Choice Blindness, Confabulatory Introspection, and Obsessive–Compulsive Symptoms: Investigation in a Clinical Sample

  • Shiu F. WongEmail author
  • Frederick Aardema
  • Martha Giraldo-O’Meara
  • Lars Hall
  • Petter Johansson
Original Article


The content of obsessions in obsessive–compulsive disorder (OCD) often run contrary to the actual self of the individual experiencing them. The ego-dystonic nature of obsessions has led some researchers to propose that individuals with OCD form these false beliefs about themselves due to limited introspective access. The current study therefore aimed to extend on recent findings from non-clinical samples, which suggest the relevance of confabulatory introspection on OCD symptoms, in a clinical population. Participants were community participants diagnosed with OCD (n = 54) or another anxiety or mood disorder (n = 28), as well as healthy individuals (n = 110). Groups completed the Choice Blindness Paradigm, an experimental task designed to have participants confabulate outside of their awareness. Contrary to predictions, the OCD group did not have a greater proportion of individuals who confabulated on this task. Furthermore, only within healthy participants was the occurrence of confabulation associated with elevated OCD symptoms. We speculate that confabulatory introspection may be an important precursor to the development of clinical obsessions and its early detection could inform the prevention of obsessive–compulsive and related disorders.


Choice blindness Obsessive–compulsive disorder 



The study was supported by a grant (no. 111261) awarded to the second author from the Canadian Institutes for Health Research (CIHR). The first author is also a recipient of a senior research scholar award from the Quebec Health Research Fund (Fonds de la recherche en santé du Québec). The fourth and fifth authors were supported by the Swedish Research Council (2014-1371).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyConcordia UniversityMontréalCanada
  2. 2.Centre de Recherche de l’Institut Universitaire en Santé Mentale de MontréalMontréalCanada
  3. 3.Department of Psychiatry and AddictologyUniversity of MontréalMontréalCanada
  4. 4.Lund University Cognitive Science, Lund UniversityLundSweden

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