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Differences in metacognitive functioning between obsessive-compulsive disorder patients and highly compulsive
Monja Hoven1, Marion Rouault2,3, Ruth van Holst1
1Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Psychological Medicine
|August 9, 2023
Summary
Obsessive-compulsive disorder (OCD) patients show underconfidence, while highly compulsive individuals exhibit overconfidence. Metacognitive functioning differs between clinical OCD and general population samples, cautioning against generalizing findings.
Area of Science:
- Cognitive psychology
- Neuroscience
- Psychiatry
Background:
- Confidence, a metacognitive process, influences behavior, with abnormalities noted in obsessive-compulsive disorder (OCD).
- Conflicting findings exist regarding confidence levels in OCD patients versus highly compulsive individuals from the general population.
- This discrepancy raises questions about the generalizability of findings from general population studies to clinical OCD populations.
Purpose of the Study:
- To investigate confidence at local, global, and self-belief levels in OCD patients, controls, and highly compulsive individuals.
- To determine if metacognitive functioning in highly compulsive individuals mirrors that of clinical OCD patients.
- To clarify the relationship between compulsive behavior and confidence estimation in distinct populations.
Main Methods:
- Studied confidence at three hierarchical levels: single decisions (local), task performance (global), and self-beliefs.
- Recruited 40 medication-free OCD patients (no comorbidities), 40 controls, and 40 highly compulsive individuals (HComp) from the general population.
- Compared metacognitive performance across the three groups.
Main Results:
- OCD patients demonstrated relative underconfidence across all three confidence levels.
- Highly compulsive individuals (HComp) showed overconfidence and reduced metacognitive sensitivity compared to OCD patients.
- Findings align with distinct notions of confidence abnormalities in OCD versus general compulsive behavior.
Conclusions:
- Metacognitive functioning in highly compulsive individuals is distinct from that in clinical OCD patients.
- Obsessive-compulsive (OC) symptoms are associated with different (meta)cognitive processes in clinical OCD versus general compulsive populations.
- Generalizing metacognitive findings from general population samples to clinical OCD populations requires caution.
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