Obsessive-compulsive tendencies are related to seeking proxies for internal states in everyday life

In recent years we have proposed and investigated the Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD), which postulates that deficient access to internal states is a key feature of the disorder. According to this model, rules and rituals that often characterize people with OCD can be understood as proxies for deficiently accessible internal states. Here we compliment this earlier experimental work by examining whether reliance on proxies for internal states in everyday life is associated with OCD.

We developed an inventory for assessing reliance on proxies in everyday life and examined its relationship with obsessive-compulsive tendencies in two internet panel studies. The internal states included hunger, enjoyment, interpersonal liking, preferences, a sense of understanding, and intuitions about correct solutions to problems. The proxies included one's own behavior, the opinion of others, and objective indices such as grades and elapsed time since eating.

In both studies, participants with obsessive-compulsive tendencies reported relying more on external, discernible proxies for a variety of internal states. These results remained significant after controlling for concurrent anxiety and depression.

Our inventory is by necessity limited in its sampling of internal states and proxies and further correlational and experimental studies will be needed to examine additional areas of application, such as decision making and interpersonal liking.

These results are consistent with and expand the Seeking Proxies for Internal States (SPIS) model and may have implications for understanding and treating individual with OCD.