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Clinicians have suspected that obsessive-compulsive disorder (OCD) is associated with fundamental information-processing deficits beyond those attributable to mood disturbance alone. Neuropsychological investigations can be divided into four broad areas concerned with general intellectual functioning, an 'under-inclusive' thinking style, performance on tests sensitive to frontal lobe impairment and performance on tests of memory. This body of research is critically reviewed. It is suggested that there is modest evidence for the presence of non-verbal and praxic memory deficits in patients with OCD. These deficits are consistent with contemporary theories of fronto-striatal functioning and may represent the cognitive substrate of doubt-related phenomena such as checking. The demonstration of specific memory impairments in OCD may have significant implications for the revision of existing models of OCD and the development of novel treatment strategies that reduce doubt in compulsive checkers by increasing the distinctiveness of past actions.

A new model of worry is presented, differing from previous work in which worry was set within a broader theory of anxiety. It is proposed that threat is initially evaluated in terms of imminence, likelihood, and cost set against perceived self-efficacy; this evaluation can produce worry as a relatively automatic response. Worry serves the functions of alarm, prompt, and preparation; in terms of processes, it leads to an unfocused attentional style, sensitivity to emotional information, and arousal (which produces self-absorption). Threat (and worry) are maintained if there are elevated evidence requirements or inappropriate problem solving. The therapeutic implications of the model are discussed briefly.

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