OCD-like checking in the lab: A meta-analysis and improvement of an experimental paradigm

Hout, Marcel A. van den; Dis, Eva A. M. van; Woudenberg, C. van; Groep, Ilse H. van de

doi:10.1016/j.jocrd.2017.11.006

Cited by 25 publications

(19 citation statements)

References 28 publications

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“…Reward PEs, referring to the response to feedback that is either worse or better than expected, can be conceptualized as another type of PE (which affects confidence regarding policies; FitzGerald, Dolan, & Friston, 2015). Consistent with our hypothesis, OCD patients exhibit increased reward PE signals in the anterior cingulate cortex (Hauser et al, 2017), and a stronger influence of reward PEs on action (Vaghi et al, 2017). Interestingly, in the latter study, the authors report that patients acted as if the contingencies had to be learned anew on each trial.…”

Section: High Transition Uncertainty Can Explain Abnormalities In Thesupporting

confidence: 78%

“…Notably, greater action-dependent transition uncertainty led to an increase in the overall posterior uncertainty only after washing. This effect can partially explain the well-documented paradoxical effect of compulsions on increasing uncertainty and additional compulsive urges (for a review see van den Hout, van Dis, van Woudenberg, & van de Groep, 2018).…”

Section: Excessive Transition Uncertainty In Ocdmentioning

confidence: 98%

“…Finally, this increased weighting of PEs seems more likely to be the result of high transition uncertainty than underestimation of sensory noise. Indeed, in two studies (Ray Li et al, 2000;Vaghi et al, 2017), increased weighting of PEs was related to perceiving the world as highly unstable.…”

Section: High Transition Uncertainty Can Explain Abnormalities In Thementioning

confidence: 99%

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Searching for an anchor in an unpredictable world: A computational model of obsessive compulsive disorder.

Fradkin

Adams

Parr

et al. 2020

Psychological Review

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In this article, we develop a computational model of obsessive compulsive disorder (OCD). We propose that OCD is characterized by a difficulty in relying on past events to predict the consequences of patients' own actions and the unfolding of possible events. Clinically, this corresponds both to patients' difficulty in trusting their own actions (and therefore repeating them), and to their common preoccupation with unlikely chains of events. Critically, we develop this idea on the basis of the well-developed framework of the Bayesian brain, where this impairment is formalized as excessive uncertainty regarding state transitions. We illustrate the validity of this idea using quantitative simulations and use these to form specific empirical predictions. These predictions are evaluated in relation to existing evidence, and are used to delineate directions for future research. We show how seemingly unrelated findings and phenomena in OCD can be explained by the model including: a persistent experience that actions were not adequately performed and a tendency to repeat actions; excessive information gathering (i.e. checking); indecisiveness and pathological doubt; overreliance on habits at the expense of goal-directed behavior; and over-responsiveness to sensory stimuli, thoughts, and feedback. We discuss the relationship and interaction between our model and other prominent models of OCD, including models focusing on harm-avoidance, not-just-right experiences, or impairments in goal-directed behavior. Finally, we outline potential clinical implications and suggest lines for future research.

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Section: High Transition Uncertainty Can Explain Abnormalities In Thesupporting

confidence: 78%

Section: Excessive Transition Uncertainty In Ocdmentioning

confidence: 98%

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Searching for an anchor in an unpredictable world: A computational model of obsessive compulsive disorder.

Fradkin

Adams

Parr

et al. 2020

Psychological Review

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“…Repeated checking increases familiarity with the checked issues, which in turn promotes conceptual processing (“knowing”) and inhibits perceptual processes (“remembering”). These results have been replicated in OCD patients (Coles, Radomsky, & Horng, ; Radomsky, Gilchrist, & Dussault, ) and in healthy volunteers engaged in a virtual checking task (van den Hout, van Dis, van Woudenberg, & van de Groep, ). Hence, the decline in memory confidence with repeated checking is a normal phenomenon.…”

Section: Introductionmentioning

confidence: 76%

A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder

Bouvard

Fournet

Denis

et al. 2020

Clin Psychology and Psychoth

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The structured Repeated Action Diary (RAD) collects in vivo data on compulsions and their various characteristics. Certain compulsions (i.e., those ending because the patient feels certain that it is safe to stop) are then compared with uncertain compulsions. The compulsion profile in patients with obsessive compulsive disorder (OCD) was assessed by using the RAD. Thirty‐two patients from two sources participated in the study. Before pooling the two subgroups, we checked that they did not differ significantly with regard to demographic and clinical variables. Patients reported several categories of compulsion. The most frequently reported compulsions were washing and checking. In a given person, checking compulsions (in contrast to washing compulsions) were often produced by several different obsessions. Almost all the patients reported repeating the compulsions because of a need to feel sure. There were far more “certain” compulsions than “uncertain” compulsions. The number of repetitions was significantly lower for certain compulsions than for uncertain compulsions. The person felt greater relief from guilt and responsibility and a greater decrease in discomfort at the end of a compulsive episode for certain compulsions than for uncertain compulsions. In conclusion, the need to ritualize (prompted by uncertainty, i.e., potential danger) might explain the maintenance (or posttreatment recurrence) of OCD in many patients. The need for certainty in the completion of a compulsion may be worth considering as a therapeutic tool. The development of an approach based on the need for certainty might help to improve treatment outcomes.

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“…We examined a non-clinical sample and did not use stress induction pre-gazing to imitate distressing emotions, which are known to trigger engaging in gazing rituals [4]. Note that in studies on effects of repeated checking, individuals with OCD showed the same paradoxical decrease in memory confidence as healthy individuals [43], suggesting the same may hold true for the paradigm reported here. However, the study design limits the generalizability of the findings regarding effects in individuals with clinical BDD.…”

Section: Discussionmentioning

confidence: 98%

Gazing at facial features increases dissociation and decreases attractiveness ratings in non-clinical females – A potential explanation for a common ritual in body dysmorphic disorder

et al. 2019

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Rituals, such as gazing at faces, are common in body dysmorphic disorder (BDD) and appear in cognitive-behavioral models as a maintaining factor. Rituals are also common in obsessive-compulsive disorder (OCD). In contrast to OCD, the proposed associations between rituals and intrusive thoughts/appearance preoccupation have not been empirically investigated for BDD. We examined if the assumed effect of gazing rituals on attractiveness ratings exists and if it is associated with dissociation. In an experiment, we asked N = 65 non-clinical females to focus on the nose of a photographed face at pre- and post-test. In between, participants gazed at the nose of either the same (relevant gazing) or another face (irrelevant gazing). We found increasing dissociation after gazing in both conditions and a differentially stronger decrease of attractiveness ratings in the relevant gazing condition. Our findings support the hypothesized effect of gazing rituals on attractiveness evaluation in cognitive-behavioral models for BDD.

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OCD-like checking in the lab: A meta-analysis and improvement of an experimental paradigm

Cited by 25 publications

References 28 publications

Searching for an anchor in an unpredictable world: A computational model of obsessive compulsive disorder.

Searching for an anchor in an unpredictable world: A computational model of obsessive compulsive disorder.

A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder

Gazing at facial features increases dissociation and decreases attractiveness ratings in non-clinical females – A potential explanation for a common ritual in body dysmorphic disorder

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