TY - JOUR
T1 - Differences in metacognitive functioning between obsessive-compulsive disorder patients and highly compulsive individuals from the general population
AU - Hoven, Monja
AU - Rouault, Marion
AU - van Holst, Ruth
AU - Luigjes, Judy
N1 - Funding Information: This work was supported by a VENI grant (JL; grant number 916-18-119). JL was supported by a VENI grant (916-18-119), MR is the beneficiary of a postdoctoral fellowship from the AXA Research Fund. MR's work was also supported by the Fondation des Treilles. Publisher Copyright: Copyright © The Author(s), 2023. Published by Cambridge University Press.
PY - 2023/12/9
Y1 - 2023/12/9
N2 - Background Our confidence, a form of metacognition, guides our behavior. Confidence abnormalities have been found in obsessive-compulsive disorder (OCD). A first notion based on clinical case-control studies suggests lower confidence in OCD patients compared to healthy controls. Contrarily, studies in highly compulsive individuals from general population samples showed that obsessive-compulsive symptoms related positively or not at all to confidence. A second notion suggests that an impairment in confidence estimation and usage is related to compulsive behavior, which is more often supported by studies in general population samples. These opposite findings call into question whether findings from highly compulsive individuals from the general population are generalizable to OCD patient populations. Methods To test this, we investigated confidence at three hierarchical levels: local confidence in single decisions, global confidence in task performance and higher-order self-beliefs in 40 OCD patients (medication-free, no comorbid diagnoses), 40 controls, and 40 matched highly compulsive individuals from the general population (HComp). Results In line with the first notion we found that OCD patients exhibited relative underconfidence at all three hierarchical levels. In contrast, HComp individuals showed local and global overconfidence and worsened metacognitive sensitivity compared with OCD patients, in line with the second notion. Conclusions Metacognitive functioning observed in a general highly compulsive population, often used as an analog for OCD, is distinct from that in a clinical OCD population, suggesting that OC symptoms in these two groups relate differently to (meta)cognitive processes. These findings call for caution in generalizing (meta)cognitive findings from general population to clinical samples.
AB - Background Our confidence, a form of metacognition, guides our behavior. Confidence abnormalities have been found in obsessive-compulsive disorder (OCD). A first notion based on clinical case-control studies suggests lower confidence in OCD patients compared to healthy controls. Contrarily, studies in highly compulsive individuals from general population samples showed that obsessive-compulsive symptoms related positively or not at all to confidence. A second notion suggests that an impairment in confidence estimation and usage is related to compulsive behavior, which is more often supported by studies in general population samples. These opposite findings call into question whether findings from highly compulsive individuals from the general population are generalizable to OCD patient populations. Methods To test this, we investigated confidence at three hierarchical levels: local confidence in single decisions, global confidence in task performance and higher-order self-beliefs in 40 OCD patients (medication-free, no comorbid diagnoses), 40 controls, and 40 matched highly compulsive individuals from the general population (HComp). Results In line with the first notion we found that OCD patients exhibited relative underconfidence at all three hierarchical levels. In contrast, HComp individuals showed local and global overconfidence and worsened metacognitive sensitivity compared with OCD patients, in line with the second notion. Conclusions Metacognitive functioning observed in a general highly compulsive population, often used as an analog for OCD, is distinct from that in a clinical OCD population, suggesting that OC symptoms in these two groups relate differently to (meta)cognitive processes. These findings call for caution in generalizing (meta)cognitive findings from general population to clinical samples.
KW - analogue
KW - compulsivity
KW - confidence
KW - global confidence
KW - obsessive-compulsive disorder
UR - http://www.scopus.com/inward/record.url?scp=85167907892&partnerID=8YFLogxK
U2 - https://doi.org/10.1017/S003329172300209X
DO - https://doi.org/10.1017/S003329172300209X
M3 - Article
C2 - 37553980
SN - 0033-2917
VL - 53
SP - 7933
EP - 7942
JO - Psychological Medicine
JF - Psychological Medicine
IS - 16
ER -