The current study is the first to investigate confabulatory introspection in relation to clinical psychological symptoms utilizing the Choice Blindness Paradigm (CBP). It was hypothesized that those with obsessive-compulsive symptoms are more likely to confabulate mental states. To test this hypothesis, an experimental choice blindness task was administered in two nonclinical samples (n = 47; n = 76). Results showed that a confabulatory introspection is significantly related to obsessive-compulsive symptoms. There was evidence for its specificity to symptoms of OCD depending on the obsessional theme addressed in the choice blindness task. However, confabulatory introspection was also found to be relevant to other symptoms, including depression and schizotypy. The results highlight a potentially fruitful new area of clinical investigation in the area of insight and self-knowledge, not limited to OCD alone, but potentially other disorders as well.

The current paper describes a case series using a new strategy for facilitating change based on Augmentation of Psychotherapy through Alternative Preconscious Priming (APAP) (1) in the treatment of eight treatment-resistant patients suffering from social phobia or generalized anxiety disorder. The patients had previously only shown a partial response to cognitive behavioral therapy (CBT) despite good treatment adherence. The patients completed APAP using a computerized program, which consisted of three steps during which alternative, more functional thoughts and beliefs relevant to the idiosyncratic difficulties experienced by the patients were formulated. Subsequently, these formulations were recorded and mixed with masking relaxing music, which the patient listened to in a passive state twice daily for 20 min for a period of 8 weeks. This case series aimed to assess the effect and acceptability of APAP using quantitative and qualitative measures administered before, after, and 16 weeks’ posttreatment. Results showed a reduction in dysfunctional idiosyncratic thoughts reported by most patients, as well as mild improvements in anxiety and important improvements in quality of life. APAP could be a valuable addition to CBT by facilitating or enhancing cognitive and symptom change. Further studies are needed to confirm these promising results.

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