Skip to main content
SpringerLink
Log in

Cognitive Confidence and Inferential Confusion in Obsessive-Compulsive Disorder: Differences Across Subtypes

  • Published:
International Journal of Cognitive Therapy Aims and scope Submit manuscript

Abstract

A lack of cognitive confidence (CC), defined as a distrust of one’s attention, perception, and memory, has been implicated in obsessive-compulsive disorder (OCD) and could account for its core symptoms. The early research focus has been on CC in the context of checking OCD, yet research suggests that the construct may also apply to other OCD subtypes. A closely intertwined construct also implicated in OCD is inferential confusion (IC), whereby a distrust of the senses leads to an investment in imaginary possibilities. This study aimed to simultaneously examine these constructs across OCD subtypes. A total of 128 participants with OCD completed a measure of CC (MCQ-65; Metacognitions Questionnaire), IC (ICQ-EV; Inferential Confusion Questionnaire), and OCD symptoms (VOCI; Vancouver Obsessional Compulsive Inventory). TwoStep cluster analyses for CC revealed two clusters: (1) low CC/high checking/higher OCD symptoms and (2) high CC/low checking/lower OCD symptoms. The analyses for IC resulted in three clusters: (1) average IC/high “just right”/high contamination/low obsessionality, (2) high IC/ high “just right”/high obsessionality, and (3) low IC/low obsessionality/low checking. Results are discussed in terms of the heterogeneity of OCD, which highlight the need to tailor research paradigms and treatment targets to different OCD presentations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Aardema, F., & O’Connor, K. (2007). The menace within: obsessions and the self. Journal of Cognitive Psychotherapy, 21, 182–197.

    Article  Google Scholar 

  • Aardema, F., & O’Connor, K. (2012). Dissolving the tenacity of obsessional doubt: implications for treatment outcome. Journal of Behavior Therapy and Experimental Psychiatry, 43, 855–861.

    Article  Google Scholar 

  • Aardema, F., & Wong, S. F. (2020). Feared possible selves in cognitive-behavioral theory: an analysis of its historical and empirical context, and introduction of a working model. Journal of Obsessive Compulsive and Related Disorders, 24, 100479.

    Article  Google Scholar 

  • Aardema, F., O’Connor, K. P., Emmelkamp, P. M., Marchand, A., & Todorov, C. (2005). Inferential confusion in obsessive–compulsive disorder: the inferential confusion questionnaire. Behaviour Research and Therapy, 43, 293–308. https://doi.org/10.1016/j.brat.2004.02.003.

    Article  Google Scholar 

  • Aardema, F., O’Connor, K. P., & Emmelkamp, P. M. (2006). Inferential confusion and obsessive beliefs in obsessive-compulsive disorder. Cognitive Behaviour Therapy, 35, 138–147. https://doi.org/10.1080/16506070600621922.

    Article  Google Scholar 

  • Aardema, F., Wu, K. D., Careau, Y., O’Connor, K., Julien, D., & Dennie, S. (2010). The expanded version of the Inferential Confusion Questionnaire: further development and validation in clinical and non-clinical samples. Journal of Psychopathology and Behavioral Assessment, 32, 448–462. https://doi.org/10.1007/s10862-009-9157-x.

    Article  Google Scholar 

  • Aardema, F., Moulding, R., Radomsky, A. S., Doron, G., Allamby, J., & Souki, E. (2013). Fear of self and obsessionality: development and validation of the Fear of Self Questionnaire. Journal of Obsessive-Compulsive and Related Disorders, 2, 306–315. https://doi.org/10.1016/j.jocrd.2013.05.005.

    Article  Google Scholar 

  • Aardema, F., O’Connor, K. P., Delorme, M. E., & Audet, J. S. (2017). The inference-based approach (IBA) to the treatment of obsessive–compulsive disorder: an open trial across symptom subtypes and treatment-resistant cases. Clinical Psychology & Psychotherapy, 24, 289–301.

    Article  Google Scholar 

  • Abramovitch, A., Abramowitz, J. S., & Mittelman, A. (2013). The neuropsychology of adult obsessive–compulsive disorder: a meta-analysis. Clinical Psychology Review, 33, 1163–1171. https://doi.org/10.1016/j.cpr.2013.09.004.

    Article  Google Scholar 

  • Alcolado, G. M., & Radomsky, A. S. (2016). A novel cognitive intervention for compulsive checking: targeting maladaptive beliefs about memory. Journal of Behavior Therapy and Experimental Psychiatry, 53, 75–83. https://doi.org/10.1016/j.jbtep.2015.02.009.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC: Author.

  • American Psychiatric Association. (2013). Anxiety Disorders. In Diagnostic and Statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.dsm05

  • Beck, A. T., & Steer, R. A. (1990). Manual for the Beck Anxiety Inventory. San Antonio: Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996). Comparison of Beck Depression Inventories-I and-II in psychiatric outpatients. Journal of Personality Assessment, 67, 588–597. https://doi.org/10.1207/s15327752jpa6703_13.

    Article  Google Scholar 

  • Bloch, M. H., Landeros-Weisenberger, A., Rosario, M. C., Pittenger, C., & Leckman, J. F. (2008). Meta-analysis of the symptom structure of obsessive-compulsive disorder. American Journal of Psychiatry, 165, 1532–1542. https://doi.org/10.1176/appi.ajp.2008.08020320.

    Article  Google Scholar 

  • Bourque, P., & Beaudette, D. (1982). Étude psychométrique du questionnaire de dépression de Beck auprès d'un échantillon d'étudiants universitaires francophones. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 14, 211.

    Article  Google Scholar 

  • Calamari, J. E., Cohen, R. J., Rector, N. A., Szacun-Shimizu, K., Riemann, B. C., & Norberg, M. M. (2006). Dysfunctional belief-based obsessive-compulsive disorder subgroups. Behaviour Research and Therapy, 44, 1347–1360. https://doi.org/10.1016/j.brat.2005.10.005.

    Article  Google Scholar 

  • Cartwright-Hatton, S., & Wells, A. (1997). Beliefs about worry and intrusions: the meta-cognitions questionnaire and its correlates. Journal of Anxiety Disorders, 11, 279–296. https://doi.org/10.1016/S0887-6185(97)00011-X.

    Article  Google Scholar 

  • Chik, H. M., Calamari, J. E., Rector, N. A., & Riemann, B. C. (2010). What do low-dysfunctional beliefs obsessive–compulsive disorder subgroups believe? Journal of Anxiety Disorders, 24, 837–846. https://doi.org/10.1016/j.janxdis.2010.06.006.

    Article  Google Scholar 

  • Coles, M. E., Radomsky, A. S., & Horng, B. (2006). Exploring the boundaries of memory distrust from repeated checking: increasing external validity and examining thresholds. Behaviour Research and Therapy, 4, 995–1006. https://doi.org/10.1016/j.brat.2005.08.001.

    Article  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1997). User's guide for the structured clinical interview for DSM-IV axis I disorders SCID-I: clinician version. Washington, DC: American Psychiatric Pub.

    Google Scholar 

  • Freeston, M. H., Ladouceur, R., Thibodeau, N., Gagnon, F., & Rheaume, J. (1994). The Beck Anxiety Inventory: psychometric properties of a French translation. L'Encephale, 20, 4755.

    Google Scholar 

  • Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., et al. (1989). The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Archives of General Psychiatry, 46, 1006–1011. https://doi.org/10.1001/archpsyc.1989.01810110048007.

    Article  Google Scholar 

  • Goods, N. A. R., Rees, C. S., Egan, S. J., & Kane, R. T. (2014). The relationship between magical thinking, inferential confusion and obsessive–compulsive symptoms. Cognitive Behaviour Therapy, 43, 342–350. https://doi.org/10.1080/16506073.2014.941393.

    Article  Google Scholar 

  • Hermans, D., Martens, K., De Cort, K., Pieters, G., & Eelen, P. (2003). Reality monitoring and metacognitive beliefs related to cognitive confidence in obsessive–compulsive disorder. Behaviour Research and Therapy, 41, 383–401. https://doi.org/10.1016/S0005-7967(02)00015-3.

    Article  Google Scholar 

  • Hermans, D., Engelen, U., Grouwels, L., Joos, E., Lemmens, J., & Pieters, G. (2008). Cognitive confidence in obsessive-compulsive disorder: distrusting perception, attention and memory. Behaviour Research and Therapy, 46, 98–113. https://doi.org/10.1177/1049732302238251.

    Article  Google Scholar 

  • Julien, D., Careau, Y., O’Connor, K. P., Bouvard, M., Rhéaume, J., Langlois, F., et al. (2008). Specificity of belief domains in OCD: Validation of the French version of the Obsessive Beliefs Questionnaire and a comparison across samples. Journal of Anxiety Disorders, 22, 1029–1041. https://doi.org/10.1016/j.janxdis.2007.11.003.

    Article  Google Scholar 

  • Larøi, F., Van der Linden, M., & d’Acremont, M. (2009). Validity and reliability of a French version of the metacognitions questionnaire in a nonclinical population. Swiss Journal of Psychology, 68, 125–132.

    Article  Google Scholar 

  • Leckman, J. F., Grice, D. E., Boardman, J., Zhang, H., Vitale, A., Bondi, C., et al. (1997). Symptoms of obsessive-compulsive disorder. American Journal of Psychiatry, 154, 911–917. https://doi.org/10.1212/CON.0000000000000603.

    Article  Google Scholar 

  • Lochner, C., & Stein, D. J. (2003). Heterogeneity of obsessive-compulsive disorder: a literature review. Harvard Review of Psychiatry, 11, 113–132. https://doi.org/10.1080/10673220303949.

    Article  Google Scholar 

  • Mataix-Cols, D., do Rosario-Campos, M. C., & Leckman, J. F. (2005). A multidimensional model of obsessive-compulsive disorder. American Journal of Psychiatry, 162, 228–238. https://doi.org/10.1176/appi.ajp.162.2.228.

    Article  Google Scholar 

  • McKay, D., Abramowitz, J. S., Calamari, J. E., Kyrios, M., Radomsky, A., Sookman, D., et al. (2004). A critical evaluation of obsessive–compulsive disorder subtypes: Symptoms versus mechanisms. Clinical Psychology Review, 24, 283–313. https://doi.org/10.1016/j.cpr.2004.04.003.

    Article  Google Scholar 

  • Mollard, E., Cottraux, J., & Bouvard, M. (1989). Version française de l’Échelle d’obsession–compulsion de Yale–Brown. L’Encéphale, 15, 335–341.

  • Morrison, A. P., & Wells, A. (2003). A comparison of metacognitions in patients with hallucinations, delusions, panic disorder, and non-patient controls. Behaviour Research and Therapy, 41, 251–256.

    Article  Google Scholar 

  • Muller, J., & Roberts, J. E. (2005). Memory and attention in obsessive–compulsive disorder: a review. Journal of Anxiety Disorders, 19, 1–28. https://doi.org/10.1016/j.janxdis.2003.12.001.

    Article  Google Scholar 

  • Nedeljkovic, M., Moulding, R., Kyrios, M., & Doron, G. (2009). The relationship of cognitive confidence to OCD symptoms. Journal of Anxiety Disorders, 23, 463–468. https://doi.org/10.1016/j.janxdis.2008.10.001.

    Article  Google Scholar 

  • Norušis, M. J. (2010). Chapter 16: Cluster analysis. In PASW Statistics 18 Statistical ProceduresCompanion (pp. 361–391). Upper Saddle River: Prentice Hall.

    Google Scholar 

  • O’Connor, K., & Robillard, S. (1995). Inference processes in obsessive-compulsive disorder: some clinical observations. Behaviour Research and Therapy, 8, 887–896.

    Article  Google Scholar 

  • O’Connor, K., Ouellet-Courtois, C., & Aaderma, F. (December 2018). Innovative cognitive-behavioural treatments for obsessive-compulsive disorder. In L. Fontenelle & M. Yucel (Eds.), A transdiagnostic diagnostic approach to obsessions, compulsions and related phenomena (pp. 217–228). Cambridge: Cambridge University Press. https://doi.org/10.1017/9781108164313.

    Chapter  Google Scholar 

  • Obsessive Compulsive Cognitions Working Group. (2003). Psychometric validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory: Part I. Behaviour Research and Therapy, 41, 863–878. https://doi.org/10.1016/S0005-7967(02)00099-2.

    Article  Google Scholar 

  • Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—part 2: factor analyses and testing of a brief version. Behaviour Research and Therapy, 43, 1527–1542. https://doi.org/10.1016/j.brat.2004.07.010.

    Article  Google Scholar 

  • O’Connor, K., Aardema, F., & Pélissier, M. C. (2005). Beyond reasonable doubt: reasoning processes in obsessive-compulsive disorder and related disorders. Wiley, Chichester.

  • Olley, A., Malhi, G., & Sachdev, P. (2007). Memory and executive functioning in obsessive–compulsive disorder: a selective review. Journal of Affective Disorders, 104, 15–23. https://doi.org/10.1016/j.jad.2007.02.023.

    Article  Google Scholar 

  • Olstad, S., Solem, S., Hjemdal, O., & Hagen, R. (2015). Metacognition in eating disorders: Comparison of women with eating disorders, self-reported history of eating disorders or psychiatric problems, and healthy controls. Eating Behaviors, 16, 17–22. https://doi.org/10.1016/j.eatbeh.2014.10.019.

    Article  Google Scholar 

  • Ouellet-Courtois, C., Wilson, S., & O’Connor, K. (2018). Cognitive confidence in obsessive-compulsive disorder: A systematic review and meta-analysis. Journal of Obsessive-Compulsive and Related Disorders, 19, 77–86. https://doi.org/10.1016/j.jocrd.2018.08.003.

    Article  Google Scholar 

  • Ouimet, A. J., Ashbaugh, A. R., & Radomsky, A. S. (2019). Hoping for more: how cognitive science has and hasn't been helpful to the OCD clinician. Clinical Psychology Review, 69, 14–29. https://doi.org/10.1016/j.cpr.2018.04.003.

    Article  Google Scholar 

  • Purcell Lalonde, M., & O’Connor, K. (2015). Food for thought: change in ego-dystonicity and fear of self in bulimia nervosa over the course of inference-based treatment. Journal of Psychology and Clinical Psychiatry, 3, 00133.

  • Rachman, S. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40, 625–639. https://doi.org/10.1016/S0005-7967(01)00028-6.

    Article  Google Scholar 

  • Radomsky, A. S., Rachman, S., & Hammond, D. (2001). Memory bias, confidence and responsibility in compulsive checking. Behaviour Research and Therapy, 39, 813–822. https://doi.org/10.1016/S0005-7967(00)00079-6.

    Article  Google Scholar 

  • Radomsky, A. S., Gilchrist, P. T., & Dussault, D. (2006a). Repeated checking really does cause memory distrust. Behaviour Research and Therapy, 44, 305–316. https://doi.org/10.1016/j.brat.2005.02.005.

    Article  Google Scholar 

  • Radomsky, A. S., Ouimet, A. J., Ashbaugh, A. R., Lavoie, S. L., Parrish, C. L., & O’Connor, K. P. (2006b). Psychometric properties of the French and English versions of the Vancouver Obsessional-Compulsive Inventory and the Symmetry Ordering and Arranging Questionnaire. Cognitive Behaviour Therapy, 35, 164–173.

    Article  Google Scholar 

  • Radomsky, A. S., Dugas, M. J., Alcolado, G. M., & Lavoie, S. L. (2014). When more is less: doubt, repetition, memory, metamemory, and compulsive checking in OCD. Behaviour Research and Therapy, 59, 30–39. https://doi.org/10.1016/j.brat.2014.05.008.

    Article  Google Scholar 

  • Schulze, D., Kathmann, N., & Reuter, B. (2018). Getting it just right: a reevaluation of OCD symptom dimensions integrating traditional and Bayesian approaches. Journal of Anxiety Disorders, 56, 63–73. https://doi.org/10.1016/j.janxdis.2018.04.003.

    Article  Google Scholar 

  • Shafran, R. (1997). The manipulation of responsibility in obsessive-compulsive disorder. The British Journal of Clinical Psychology, 36, 397–407.

    Article  Google Scholar 

  • Solem, S., Håland, Å. T., Vogel, P. A., Hansen, B., & Wells, A. (2009). Change in metacognitions predicts outcome in obsessive–compulsive disorder patients undergoing treatment with exposure and response prevention. Behaviour Research and Therapy, 47, 301–307. https://doi.org/10.1016/j.brat.2009.01.003.

    Article  Google Scholar 

  • Stein, M. B., Rode, D. R., Anderson, G., & Walker, J. R. (1997). Obsessive-compulsive disorder in the community: an epidemiologic survey with clinical appraisal. American Journal of Psychiatry, 154, 1120–1126. https://doi.org/10.1176/ajp.154.8.1120.

    Article  Google Scholar 

  • Summerfeldt, L. J. (2004). Understanding and treating incompleteness in obsessive-compulsivedisorder. Journal of Clinical Psychology, 60, 1155–1168. https://doi.org/10.1002/jclp.20080.

    Article  Google Scholar 

  • Summerfeldt, L. J. (2007). Treating incompleteness, ordering, and arranging concerns. In M. M. Antony, C. Purdon, & L. J. Summerfeldt (Eds.), Psychological treatment of obsessive–compulsive disorder: fundamentals and beyond. Washington, DC: American Psychological Association.

    Google Scholar 

  • Summerfeldt, L. J., Richter, M. A., Antony, M. M., & Swinson, R. P. (1999). Symptom structure in obsessive-compulsive disorder: a confirmatory factor-analytic study. Behaviour Research and Therapy, 37, 297–311. https://doi.org/10.1016/S0005-7967(98)00134-X.

    Article  Google Scholar 

  • Taillon, A., O’Connor, K., Dupuis, G., & Lavoie, M. (2013). Inference-based therapy for body dysmorphic disorder. Clinical Psychology & Psychotherapy, 20, 67–76. https://doi.org/10.1002/cpp.767.

    Article  Google Scholar 

  • Tallis, F., Pratt, P., & Jamani, N. (1999). Obsessive compulsive disorder, checking, and non- verbal memory: a neuropsychological investigation. Behaviour Research and Therapy, 37, 161–166. https://doi.org/10.1016/S0005-7967(98)00075-8.

    Article  Google Scholar 

  • Taylor, J., & Purdon, C. (2016). Responsibility and hand washing behaviour. Journal of Behavior Therapy and Experimental Psychiatry, 51, 43–50. https://doi.org/10.1016/j.jbtep.2015.12.005.

    Article  Google Scholar 

  • Taylor, S., Abramowitz, J. S., McKay, D., Calamari, J. E., Sookman, D., Kyrios, M., et al. (2006). Do dysfunctional beliefs play a role in all types of obsessive–compulsive disorder? Journal of Anxiety Disorders, 20, 85–97. https://doi.org/10.1016/j.janxdis.2004.11.005.

    Article  Google Scholar 

  • Thordarson, D. S., Radomsky, A. S., Rachman, S., Shafran, R., Sawchuk, C. N., & Hakstian, A. R. (2004). The Vancouver obsessional compulsive inventory (VOCI). Behaviour Research and Therapy, 42, 1289–1314. https://doi.org/10.1016/j.brat.2003.08.007.

    Article  Google Scholar 

  • Tolin, D. F., Woods, C. M., & Abramowitz, J. S. (2003). Relationship between obsessive beliefs and obsessive–compulsive symptoms. Cognitive Therapy and Research, 27, 657–669. https://doi.org/10.1023/A:1026351711837.

    Article  Google Scholar 

  • Van den Hout, M. A., & Kindt, M. (2003a). Repeated checking causes memory distrust. Behaviour Research and Therapy, 41, 301–316. https://doi.org/10.1016/S0005-7967(02)00012-8.

    Article  Google Scholar 

  • Van den Hout, M. A., & Kindt, M. (2003b). Phenomenological validity of an OCD-memory model and the remember/know distinction. Behaviour Research and Therapy, 41, 369–378. https://doi.org/10.1016/S0005-7967(02)00097-9.

    Article  Google Scholar 

  • Van den Hout, M. A., & Kindt, M. (2004). Obsessive-compulsive disorder and the paradoxical effects of perseverative behaviour on experienced uncertainty. Journal of Behavior Therapy and Experimental Psychiatry, 35, 165–181. https://doi.org/10.1016/j.jbtep.2004.04.007.

    Article  Google Scholar 

  • Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chichester, UK: Wiley.

  • Wilson, S., Aardema, F., & O’Connor, K. (2018). Possibility-based information elicits doubt in bulimia nervosa: a study of inductive reasoning. International Journal of Cognitive Therapy, 11, 410–420. https://doi.org/10.1007/s41811-018-0032-y.

    Article  Google Scholar 

  • Wu, K. D., & Carter, S. A. (2008). Further investigation of the obsessive beliefs questionnaire: factor structure and specificity of relations with OCD symptoms. Journal of Anxiety Disorders, 22, 824–836. https://doi.org/10.1016/j.janxdis.2007.08.008.

    Article  Google Scholar 

  • Wu, K. D., Aardema, F., & O’Connor, K. P. (2009). Inferential confusion, obsessive beliefs, and obsessive-compulsive symptoms: a replication and extension. Journal of Anxiety Disorders, 23, 746–752. https://doi.org/10.1016/j.janxdis.2009.02.017.

    Article  Google Scholar 

  • Yorulmaz, O., Gençöz, T., & Woody, S. (2010). Vulnerability factors in OCD symptoms: cross-cultural comparisons between Turkish and Canadian samples. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 17, 110–121. https://doi.org/10.1002/cpp.642.

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank Charles-Édouard Giguère for his help with the statistical analyses.

Funding

This work was supported by the Fonds de recherche du Québec-Société Culture (FRQSC) [grant number 256181] and the Canadian Institutes of Health Research (CIHR) [grant number 93556]. FRQSC and CIHR both had no role in the study design, analysis, or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Author information

Authors and Affiliations

  1. OCD Spectrum Study Center, Montreal Mental Health University Institute, 7331 Hochelaga, Montreal, Quebec, H1N 3V2, Canada

    Catherine Ouellet-Courtois, Frederick Aardema & Kieron O’Connor

  2. Psychology Department, Université de Montréal, Montreal, Canada

    Catherine Ouellet-Courtois

  3. Psychiatry Department, Université de Montréal, 2900, boul. Édouard-Montpetit, Montreal, Quebec, H3T 1J4, Canada

    Frederick Aardema & Kieron O’Connor

Authors
  1. Catherine Ouellet-Courtois
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frederick Aardema
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kieron O’Connor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine Ouellet-Courtois.

Ethics declarations

Conflict of Interest

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ouellet-Courtois, C., Aardema, F. & O’Connor, K. Cognitive Confidence and Inferential Confusion in Obsessive-Compulsive Disorder: Differences Across Subtypes. J Cogn Ther 13, 358–378 (2020). https://doi.org/10.1007/s41811-020-00087-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41811-020-00087-2

Keywords

Search

Navigation