Skip to main content
SpringerLink
Log in

Decreased memory confidence in obsessive–compulsive disorder for scenarios high and low on responsibility: is low still too high?

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Previous research suggests that patients with obsessive–compulsive disorder (OCD), particularly checkers, display an inflated sense of responsibility. For the present study, we tested whether memory confidence in OCD is reduced under conditions of heightened responsibility and/or reflects poor memory vividness. A computerized task designed to modulate perceived responsibility was administered to 26 OCD patients (12 checkers) and 21 healthy controls. In the experimental condition (high responsibility), participants had to allocate daily medications to ten fictive patients in a hospital emergency ward, whereas in the control condition (low responsibility) participants had to allocate bath essences for ten hotel guests. Participants’ response time and accuracy were recorded as well as their memory confidence, memory vividness, and subjective success. Irrespective of the condition, OCD patients performed as accurately as healthy controls, but appraised their performance as worse than that of controls. Memory confidence was decreased in patients, particularly checkers. No group differences emerged on vividness, and none of the effects were moderated by the condition (high versus low responsibility). The relationship between responsibility and OCD behavior is complex. Results suggest metamemory problems in OCD checkers, even when induced responsibility is low. The findings speak against “cold” memory deficits in OCD, as patients did not differ from controls on accuracy, reaction time, or vividness. Future research should focus on idiosyncratic beliefs and scenarios that inflate responsibility and elicit cognitive biases.

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.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Abramowitz JS, Taylor S, McKay D (2009) Obsessive–compulsive disorder. Lancet 374:491–499. doi:10.1016/S0140-6736(09)60240-3

    Article  PubMed  Google Scholar 

  2. Bloch MH, Landeros-Weisenberger A, Rosario MC et al (2008) Meta-analysis of the symptom structure of obsessive–compulsive disorder. Am J Psychiatry 165:1532–1542. doi:10.1176/appi.ajp.2008.08020320

    Article  PubMed  PubMed Central  Google Scholar 

  3. Röhlinger J, Wulf F, Fieker M, Moritz S (2015) Sensory properties of obsessive thoughts in OCD and the relationship to psychopathology. Psychiatry Res 230:592–596. doi:10.1016/j.psychres.2015.10.009

    Article  PubMed  Google Scholar 

  4. Moritz S, Claussen M, Hauschildt M, Kellner M (2014) Perceptual properties of obsessive thoughts are associated with low insight in obsessive–compulsive disorder. J Nerv Ment Dis 202:562–565. doi:10.1097/NMD.0000000000000156

    Article  PubMed  Google Scholar 

  5. Shavitt RG, de Mathis MA, Oki F et al (2014) Phenomenology of OCD: Lessons from a large multicenter study and implications for ICD-11. J Psychiatr Res 57:141–148. doi:10.1016/j.jpsychires.2014.06.010

    Article  PubMed  Google Scholar 

  6. Tallis F (1997) The neuropsychology of obsessive–compulsive disorder: a review and consideration of clinical implications. Br J Clin Psychol 36:3–20. doi:10.1111/j.2044-8260.1997.tb01226.x

    Article  PubMed  Google Scholar 

  7. Kuelz AK, Hohagen F, Voderholzer U (2004) Neuropsychological performance in obsessive–compulsive disorder: A critical review. Biol Psychol 65:185–236. doi:10.1016/j.biopsycho.2003.07.007

    Article  PubMed  Google Scholar 

  8. Abramovitch A, Abramowitz JS, Mittelman A (2013) The neuropsychology of adult obsessive–compulsive disorder: a meta-analysis. Clin Psychol Rev 33:1163–1171. doi:10.1016/j.cpr.2013.09.004

    Article  PubMed  Google Scholar 

  9. Shin NY, Lee TY, Kim E, Kwon JS (2014) Cognitive functioning in obsessive–compulsive disorder: a meta-analysis. Psychol Med 44:1121–1130. doi:10.1017/S0033291713001803

    Article  CAS  PubMed  Google Scholar 

  10. Benzina N, Mallet L, Burguière E et al (2016) Cognitive dysfunction in obsessive–compulsive disorder. Curr Psychiatry Rep 18:80. doi:10.1007/s11920-016-0720-3

    Article  PubMed  Google Scholar 

  11. Snyder HR, Kaiser RH, Warren SL, Heller W (2015) Obsessive–compulsive disorder is associated with broad impairments in executive function: a meta-analysis. Clinical. Psychol Sci 3:301–330. doi:10.1177/2167702614534210

    Google Scholar 

  12. Sher KJ, Mann B, Frost RO (1984) Cognitive dysfunction in compulsive checkers: further explorations. Behav Res Ther 22:493–502. doi:10.1016/0005-7967(84)90053-6

    Article  CAS  PubMed  Google Scholar 

  13. Sher KJ, Frost RO, Otto R (1983) Cognitive deficits in compulsive checkers: an exploratory study. Behav Res Ther 21:357–363. doi:10.1016/0005-7967(83)90004-9

    Article  CAS  PubMed  Google Scholar 

  14. Reed GF (1977) Obsessional personality disorder and remembering. Br J Psychiatry 130:177–183. doi:10.1192/bjp.130.2.177

    Article  CAS  PubMed  Google Scholar 

  15. Tolin DF, Abramowitz JS, Brigidi BD et al (2001) Memory and memory confidence in obsessive–compulsive disorder. Behav Res Ther 39:913–927. doi:10.1016/S0005-7967(00)00064-4

    Article  CAS  PubMed  Google Scholar 

  16. Van Den Hout M, Kindt M (2003) Repeated checking causes memory distrust. Behav Res Ther 41:301–316. doi:10.1016/S0005-7967(02)00012-8

    Article  PubMed  Google Scholar 

  17. Abramovitch A, Cooperman A (2015) The cognitive neuropsychology of obsessive–compulsive disorder: a critical review. J Obsessive Compuls Relat Disord 5:24–36. doi:10.1016/j.jocrd.2015.01.002

    Article  Google Scholar 

  18. Jelinek L, Moritz S, Heeren D, Naber D (2006) Everyday memory functioning in obsessive–compulsive disorder. J Int Neuropsychol Soc 12:746–749. doi:10.1017/S1355617706060899

    Article  PubMed  Google Scholar 

  19. Moritz S, Kloss M, Jacobsen D et al (2005) Extent, profile and specificity of visuospatial impairment in obsessive–compulsive disorder (OCD). J Clin Exp Neuropsychol 27:795–814. doi:10.1080/13803390490918480

    Article  PubMed  Google Scholar 

  20. Moritz S, Jacobsen D, Willenborg B et al (2006) A check on the memory deficit hypothesis of obsessive–compulsive checking. Eur Arch Psychiatry Clin Neurosci 256:82–86. doi:10.1007/s00406-005-0605-7

    Article  PubMed  Google Scholar 

  21. Moritz S, Ruhe C, Jelinek L, Naber D (2009) No deficits in nonverbal memory, metamemory and internal as well as external source memory in obsessive–compulsive disorder (OCD). Behav Res Ther 47:308–315. doi:10.1016/j.brat.2009.01.004

    Article  PubMed  Google Scholar 

  22. Moritz S, Kloss M, von Eckstaedt FV, Jelinek L (2009) Comparable performance of patients with obsessive–compulsive disorder (OCD) and healthy controls for verbal and nonverbal memory accuracy and confidence: time to forget the forgetfulness hypothesis of OCD? Psychiatry Res 166:247–253. doi:10.1016/j.psychres.2008.02.006

    Article  PubMed  Google Scholar 

  23. Abramovitch A, Schweiger A (2015) Misuse of cognitive neuropsychology in psychiatry research: the intoxicating appeal of neo-reductionism. Behav Ther 38:187–191

    Google Scholar 

  24. Basso MR, Bornstein RA, Carona F, Morton R (2001) Depression accounts for executive function deficits in obsessive–compulsive disorder. Neuropsychiatry Neuropsychol Behav Neurol 14:241–245

    CAS  PubMed  Google Scholar 

  25. Moritz S, Birkner C, Kloss M et al (2001) Impact of comorbid depressive symptoms on neuropsychological performance in obsessive–compulsive disorder. J Abnormal Psychol 110:653–657. doi:10.1037/0021-843X.110.4.653

    Article  CAS  Google Scholar 

  26. Moritz S, Hottenrott B, Jelinek L et al (2012) Effects of obsessive–compulsive symptoms on neuropsychological test performance: complicating an already complicated story. Clin Neuropsychol 26:31–44. doi:10.1080/13854046.2011.639311

    Article  PubMed  Google Scholar 

  27. Abramovitch A, Dar R, Hermesh H, Schweiger A (2012) Comparative neuropsychology of adult obsessive–compulsive disorder and attention deficit/hyperactivity disorder: implications for a novel executive overload model of OCD. J Neuropsychol 6:161–191. doi:10.1111/j.1748-6653.2011.02021.x

    Article  PubMed  Google Scholar 

  28. Hezel DM, McNally RJ (2015) A theoretical review of cognitive biases and deficits in obsessive–compulsive disorder. Biol Psychol. doi:10.1016/j.biopsycho.2015.10.012

    PubMed  Google Scholar 

  29. Obsessive Compulsive Cognitions Working Group (2003) Psychometric validation of the and the Interpretation of Intrusions Inventory: part I. Behav Res Ther 41:863–878. doi:10.1016/S0005-7967(02)00099-2

    Article  Google Scholar 

  30. O’Connor K (2002) Intrusions and inferences in obsessive–compulsive disorder. Clin Psychol Psychother 9:38–46. doi:10.1002/cpp.303

    Article  Google Scholar 

  31. Aardema F, O’Connor KP, Emmelkamp PMG et al (2005) Inferential confusion in obsessive–compulsive disorder: the inferential confusion questionnaire. Behav Res Ther 43:293–308. doi:10.1016/j.brat.2004.02.003

    Article  PubMed  Google Scholar 

  32. Salkovskis PM, Forrester E (2002) Responsibility. In: Frost RO, Steketee G (eds) Cognitive approaches to obsessions and compulsions—theory, assessment, and treatment. Pergamon, Amsterdam, pp 45–51

    Chapter  Google Scholar 

  33. Salkovskis PM (1985) Obsessional–compulsive problems: a cognitive-behavioural analysis. Behav Res Ther 23:571–583. doi:10.1016/0005-7967(85)90105-6

    Article  CAS  PubMed  Google Scholar 

  34. Salkovskis PM, Wroe AL, Gledhill A et al (2000) Responsibility attitudes and interpretations are characteristic of obsessive–compulsive disorder. Behav Res Ther 38:347–372. doi:10.1016/S0005-7967(99)00071-6

    Article  CAS  PubMed  Google Scholar 

  35. Moritz S, Wahl K, Zurowski B et al (2007) Enhanced perceived responsibility decreases metamemory but not memory accuracy in obsessive–compulsive disorder (OCD). Behav Res Ther 45:2044–2052. doi:10.1016/j.brat.2007.03.003

    Article  CAS  PubMed  Google Scholar 

  36. Ladouceur R, Rhéaume J, Freeston MH et al (1995) Experimental manipulations of responsibility: an analogue test for models of obsessive–compulsive disorder. Behav Res Ther 33:937–946

    Article  CAS  PubMed  Google Scholar 

  37. Obsessive Compulsive Cognitions Working Group (1997) Cognitive assessment of obsessive–compulsive disorder. Behav Res Ther 35:667–681. doi:10.1016/S0005-7967(97)00017-X

    Article  Google Scholar 

  38. Rhéaume J, Ladouceur R, Freeston MH, Letarte H (1995) Inflated responsibility in obsessive–compulsive disorder: validation of an operational definition. Behav Res Ther 33:159–169. doi:10.1016/0005-7967(94)E0021-A

    Article  PubMed  Google Scholar 

  39. Wilson KA, Chambless DL (1999) Inflated perceptions of responsibility and obsessive–compulsive symptoms. Behav Res Ther 37:325–335. doi:10.1016/S0005-7967(98)00146-6

    Article  CAS  PubMed  Google Scholar 

  40. Cougle JR, Lee HJ, Salkovskis PM (2007) Are responsibility beliefs inflated in non-checking OCD patients? J Anxiety Disord 21:153–159. doi:10.1016/j.janxdis.2006.03.012

    Article  PubMed  Google Scholar 

  41. Shafran R (1997) The manipulation of responsibility in obsessive–compulsive disorder. Br J Clin Psychol 36:397–407

    Article  PubMed  Google Scholar 

  42. Pozza A, Dèttore D (2014) Are inflated responsibility beliefs specific to OCD? Meta-analysis of the relations of responsibility to ocd, anxiety disorders, and depression symptoms. Clin Neuropsychiatry 11:170–181.

    Google Scholar 

  43. Coles ME, Schofield CA (2008) Assessing the development of inflated responsibility beliefs: the pathways to inflated responsibility beliefs scale. Behav Ther 39:322–335. doi:10.1016/j.beth.2007.09.003

    Article  PubMed  Google Scholar 

  44. Myers SG, Wells A (2005) Obsessive–compulsive symptoms: the contribution of metacognitions and responsibility. J Anxiety Disord 19:806–817. doi:10.1016/j.janxdis.2004.09.004

    Article  PubMed  Google Scholar 

  45. Moritz S, Wahl K, Ertle A et al (2009) Neither saints nor wolves in disguise: ambivalent interpersonal attitudes and behaviors in obsessive–compulsive disorder. Behav Modif 33:274–292. doi:10.1177/0145445508327444

    Article  PubMed  Google Scholar 

  46. Moritz S, Kempke S, Luyten P et al (2011) Was Freud partly right on obsessive–compulsive disorder (OCD)? Investigation of latent aggression in OCD. Psychiatry Res 187:180–184. doi:10.1016/j.psychres.2010.09.007

    Article  PubMed  Google Scholar 

  47. Stern ER, Gonzalez R, Welsh RC, Taylor SF (2010) Updating beliefs for a decision: neural correlates of uncertainty and underconfidence. J Neurosci 30:8032–8041. doi:10.1523/JNEUROSCI.4729-09.2010

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Moritz S, Gläscher J, Sommer T et al (2006) Neural correlates of memory confidence. NeuroImage 33:1188–1193. doi:10.1016/j.neuroimage.2006.08.003

    Article  PubMed  Google Scholar 

  49. MacDonald PA, Antony MM, MacLeod CM, Richter MA (1997) Memory and confidence in memory judgments among individuals with obsessive–compulsive disorder and non-clinical controls. Behav Res Ther 35:497–505. doi:10.1016/S0005-7967(97)00013-2

    Article  CAS  PubMed  Google Scholar 

  50. Dar R, Rish S, Hermesh H et al (2000) Realism of confidence in obsessive–compulsive checkers. J Abnorm Psychol 109:673–678. doi:10.1037/0021-843X.109.4.673

    Article  CAS  PubMed  Google Scholar 

  51. Hermans D, Engelen U, Grouwels L et al (2008) Cognitive confidence in obsessive–compulsive disorder: distrusting perception, attention and memory. Behav Res Ther 46:98–113. doi:10.1016/j.brat.2007.11.001

    Article  PubMed  Google Scholar 

  52. Hermans D, Martens K, De Cort K et al (2003) Reality monitoring and metacognitive beliefs related to cognitive confidence in obsessive–compulsive disorder. Behav Res Ther 41:383–401. doi:10.1016/S0005-7967(02)00015-3

    Article  PubMed  Google Scholar 

  53. Radomsky AS, Rachman S, Hammond D (2001) Memory bias, confidence and responsibility in compulsive checking. Behav Res Ther 39:813–822. doi:10.1016/S0005-7967(00)00079-6

    Article  CAS  PubMed  Google Scholar 

  54. Cougle JR, Salkovskis PM, Wahl K (2007) Perception of memory ability and confidence in recollections in obsessive–compulsive checking. J Anxiety Disord 21:118–130. doi:10.1016/j.janxdis.2006.03.015

    Article  PubMed  Google Scholar 

  55. Boschen MJ, Vuksanovic D (2007) Deteriorating memory confidence, responsibility perceptions and repeated checking: comparisons in OCD and control samples. Behav Res Ther 45:2098–2109. doi:10.1016/j.brat.2007.03.009

    Article  PubMed  Google Scholar 

  56. Brown HD, Kosslyn SM, Breiter HC et al (1994) Can patients with obsessive–compulsive disorder discriminate between percepts and mental images? A signal detection analysis. J Abnorm Psychol 103:445–454. doi:10.1037/0021-843X.103.3.445

    Article  CAS  PubMed  Google Scholar 

  57. Klumpp H, Amir N, Garfinkel SN (2009) False memory and obsessive–compulsive symptoms. Depress Anxiety 26:396–402. doi:10.1002/da.20526

    Article  PubMed  PubMed Central  Google Scholar 

  58. Van Den Hout M, Kindt M (2003) Phenomenological validity of an OCD-memory model and the remember/know distinction. Behav Res Ther 41:369–378. doi:10.1016/S0005-7967(02)00097-9

    Article  PubMed  Google Scholar 

  59. Sheehan DV, Lecrubier Y, Sheehan KH et al (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59:22–33. doi:10.1016/S0924-9338(99)80239-9

    PubMed  Google Scholar 

  60. Lehrl S (1995) Mehrfachwahl-Wortschatz-Intelligenztest: MWT-B [Multiple choice vocabulary test: MWT-B]. 3rd ed. PERIMED-spitta, Balingen

    Google Scholar 

  61. Goodman WK, Price LH, Rasmussen SA et al (1989) The Yale-Brown Obsessive–Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry 46:1006–1011. doi:10.1001/archpsyc.1989.01810110048007

    Article  CAS  PubMed  Google Scholar 

  62. Hand I, Büttner-Westphal H (1991) Die Yale-Brown Obsessive–Compulsive Scale (Y-BOCS): Ein halbstrukturiertes Interview zur Beurteilung des Schweregrades von Denk- und Handlungszwängen [Yale-Brown Obsessive–Compulsive Scale (Y-BOCS): a semistructured interview for the assessment of the severity of obsessions and compulsions]. Verhaltenstherapie 1:223–225. doi:10.1159/000257972

    Article  Google Scholar 

  63. Jacobsen D, Kloss M, Fricke S, et al (2003) Reliabilität der Deutschen Version der Yale-Brown Obsessive–Compulsive Scale (Reliability of the German version of the Yale-Brown Obsessive–Compulsive Scale). Verhaltenstherapie 13:111–113. doi:10.1159/000072184

    Article  Google Scholar 

  64. Goodman WK, Price LH, Rasmussen SA et al (1989) The Yale-Brown Obsessive–Compulsive Scale. II. Validity. Arch Gen Psychiatry 46:1012–1016. doi:10.1001/archpsyc.1989.01810110054008

    Article  CAS  PubMed  Google Scholar 

  65. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62. doi:10.1136/jnnp.23.1.56

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Gönner S, Leonhart R, Ecker W (2008) The Obsessive–Compulsive Inventory-Revised (OCI-R): Validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders. J Anxiety Disord 22:734–749. doi:10.1016/j.janxdis.2007.07.007

    Article  PubMed  Google Scholar 

  67. Foa EB, Huppert JD, Leiberg S et al (2002) The Obsessive–Compulsive Inventory: development and validation of a short version. Psychol Assess 14:485–496. doi:10.1037/1040-3590.14.4.485

    Article  PubMed  Google Scholar 

  68. Ladouceur R, Rhéaume J, Aublet F (1997) Excessive responsibility in obsessional concerns: A fine-grained experimental analysis. Behav Res Ther 35:423–427. doi:10.1016/S0005-7967(96)00117-9

    Article  CAS  PubMed  Google Scholar 

  69. Abramowitz JS, Fabricant LE, Taylor S et al (2014) The relevance of analogue studies for understanding obsessions and compulsions. Clin Psychol Rev 34:206–217. doi:10.1016/j.cpr.2014.01.004

    Article  PubMed  Google Scholar 

  70. Radomsky AS, Rachman S (1999) Memory bias in obsessive–compulsive disorder (OCD). Behav Res Ther 37:605–618. doi:10.1016/S0005-7967(98)00151-X

    Article  CAS  PubMed  Google Scholar 

  71. Mancini F, D’Olimpio F, Cieri L (2004) Manipulation of responsibility in non-clinical subjects: does expectation of failure exacerbate obsessive–compulsive behaviors? Behav Res Ther 42:449–457. doi:10.1016/S0005-7967(03)00153-0

    Article  PubMed  Google Scholar 

  72. Zermatten A, Van der Linden M, Larøi F, Ceschi G (2006) Reality monitoring and motor memory in checking-prone individuals. J Anxiety Disord 20:580–596. doi:10.1016/j.janxdis.2005.08.001

    Article  PubMed  Google Scholar 

  73. Rachman S, Thordarson DS, Shafran R, Woody SR (1995) Perceived responsibility: structure and significance. Behav Res Ther 33:779–784. doi:10.1016/0005-7967(95)00016-Q

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Robyn Langdon for suggestions. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Both authors have equally contributed to the manuscript and share first authorship.

Author information

Authors and Affiliations

  1. Clinical Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Steffen Moritz

  2. Research in Psychotherapy, Clinical Psychology, Institute of Psychology, University of Zurich, Binzmuehlestrasse 14/16, 8050, Zurich, Switzerland

    Anne Jaeger

Authors
  1. Steffen Moritz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne Jaeger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steffen Moritz.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Steffen Moritz and Anne Jaeger—co-first authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moritz, S., Jaeger, A. Decreased memory confidence in obsessive–compulsive disorder for scenarios high and low on responsibility: is low still too high?. Eur Arch Psychiatry Clin Neurosci 268, 291–299 (2018). https://doi.org/10.1007/s00406-017-0783-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-017-0783-0

Keywords

Search

Navigation