What Checkers Actually Check: An Eye Tracking Study of Inhibitory Control and Working Memory

Abstract

BackgroundNot only is compulsive checking the most common symptom in Obsessive Compulsive Disorder (OCD) with an estimated prevalence of 50–80% in patients, but approximately ∼15% of the general population reveal subclinical checking tendencies that impact negatively on their performance in daily activities. Therefore, it is critical to understand how checking affects attention and memory in clinical as well as subclinical checkers. Eye fixations are commonly used as indicators for the distribution of attention but research in OCD has revealed mixed results at best.Methodology/Principal FindingHere we report atypical eye movement patterns in subclinical checkers during an ecologically valid working memory (WM) manipulation. Our key manipulation was to present an intermediate probe during the delay period of the memory task, explicitly asking for the location of a letter, which, however, had not been part of the encoding set (i.e., misleading participants). Using eye movement measures we now provide evidence that high checkers’ inhibitory impairments for misleading information results in them checking the contents of WM in an atypical manner. Checkers fixate more often and for longer when misleading information is presented than non-checkers. Specifically, checkers spend more time checking stimulus locations as well as locations that had actually been empty during encoding.Conclusions/SignificanceWe conclude that these atypical eye movement patterns directly reflect internal checking of memory contents and we discuss the implications of our findings for the interpretation of behavioural and neuropsychological data. In addition our results highlight the importance of ecologically valid methodology for revealing the impact of detrimental attention and memory checking on eye movement patterns.

Neural Correlates of Impaired Cognitive Control over Working Memory in Schizophrenia

“…Similar impairments in inhibitory control may underlie cognitive deficits in other psychiatric disorders such as depression, obsessive compulsive disorder, or attention deficit hyperactivity disorder (49–53). In a similar task to that used here, patients with depression demonstrated a specific deficit in inhibiting negatively, but not positively valenced content from WM (51, 54).…”

“Not Just Right Experiences” are specific to obsessive–compulsive disorder: Further evidence from Italian clinical samples

“…Research conducted during the last few years has increasingly considered the lack of a sense of satisfaction and presence of feelings of doubt as central features of obsessions and associated compulsions (Ferrão et al, 2012;Gentsch, Schütz-Bosbach, Endrass, & Kathmann, 2012;Harkin, Miellet, & Kessler, 2012;Taylor et al, 2014) even though a few studies found such features also in Tourette syndrome (e.g., Prado et al, 2008), tic disorders (Ferrão et al, 2012), and autism (Kloosterman, Summerfeldt, Parker, & Holden, 2013). These features have been referred to as "feelings of incompleteness," or "not just-right phenomena/experiences" (NJREs) and may be defined as "the subjective sense that something isn't just as it should be", an unsettled feeling because something in the individuals or in the world around them is not right.…”

Differential role of visuospatial working memory in the propensity toward uncertainty in patients with obsessive–compulsive disorder and in healthy subjects

“…Checking behaviour may therefore be viewed as the behavioural output of a perceived uncertainty, a coping strategy to compensate for visuospatial memory deficits or both. Furthermore, the repeated loss of accuracy, possibly related to memory deficits, may decrease confidence in memory and increase the likelihood of the occurrence of intrusive thoughts (Harkin & Kessler, 2011; Harkin et al 2012). However, these results were observed in subclinical samples and need to be replicated in patients suffering from OCD (Harkin et al 2012).…”