Attenuation of access to internal states in high obsessive-compulsive individuals might increase susceptibility to false feedback: Evidence from a visuo-motor hand-reaching task

Ezrati, Or; Friedman, Jason; Dar, Reuven

doi:10.1016/j.jbtep.2018.12.006

Cited by 7 publications

(5 citation statements)

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“…According to the Seeking Proxies for Internal States (SPIS) model (Dar, Lazarov, & Liberman, 2021 ), OCD symptoms are associated with attenuated access to internal states. Evidence supporting this hypothesis was obtained in relation to several internal states, including muscle tension (Lazarov, Dar, Liberman, & Oded, 2012b ; Lazarov, Liberman, Hermesh, & Dar, 2014 ), emotions (Dar, Lazarov, & Liberman, 2016 ; Lazarov, Friedman, Comay, Liberman, & Dar, 2020 ), interoception (Ezrati, Friedman, & Dar, 2019 ; Ezrati, Sherman, & Dar, 2018 ), and a sense of understanding (Dar, Eden, van Dongen, Hauschildt, & Liberman, 2019 ). As estimating one's performance requires accessing an internal state (in the current review, particularly one's memory), the under-confidence seen in our analysis might be an expression of a general difficulty in accessing these states in OCD.…”

Section: Discussionmentioning

confidence: 91%

Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis

et al. 2022

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People with obsessive-compulsive disorder (OCD) tend to distrust their memory, perception, and other cognitive functions, and many OCD symptoms can be traced to diminished confidence in one's cognitive processes. For example, poor confidence in recall accuracy can cause doubt about one's memory and motivate repeated checking. At the same time, people with OCD also display performance deficits in a variety of cognitive tasks, so their reduced confidence must be evaluated in relation to their actual performance. To that end, we conducted an exhaustive review and meta-analysis of studies in which OCD participants and non-clinical control participants performed cognitive tasks and reported their confidence in their performance. Our search resulted in 19 studies that met criteria for inclusion in the quantitative analysis, with all studies addressing either memory or perception. We found that both performance and reported confidence were lower in OCD than in control participants. Importantly, however, confidence was more impaired than performance in participants with OCD. These findings suggest that people with OCD are less confident in their memory and perception than they should be, indicating a genuine under-confidence in this population. We discuss potential mechanisms that might account for this finding and suggest avenues for further research into under-confidence and related meta-cognitive characteristics of OCD.

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Section: Discussionmentioning

confidence: 91%

Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis

et al. 2022

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“…Research also points to subjective doubt being an important feature of OCD, 30 with a nascent OCD model postulating an attenuated access to internal states (such as emotions, bodily sensations, muscle tension and proprioception). [31][32][33] Chronic pain and OCD are complex conditions linked with significant disability and distress. In consideration of the aspects and processes highlighted above, further study into the association and impact of OCD on chronic pain and its rehabilitation is merited.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Protocol for a mixed-method cohort study investigating the prevalence and impact of obsessive–compulsive disorder (OCD) in chronic pain rehabilitation

et al. 2021

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IntroductionWhile there is considerable and growing research in the individual fields of obsessive–compulsive disorder (OCD) and chronic pain, focused research into their potential association remains limited. By exploring this potential association, better theoretical understanding of and better therapeutic approaches to chronic pain management could be developed. The study’s aim is to explore the prevalence and impact of obsessions–compulsions on the experience and rehabilitation of chronic pain among individuals attending different branches of a New Zealand pain service.Methods and analysisThis is a cohort study using well-validated questionnaires and semistructured interviews. Participants will be recruited through community pain services from a private rehabilitation-focused company with branches across New Zealand. Participants will complete an OCD screening measure (Obsessive–Compulsive Inventory-Revised (OCI-R)). These results will be used to compare results from the specialist pain services benchmarking electronic Persistent Pain Outcomes Collaboration measure sets, at both participant intake and completion of each Pain Service Programme. Prevalence rates of OCD caseness from the OCI-R will be estimated with 95% CI. Generalised linear regression models will be used to explore differences in pain baseline and outcome factors between those with high and low obsessive–compulsive symptoms. Semistructured interviews, assessed through interpretative phenomenological analysis (IPA), will be used to provide information on lived experiences of individuals with comorbid chronic pain and OCD. This will be supported through the administration of an Obsessive Beliefs Questionnaire 44.Ethics and disseminationEthical approval has been obtained from the Health and Disability Ethics Committee (HDEC20/CEN/82). Study results will be disseminated at professional conferences and in peer-reviewed journals. A lay summary of findings will be provided to requesting participants or through attendance at a local hui (gathering).Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12621000758808).

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“…According to current accounts of perceived agency, such reduced reliability of internal (e.g., sensorimotor signals, predictions, intentions) agency cues would lead to a stronger relative weighting of other (e.g., explicit feedback, valence of action outcomes) cues in the construction of a SoA (Synofzik, Vosgerau et al 2009, Gentsch and Synofzik 2014, Fradkin, Adams et al 2020). Existing evidence indeed shows that subclinical analog groups with high OC tendencies (Lazarov, Dar et al 2010, Lazarov, Dar et al 2012, Ezrati, Friedman et al 2019) and patients with OCD (Lazarov, Liberman et al 2014) are more susceptible to the effects of false feedback. In line with these findings, and based on the fact that doubt and uncertainty are a central feature of OCD, Lazarov and colleagues proposed the Seeking Proxies for Internal States (SPIS) model (Lazarov, Liberman et al 2014, Lazarov, Liberman et al 2014, Dar, Lazarov et al 2021).…”

Section: Introductionmentioning

confidence: 96%

“…This model suggests that OCD can be characterized by attenuated access to internal states, i.e., states that cannot be reliably assessed by outside observers, such as physiological states, intentions, etc., for which patients try to compensate by relying (more) on other proxies, such as rules, rituals, explicit feedback, i.e., any information that seems less ambiguous. The authors and colleagues present studies that seem to support this notion, showing, for example, impaired performance in producing certain muscle tensions and a greater tendency to demand/rely on explicit proxies when available, albeit most of the evidence comes from non-clinical populations (Lazarov, Dar et al 2010, Lazarov, Dar et al 2012, Lazarov, Dar et al 2012, Lazarov, Liberman et al 2014, Lazarov, Cohen et al 2015, Dar, Eden et al 2019, Ezrati, Friedman et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Disturbance of the Sense of Agency in Obsessive-Compulsive Disorder and its Modulation by Social Context

Roth,

Lindner,

Fallgatter

et al. 2024

Preprint

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Executing precise actions and perceiving them as one’s own is a fundamental ability underlying the sense of agency (SoA). The SoA thereby heavily relies on the accuracy and reliability of forward models, capturing sensory movement consequences. Impairments thereof thus represent a promising candidate mechanism contributing to cases of SoA pathogenesis. In obsessive-compulsive disorder (OCD), for example, the feeling of control over one’s actions is perturbed: Compulsive actions are often experienced as uncontrollable and performed without conscious awareness. At the same time, compulsions can be coupled with an inflated sense of illusory control for uncontrollable events. Here we studied self-action perception in virtual reality with and without veridical or rotated visual feedback about subjects’ pointing movements to test whether patients’ internal forward models are indeed less reliable compared to controls. Interestingly, OCD patients did not exhibit deficits in their accuracy and reliability of motor performance and self-action perception in the absence of visual feedback, suggesting intact forward models. Nonetheless, OCD patients weighted rotated visual action-feedback significantly stronger perceptually. Furthermore, they adapted their movement to this false feedback on a trial-by-trial basis. Finally, increasing the social relevance of action consequences led to stronger feedback weighting in all participants while this effect increased with the strength of OCD symptomatology under conditions with strongest social relevance. We suggest that internal forward models are equally reliable in OCD but their weight is pathologically decreased leading to patients’ overreliance on explicit visual action-feedback and, more generally, to their over-attribution of unrelated events to themselves.

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Attenuation of access to internal states in high obsessive-compulsive individuals might increase susceptibility to false feedback: Evidence from a visuo-motor hand-reaching task

Cited by 7 publications

References 38 publications

Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis

Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis

Protocol for a mixed-method cohort study investigating the prevalence and impact of obsessive–compulsive disorder (OCD) in chronic pain rehabilitation

Disturbance of the Sense of Agency in Obsessive-Compulsive Disorder and its Modulation by Social Context

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