Hoping for more: How cognitive science has and hasn't been helpful to the OCD clinician

Cognitive-behavioural models of obsessive-compulsive disorder (OCD) stemmed from knowledge acquired from cognitive science. Researchers continue to apply basic cognitive-affective science methods to understanding OCD, with the overarching goal of improving and refining evidence-based treatments. However, the degree to which such research has contributed to this goal is unclear. We reviewed OCD research in the general areas that comprise basic cognitive science, and evaluated the degree to which it has contributed to our understanding of the development, maintenance, and treatment of OCD. We focused on studies that either compared people with and without OCD and/or used experimental psychopathology methods with human participants, and attempted to resolve some of the conflicting theories related to the importance of cognitive deficits vs. cognitive biases. Overall, we observed equivocal findings for deficits in perception, attention, memory, and executive functioning. Moreover, many so-called deficits were moderated and/or explained by OCD-relevant beliefs, highlighting the role of confidence in cognitive processes as integral to our understanding of OCD. We discussed these findings in terms of cognitive measurement, cognitive-behavioural models, and clinical applicability, and made recommendations for future research that may offer innovation and insight helpful to clinicians working to improve the symptoms and lives of people with OCD.