Obsessive–compulsive disorder and the paradoxical effects of perseverative behaviour on experienced uncertainty

Abstract

Patients suffering from Obsessive-compulsive disorder (OCD) tend to check repeatedly and after checking episodes they tend to be uncertain about their memory for checked events. It seems plausible that memory distrust motivates checking, but why checking is repeated and why one check is not enough to reassure the patient is uncertain.To study this, an interactive computer animation displaying light bulbs or gas rings was developed and healthy participants were asked to engage in repeated checking. In five separate experiments we found that repeatedly checking the same class of items resulted in sharp decreases in detail and vividness of memory of the checked events while the accuracy of the memory remained intact. The phenomenological quality of the experienced memory distrust was highly similar to the ambivalence OCD patients tend to report about their memory after checking. Furthermore, there were some indications that repeated checking not only undermines trust in memory, but may also reduce the sense that one acted responsibly.The experimental preparation may be used as a model for OCD checking. The study suggests that repeated checking is sufficient to cause paradoxical effects on memory trust and that repeated checking is a counterproductive safety strategy. r

Attentional Focus During Repeated Checking Influences Memory but not Metamemory

“…In addition to the large declines in confidence, vividness, and detail, these more recent studies also found small declines in memory accuracy. Van den Hout and Kindt (2004) argued that the conditions of high familiarity, such as those produced by the ''relevant checking'' condition in their study, inhibited processing of the perceptual features of a stimulus which in turn decreased the vividness and detail of later recollections, and subsequently deflated the confidence in that recollection.…”

“…Recent research suggests that the declines in memory confidence following repeated checking, at least in non-clinical samples, are larger than the changes in memory accuracy that have been observed (Van den Hout & Kindt, 2004;Coles, Radomsky, & Horng, 2006;Radomsky, Gilchrist, & Dussault, 2006) and that decreases in memory confidence appear to be most salient under conditions of high responsibility (Radomsky et al, 2001). It may be that compulsive checkers do not have a worse memory than others, but rather are less confident in their memory.…”

“…It follows from these models that increasing the amount of detail encoded (e.g., increased processing of perceptual features according to Van den Hout and Kindt (2004), or increased processing of threat-irrelevant cues according to Radomsky et al (2001)) may attenuate these declines in memory confidence. Not only would demonstrating that increased encoding of detail attenuates declines in memory confidence add support to these theories of how repeated checking affects memory and meta-memory, this finding could also offer clinicians additional tools in the cognitive-behavioral treatment of compulsive checking.…”

The Role of Distinctiveness of Stimulus in Memory Distrust as a Function of Repeated Checking

“…Son olarak, ilgili kontrol grubundaki katılımcılar diğer gruba oranla ocakların tam olarak kapalı olup olmadığıyla ilgili soruya anlamlı olarak daha az emin bir şekilde yanıt vermişlerdir. Bu değerlendirme "sonuçtaki güven" (outcome confidence) olarak isimlendirilmiş-tir (Ashbaugh ve Radomsky 2007;van den Hout ve Kindt 2003a, 2003b, 2004, Radomsky ve ark. 2006).…”

“…Başka türlü ifade edilecek olursa, bu yazarlar dış dünyadan gelen verileri kaydetme esnasında algısal (perceptual) düzeyde işlemlemenin anlamsal (semantic) tipteki işlemlemeye doğru dönüştüğünü/değiştiğini önermişlerdir (Tulving 1985). Böylelikle deneydeki katılımcılar bahsedilen hipoteze göre son kontrol seansında özgül olarak hatırlama-dan genel manada bilmeye geçiş yapmışlardır (van den Hout ve Kindt 2004, Johnston ve Hawley 1994, Tulving 1985. İddia takip edildiğinde, bu sürecin sonunda hafızanın canlılık ve detayı azalır.…”