual decision making weaknesses in compulsivity

“…Traditional studies of metacognition using questionnaires 11,14,21–25 or subjective confidence ratings 10,12,13,15 are subject to influences that may mimic a metacognitive impairment, such as systematic response biases in questionnaires and other confidence scales 26 . Here, we operationalize metacognition as the objective sensitivity of confidence ratings to discrimination performance, as defined by signal detection theory 27 .…”

Metacognition and episodic memory in obsessive-compulsive disorder

“…An early memory deficit theory of OCD sought to explain pathological doubt and checking rituals by low memory accuracy (Sher, Frost, Kushner, Crews, & Alexander, 1989;Sher, Frost, & Otto, 1983). This model conceptualized obsessive-compulsive pathology as a consequence of preexisting memory problems but the theory has failed to find consistent empirical support (Moritz, Jacobsen, Willenborg, Jelinek, & Fricke, 2006;Tallis, Pratt, & Jamani, 1999).…”

Assessing neurocognitive function in psychiatric disorders: A roadmap for enhancing consensus

“…Though there are many points of controversy in the field, one question that leads to spirited debate is whether OCD patients have memory deficits when compared to healthy controls. In addition, memory deficiencies have been proposed as an explanatory model for how checking compulsions in a particular subtype of OCD might develop (Harkin & Kessler, 2011; Jaafari et al, 2013; Moritz, Jacobsen, Willenborg, Jelinek, & Fricke, 2006). …”

“…A classic example of a checking compulsion is repeatedly checking the door to make sure it has been locked properly; the corresponding obsession is the intrusive fear that the front door was not properly locked and harm will therefore come to one’s family. In the subgroup of OCD patients with predominant checking compulsions, it has been suggested that working memory deficits may play an etiological role in the generation of repetitive checking behavior (Jaafari et al, 2013; Moritz et al, 2006). In this explanatory model, OCD patients would literally not remember if they had checked the door lock properly, and would therefore need to repeat the behavior until they could retain the memory of locking the door.…”