Disentangling Doubt and Checking Behaviors and Examining Their Association With Obsessive Compulsive Symptoms

Abstract

Experiencing doubt in an uncertain situation has been theorized to be an antecedent of compulsive checking. However, whether and when obsessive compulsive (OC) symptoms are associated with experiencing doubt and increased checking is unclear. In this study, we investigated the relationship between OC symptoms, the experience of doubt, and checking in a tone-discrimination task. Doubt was measured using mouse tracking, an indirect, unobtrusive measure. The results of two studies (N = 119) showed that OC symptoms were associated with elevated experiences of doubt when uncertainty was low. However, OC symptoms were not associated with increased checking, but doubt was. Results highlight the utility of mouse-tracking measures to capture the tendency of individuals with OC symptoms to experience doubt even under neutral conditions. The unexpected null results concerning checking suggest some specific directions for research to determine the conditions under which doubt evolves into checking in obsessive compulsive disorder.

Keywords

checking doubt mouse tracking obsessive compulsive disorder uncertainty

Get full access to this article

View all access options for this article.

References

Abramowitz

J. S.

Fabricant

L. E.

Taylor

Deacon

B. J.

McKay

Storch

E. A.

(2014). The relevance of analogue studies for understanding obsessions and compulsions. Clinical Psychology Review, 34(3), 206–217. https://doi.org/10.1016/j.cpr.2014.01.004

Arntz

Voncken

Goosen

A. C. A.

(2007). Responsibility and obsessive–compulsive disorder: An experimental test. Behaviour Research and Therapy, 45(3), 425–435. https://doi.org/10.1016/j.brat.2006.03.016

Bates

Mächler

Bolker

Walker

(2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1–48. https://doi.org/10.18637/jss.v067.i01

Brooks

M. E.

Kristensen

Benthem

K. J.

van Magnusson

Berg

C. W.

Nielsen

Skaug

H. J.

Mächler

Bolker

B. M.

(2017). GlmmTMB balances speed and flexibility among packages for zero-inflated generalized linear mixed modeling. The R Journal, 9(2), 378–400. https://doi.org/10.3929/ethz-b-000240890

Bürkner

P.-C.

(2018). Advanced Bayesian multilevel modeling with the R package brms. The R Journal, 10(1), 395–411. https://journal.r-project.org/archive/2018/RJ-2018-017/index.html

Clair

A.-H.

N’Diaye

Baroukh

Pochon

J.-B.

Morgiève

Hantouche

Falissard

Pelissolo

Mallet

(2013). Excessive checking for non-anxiogenic stimuli in obsessive-compulsive disorder. European Psychiatry, 28(8), 507–513. https://doi.org/10.1016/j.eurpsy.2012.11.003

Cumming

(2014). The new statistics: Why and how. Psychological Science, 25(1), 7–29. https://doi.org/10.1177/0956797613504966

Dar

(2004). Elucidating the mechanism of uncertainty and doubt in obsessive-compulsive checkers. Journal of Behavior Therapy and Experimental Psychiatry, 35(2), 153–163. https://doi.org/10.1016/j.jbtep.2004.04.006

Dar

Rish

Hermesh

Taub

Fux

(2000). Realism of confidence in obsessive-compulsive checkers. Journal of Abnormal Psychology, 109(4), 673–678. https://doi.org/10.1037//0021-843x.109.4.673

10.

Faleer

H. E.

Fergus

T. A.

Bailey

B. E.

K. D.

(2017). Examination of an experimental manipulation of intolerance of uncertainty on obsessive-compulsive outcomes. Journal of Obsessive-Compulsive and Related Disorders, 15, 64–73. https://doi.org/10.1016/j.jocrd.2017.07.002

11.

Ferrari

J. R.

Dovidio

J. F.

(2000). Examining behavioral processes in indecision: Decisional procrastination and decision-making style. Journal of Research in Personality, 34, 127–137. https://doi.org/10.1006/jrpe.1999.2247

12.

Ferrari

J. R.

Dovidio

J. F.

(2001). Behavioral information search by indecisives. Personality and Individual Differences, 30(7), 1113–1123. https://doi.org/10.1016/S0191-8869(00)00094-5

13.

Foa

E. B.

Amir

Gershuny

Molnar

Kozak

M. J.

(1997). Implicit and explicit memory in obsessive-compulsive disorder. Journal of Anxiety Disorders, 11(2), 119–129. https://doi.org/10.1016/S0887-6185(97)00001-7

14.

Foa

E. B.

Huppert

J. D.

Leiberg

Langner

Kichic

Hajcak

Salkovskis

P. M.

(2002). The Obsessive-Compulsive Inventory: Development and validation of a short version. Psychological Assessment, 14(4), 485–496. https://doi.org/10.1037/1040-3590.14.4.485

15.

Fowle

H. J.

Boschen

M. J.

(2011). The impact of compulsive cleaning on confidence in memory and cleanliness. Journal of Anxiety Disorders, 25(2), 237–243. https://doi.org/10.1016/j.janxdis.2010.09.008

16.

Fradkin

Adams

R. A.

Parr

Roiser

J. P.

Huppert

J. D.

(2020). Searching for an anchor in an unpredictable world: A computational model of obsessive compulsive disorder. Psychological Review, 127(5), 672–699. https://doi.org/10.1037/rev0000188

17.

Fradkin

Ludwig

Eldar

Huppert

J. D.

(2020). Doubting what you already know: Uncertainty regarding state transitions is associated with obsessive compulsive symptoms. PLOS Computational Biology, 16(2), Article 1007634. https://doi.org/10.1371/journal.pcbi.1007634

18.

Freeman

J. B.

Ambady

(2009). Motions of the hand expose the partial and parallel activation of stereotypes. Psychological Science, 20(10), 1183–1188. https://doi.org/10.1111/j.1467-9280.2009.02422.x

19.

Freeman

J. B.

Ambady

(2010). MouseTracker: Software for studying real-time mental processing using a computer mouse-tracking method. Behavior Research Methods, 42(1), 226–241. https://doi.org/10.3758/BRM.42.1.226

20.

Frost

R. O.

Shows

D. L.

(1993). The nature and measurement of compulsive indecisiveness. Behaviour Research and Therapy, 31(7), 683–692, IN1–IN2. https://doi.org/10.1016/0005-7967(93)90121-A

21.

Gillan

C. M.

Robbins

T. W.

(2014). Goal-directed learning and obsessive–compulsive disorder. Philosophical Transactions of the Royal Society B: Biological Sciences, 369(1655), Article 20130475. https://doi.org/10.1098/rstb.2013.0475

22.

Hermans

Engelen

Grouwels

Joos

Lemmens

Pieters

(2008). Cognitive confidence in obsessive-compulsive disorder: Distrusting perception, attention and memory. Behaviour Research and Therapy, 46(1), 98–113. https://doi.org/10.1016/j.brat.2007.11.001

23.

Hermans

Martens

De Cort

Pieters

Eelen

(2003). Reality monitoring and metacognitive beliefs related to cognitive confidence in obsessive–compulsive disorder. Behaviour Research and Therapy, 41(4), 383–401. https://doi.org/10.1016/S0005-7967(02)00015-3

24.

Huppert

J. D.

Walther

M. R.

Hajcak

Yadin

Foa

E. B.

Simpson

H. B.

Liebowitz

M. R.

(2007). The OCI-R: Validation of the subscales in a clinical sample. Journal of Anxiety Disorders, 21(3), 394–406. https://doi.org/10.1016/j.janxdis.2006.05.006

25.

Jaafari

Frasca

Rigalleau

Rachid

Gil

Olié

J. -P.

Guehl

Burbaud

Aouizerate

Rotgé

J.-Y.

Vibert

(2013). Forgetting what you have checked: A link between working memory impairment and checking behaviors in obsessive-compulsive disorder. European Psychiatry, 28(2), 87–93. https://doi.org/10.1016/j.eurpsy.2011.07.001

26.

Jaffe-Dax

Frenkel

Ahissar

(2017). Dyslexics’ faster decay of implicit memory for sounds and words is manifested in their shorter neural adaptation. eLife, 6, Article 20557. https://doi.org/10.7554/eLife.20557

27.

Janet

(1903). Les Obessions et la Psychasthénie [Obsessions and Psychasthenia]. Alcan.

28.

Kieslich

P. J.

Henninger

Wulff

D. U.

Haslbeck

J. M.

Schulte-Mecklenbeck

(2019). Mouse-tracking: A practical guide to implementation and analysis. In Schulte-Mecklenbeck

Kühberger

Johnson

J. G.

(Eds.), A handbook of process tracing methods (pp. 111–130). Routledge.

29.

Kruglanski

A. W.

Webster

D. M.

(1996). Motivated closing of the mind: “Seizing” and “freezing.” Psychological Review, 103(2), 263–283. https://doi.org/10.1037/0033-295X.103.2.263

30.

Kruschke

(2014). Doing Bayesian data analysis: A tutorial with R, JAGS, and Stan. Academic Press.

31.

Kuznetsova

Brockhoff

P. B.

Christensen

R. H. B.

(2017). lmerTest package: Tests in linear mixed effects models. Journal of Statistical Software, 82(1), 1–26. https://doi.org/10.18637/jss.v082.i13

32.

Lazarov

Liberman

Hermesh

Dar

(2014). Seeking proxies for internal states in obsessive–compulsive disorder. Journal of Abnormal Psychology, 123(4), 695–704. https://doi.org/10.1037/abn0000004

33.

Lee

M. D.

Wagenmakers

E.-J.

(2014) Bayesian cognitive modeling: A practical course. Cambridge Core. https://doi.org/10.1017/CBO9781139087759

34.

Macdonald

P. A.

Antony

M. M.

Macleod

C. M.

Richter

M. A.

(1997). Memory and confidence in memory judgments among individuals with obsessive compulsive disorder and non-clinical controls. Behaviour Research and Therapy, 35(6), 497–505. https://doi.org/10.1016/S0005-7967(97)00013-2

35.

Mancini

D’Olimpio

Del Genio

Didonna

Prunetti

(2002). Obsessions and compulsions and intolerance for uncertainty in a non-clinical sample. Journal of Anxiety Disorders, 16(4), 401–411. https://doi.org/10.1016/S0887-6185(02)00133-0

36.

Mathôt

Schreij

Theeuwes

(2012). OpenSesame: An open-source, graphical experiment builder for the social sciences. Behavior Research Methods, 44(2), 314–324. https://doi.org/10.3758/s13428-011-0168-7

37.

McNally

R. J.

Kohlbeck

P. A.

(1993). Reality monitoring in obsessive-compulsive disorder. Behaviour Research and Therapy, 31(3), 249–253. https://doi.org/10.1016/0005-7967(93)90023-N

38.

Miller

G. A.

Chapman

J. P.

(2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology, 110(1), 40–48. https://doi.org/10.1037/0021-843X.110.1.40

39.

Milner

A. D.

Beech

H. R.

Walker

V. J.

(1971). Decision processes and obsessional behaviour. British Journal of Clinical Psychology, 10(1), 88–89. https://doi.org/10.1111/j.2044-8260.1971.tb00719.x

40.

Moscatelli

Balestrucci

(2017). MixedPsy: Statistical tools for the analysis of psychophysical data (Version 1.0.0) [Computer software]. Comprehensive R Archive Network. https://cran.r-project.org/package=MixedPsy

41.

Nakagawa

Johnson

P. C. D.

Schielzeth

(2017). The coefficient of determination R² and intra-class correlation coefficient from generalized linear mixed-effects models revisited and expanded. Journal of the Royal Society Interface, 14(134), Article 20170213. https://doi.org/10.1098/rsif.2017.0213

42.

Nedeljkovic

Kyrios

(2007). Confidence in memory and other cognitive processes in obsessive–compulsive disorder. Behaviour Research and Therapy, 45(12), 2899–2914. https://doi.org/10.1016/j.brat.2007.08.001

43.

Nedeljkovic

Moulding

Kyrios

Doron

(2009). The relationship of cognitive confidence to OCD symptoms. Journal of Anxiety Disorders, 23(4), 463–468. https://doi.org/10.1016/j.janxdis.2008.10.001

44.

Nisbett

R. E.

Wilson

T. D.

(1977). Telling more than we can know: Verbal reports on mental processes. Psychological Review, 84(3), 231–259. https://doi.org/10.1037/0033-295X.84.3.231

45.

O’Connor

Aardema

Pélissier

M.-C.

(2005). Beyond reasonable doubt: Reasoning processes in obsessive-compulsive disorder and related disorders. Wiley Online Library.

46.

Rachman

(2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40(6), 625–639. https://doi.org/10.1016/S0005-7967(01)00028-6

47.

Rapoport

J. L.

(1989). The boy who couldn’t stop washing: The experience and treatment of obsessive-compulsive disorder. Dutton.

48.

Rassin

Muris

Booster

Kolsloot

(2008). Indecisiveness and informational tunnel vision. Personality and Individual Differences, 45(1), 96–102. https://doi.org/10.1016/j.paid.2008.03.006

49.

R Core Team. (2018). R: A language and environment for statistical computing (Version 3.5.2) [Computer software]. R Foundation for Statistical Computing. http://www.R-project.org

50.

Reed

G. F.

(1985). Obsessional experience and compulsive behaviour: A cognitive structural approach. Academic Press.

51.

Ron

Oren

Dar

(2016). The doubt-certainty continuum in psychopathology, lay thinking, and science. Journal of Behavior Therapy and Experimental Psychiatry, 53, 68–74. https://doi.org/10.1016/j.jbtep.2015.08.005

52.

Rotge

J. Y.

Clair

A. H.

Jaafari

Hantouche

E. G.

Pelissolo

Goillandeau

Pochon

J. B.

Guehl

Bioulac

Burbaud

(2008). A challenging task for assessment of checking behaviors in obsessive–compulsive disorder. Acta Psychiatrica Scandinavica, 117(6), 465–473. https://doi.org/10.1111/j.1600-0447.2008.01173.x

53.

Rotge

J.-Y.

Langbour

Dilharreguy

Bordessoulles

Guehl

Bioulac

Martin-Guehl

Jaafari

Aouizerate

Allard

Burbaud

(2015). Contextual and behavioral influences on uncertainty in obsessive-compulsive disorder. Cortex, 62, 1–10. https://doi.org/10.1016/j.cortex.2012.12.010

54.

Ruscio

A. M.

Stein

D. J.

Chiu

W. T.

Kessler

R. C.

(2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53–63. https://doi.org/10.1038/mp.2008.94

55.

Salkovskis

P. M.

(1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23(5), 571–583. https://doi.org/10.1016/0005-7967(85)90105-6

56.

Salkovskis

P. M.

(1998). Psychological approaches to the understanding of obsessional problems. In Swinson

R. P.

Antony

M. M.

Rachman

Richter

M. A.

(Eds.), Obsessive compulsive disorder – Theory, research & treatment. Guilford Press.

57.

Sarig

Dar

Liberman

(2012). Obsessive-compulsive tendencies are related to indecisiveness and reliance on feedback in a neutral color judgment task. Journal of Behavior Therapy and Experimental Psychiatry, 43(1), 692–697. https://doi.org/10.1016/j.jbtep.2011.09.012

58.

Schneider

I. K.

van Harreveld

Rotteveel

Topolinski

van der Pligt

Schwarz

Koole

S. L.

(2015). The path of ambivalence: Tracing the pull of opposing evaluations using mouse trajectories. Frontiers in Psychology, 6, Article 996. https://doi.org/10.3389/fpsyg.2015.00996

59.

Strauss

A. Y.

Fradkin

McNally

R. J.

Linkovski

Anholt

G. E.

Huppert

J. D.

(2020). Why check? A meta-analysis of checking in obsessive-compulsive disorder: Threat vs. distrust of senses. Clinical Psychology Review, 75, Article 101807. https://doi.org/10.1016/j.cpr.2019.101807

60.

Taylor

Purdon

(2016). Responsibility and hand washing behaviour. Journal of Behavior Therapy and Experimental Psychiatry, 51, 43–50. https://doi.org/10.1016/j.jbtep.2015.12.005

61.

Toffolo

M. B. J.

van den Hout

M. A.

Engelhard

I. M.

Hooge

I. T. C.

Cath

D. C.

(2016). Patients with obsessive-compulsive disorder check excessively in response to mild uncertainty. Behavior Therapy, 47(4), 550–559. https://doi.org/10.1016/j.beth.2016.04.002

62.

Toffolo

M. B. J.

van den Hout

M. A.

Hooge

I. T. C.

Engelhard

I. M.

Cath

D. C.

(2013). Mild uncertainty promotes checking behavior in subclinical obsessive-compulsive disorder. Clinical Psychological Science, 1(2), 103–109. https://doi.org/10.1177/2167702612472487

63.

Tolin

D. F.

Abramowitz

J. S.

Brigidi

B. D.

Amir

Street

G. P.

Foa

E. B.

(2001). Memory and memory confidence in obsessive–compulsive disorder. Behaviour Research and Therapy, 39(8), 913–927. https://doi.org/10.1016/S0005-7967(00)00064-4

64.

van den Hout

M. A.

van Dis

E. A. M.

van Woudenberg

van de Groep

I. H.

(2019). OCD-like checking in the lab: A meta-analysis and improvement of an experimental paradigm. Journal of Obsessive-Compulsive and Related Disorders, 20, 39–49. https://doi.org/10.1016/j.jocrd.2017.11.006

65.

Webster

D. M.

Kruglanski

A. W.

(1994). Individual differences in need for cognitive closure. Journal of Personality and Social Psychology, 67(6), 1049–1062. https://doi.org/10.1037/0022-3514.67.6.1049

66.

Wojnowicz

M. T.

Ferguson

M. J.

Dale

Spivey

M. J.

(2009). The self-organization of explicit attitudes. Psychological Science, 20(11), 1428–1435. https://doi.org/10.1111/j.1467-9280.2009.02448.x

67.

Wong

S. F.

Williams

A. D.

Grisham

J. R.

(2017). Distrust of the senses and its association with obsessive-compulsive symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 57, 189–197. https://doi.org/10.1016/j.jbtep.2017.06.002

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

1.00 MB