“…There are at least two distinct possibilities: One is that individuals with OCD have intact access to their subjective states, but meta-cognitive processes such as excessive self-monitoring and self-questioning lead to doubts in regard to these states. This possibility is consistent with studies demonstrating the effects of checking behavior on memory and perception confidence (Ashbaugh & Radomsky, 2007;van den Hout & Kindt, 2003a, b;Radomsky & Alcolado, 2010;Radomsky et al, 2006;Tolin et al, 2001) and with studies that found no real memory deficits in OC individuals other than memory confidence (e.g., Abbruzzese, Bellodi, Ferri, & Scarone, 1993;Ceschi, Van der Linden, Dunker, Perroud, & Bredart, 2003;Foa, Amir, Gershuny, Molnar, & Kozak, 1997;Jelinek, Moritz, Heeren, & Nadar, 2006;Karadag, Oguzhanoglu, Ozdel, Atesci, & Amuk, 2005;Kim et al, 2006;Simpson et al, 2006). The alternative possibility is that inputs from internal states in OCD are attenuated, so that checking and self-questioning only serve to increase doubts that are grounded in a real deficiency in perceiving and experiencing internal states.…”