The Trust in Memory in OCD, and the Role of Metacognition in Diagnosis

Obsessive Compulsive Disorder (OCD) is a common mental disorder that affects the functionality of the individual, along with his quality of life. Obsessions are repetitive thoughts, images, and urges that individuals perceive to be intrusive and undesirable. Compulsions, which can be both behavioral and cognitive, are repetitive actions that are performed in response to obsessions.

The controlling behaviors are one of the major OCD symptoms. For instance, a person checking whether he locked the door, turned off the gas. The presence of such problems give rise to thoughts that OCD patients may be suffering from memory issues. Nonetheless, a study carried out on memory in OCD (Derin and Irak, 2020) revealed that the memory issues observed in OCD patients may be associated with the distrust in their memory, and the weakness in their sense of knowing, rather than a general memory performance.

The individuals involved in the research by Derin and Irmak (2020) are divided into three groups. The clinical group diagnosed with OCD; the subthreshold group presenting OCD symptoms though not getting diagnosed with OCD, and a healthy group with no OCD symptoms.

In the first phase (memorization), the participants are shown some word pairs on the screen, which they are asked to memorize.

In the second phase (remembering clues), they are given a word from the word pairs, and they are asked to remember the other word in the pairs, and to rate how sure they are of the words they remember, using a 6-grade scale (1: I am not certainly sure; 6: I am certainly sure).

In the third phase (the sense of knowing), the participants, using a 6-grade scale (1: I am not certainly sure; 6: I am certainly sure), are asked to report their assessments regarding the directive “If the first word of these word pairs is shown to you later on, and if you are asked to find its pair in a multiple-choice question, can you find and remember the word among the options?”, for every word pair they remember and misremember.

In the last phase (recognition), the word pairs, which the participants cannot remember or which they misremember, are asked in the form of multiple-choice questions, as specified in the third phase. The participants are asked to report how sure they are of the answers they give, using the 6-grade scale again.

At the end of the experiment, the participants who are divided into three groups (OCD clinical group, subthreshold group, healthy group) are measured in terms of the aspects shown below:

• Their memory performance, based on recognition and remembering;
• The trust they put in their memories;
• How correct their remembrance-related sense of knowing is (the participants are compared on whether they can actually remember or not, through the assessment on whether they can remember the word pairs or not);
• Their time of reaction for correct-incorrect answers;
• Their time of advising a rate for the trust, regarding correct and incorrect answers.

At the end of the study, it was seen that;

• The OCD patients spent more time while advising how sure they are of both their correct and incorrect answers;
• The discrepancy between the assessments they made on whether they would remember the word pairs or not, and whether they actually could remember or not, was significantly higher than the healthy group.

At the end of the experiment, the trust that they put in their memories, and the accuracy of the metacognitive decisions regarding their memories were among the prominent aspects that separated the OCD patients from the healthy groups, rather than their memory performances. Nevertheless, learning whether these prominent aspects are peculiar to OCD requires similar memory studies to be done with other clinical groups like depression, anxiety disorder, panic disorder.

REFERENCES:
– Derin, S., Irak, M. (2020). Obsesif Kompulsif Bozuklukta Bellek, Belleğe Güven ve Bilme Hissi Kararları Arasındaki İlişkiler. Psikiyatride Güncel Yaklaşımlar, Cilt: 12 Sayı: Ek 1 (Araştırma Sayısı), 1-17. DOI: 10.18863/pgy.645537.