Memory Deficits in Patients with DSM-IV Obsessive-Compulsive Disorder

Abstract

Neuropsychological testing provides increasing evidence that certain memory deficits might play an essential role in the emergence of doubts and, as a result, in perpetuating checkers’ rituals. Another account of doubting implicates metacognitive factors, such as confidence in memory. The present study examined mnestic functioning and self-perception of memory ability in a group of 27 nondepressed patients with obsessive-compulsive disorder (OCD) and 27 normal controls. All patients met DSM-IV and ICD-10 criteria for OCD, displayed prominent behavioral checking rituals and had to show a score on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) of at least 16. Significant deficits in intermediate (Lern- und Gedächtnistest; LGT-3) and immediate (Corsi Block-Tapping Test) nonverbal memory were identified in the patients with OCD compared to normal controls. Contrary to predictions, OCD patients also showed a significant deficit in general memory and verbal memory (LGT-3). With respect to metacognition, OCD patients reported less confidence in their memories than controls. These findings suggest that obsessional doubt reflects a deficit in memory as well as a deficit in memory confidence. Depending on which dysfunction predominates, different therapeutic procedures seem to be required.

Influence of comorbid obsessive-compulsive symptoms on brain event-related potentials in Gilles de la Tourette syndrome

“…Concurrently, several studies reported memory impairments and response uncertainty as features often appearing in the OCD population (O'Connor et al, 2005). Poorer performance has been observed on tests of logical memory (Sher et al, 1984), short-term (Boone et al, 1991;Christensen et al, 1992) and long-term (Zitterl et al, 2001) visual memory in participants with OCD. It has also been proposed that uncertainty and low confidence level could impede information processing in patients with OCD and mediate their memory difficulties.…”

“…Repetitive thoughts and actions characterizing OCD could occur because of repeated neural signals indicating that they have not been adequately carried out (Pitman, 1987). The resulting uncertainty could impact on memory functions and, consequently, on the capacity to inhibit thoughts and actions (Zitterl et al, 2001). …”

The Influence of Social Cognition on Ego Disturbances in Patients with Schizophrenia

“…Moritz and Woodward [61] found a positive relationship between symptoms of delusions and hallucinations and elevated levels of confidence in a word learning task; however, passivity experiences were not included either. Reduced levels of confidence in one’s own performance have been demonstrated for other psychiatric disorders like depression [62,63] and obsessive-compulsive disorder [64,65], leading to specific symptoms like rumination or checking, respectively. Regarding schizophrenia, more studies including patients with moderate-to-severe symptoms of ego disturbances are needed to investigate whether ego disturbances are associated with lower confidence in all performance tasks or only in source monitoring tasks, and whether patients with stronger symptoms, by contrast, show higher levels of confidence as suggested in the study by Moritz and Woodward [61].…”

Ein Beitrag zur Psychopathologie des Zwangs

“…B. die sog. "mnestic deficit hypothesis",d.h.dass der Zwang, v. a. der Kontrollzwang, auf eine Schwä-che mnestischer Leistung zurückzufüh-ren sei [28].Jedoch scheinen diese Ansät-ze wegen ihrer Orientierung nach der Kognition dem Willen kaum Beachtung zu schenken, während er von Jaspers [15] und Schneider [22] als ein wesentliches Moment des Zwangs angesehen wurde. Beiden Autoren zufolge ist der Zwang nur in dem Bereich des willkürlich geleiteten Seelenlebens möglich: "Die Grenze des möglichen Zwangs ist dort, wo die Grenze meines Willens ist" [15].…”

“…Dafür spricht indirekt, dass Zwangssymptome bei Hirnorganikern "nur äußerst selten" vorkommen [2]. Diese klinische Tatsache erweckt in uns auch den Verdacht, ob der Kontrollzwang -wie die eingangs erwähnte Hypothese [10,28] annimmt -auf eine mnestische Störung zurückzuführen ist, weil sie eines der Kernsymptome der Hirnorganiker ist.…”