Clinical Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Research in Psychotherapy, Clinical Psychology, Institute of Psychology, University of Zurich, Binzmuehlestrasse 14/16, 8050, Zurich, Switzerland.
Eur Arch Psychiatry Clin Neurosci. 2018 Apr;268(3):291-299. doi: 10.1007/s00406-017-0783-0. Epub 2017 Mar 28.
Previous research suggests that patients with obsessive-compulsive disorder (OCD), particularly checkers, display an inflated sense of responsibility. For the present study, we tested whether memory confidence in OCD is reduced under conditions of heightened responsibility and/or reflects poor memory vividness. A computerized task designed to modulate perceived responsibility was administered to 26 OCD patients (12 checkers) and 21 healthy controls. In the experimental condition (high responsibility), participants had to allocate daily medications to ten fictive patients in a hospital emergency ward, whereas in the control condition (low responsibility) participants had to allocate bath essences for ten hotel guests. Participants' response time and accuracy were recorded as well as their memory confidence, memory vividness, and subjective success. Irrespective of the condition, OCD patients performed as accurately as healthy controls, but appraised their performance as worse than that of controls. Memory confidence was decreased in patients, particularly checkers. No group differences emerged on vividness, and none of the effects were moderated by the condition (high versus low responsibility). The relationship between responsibility and OCD behavior is complex. Results suggest metamemory problems in OCD checkers, even when induced responsibility is low. The findings speak against "cold" memory deficits in OCD, as patients did not differ from controls on accuracy, reaction time, or vividness. Future research should focus on idiosyncratic beliefs and scenarios that inflate responsibility and elicit cognitive biases.
先前的研究表明，强迫症（OCD）患者，尤其是检查者，表现出过度的责任感。在本研究中，我们测试了 OCD 患者的记忆信心是否在责任感增强的情况下降低，或者反映了记忆生动性差。设计了一个计算机任务来调节感知到的责任感，该任务由 26 名 OCD 患者（12 名检查者）和 21 名健康对照者完成。在实验条件（高责任感）下，参与者必须将日常药物分配给医院急诊病房的十个虚构患者，而在对照条件（低责任感）下，参与者必须将沐浴香精分配给十个酒店客人。记录了参与者的反应时间和准确性，以及他们的记忆信心、记忆生动性和主观成功。无论条件如何，OCD 患者的表现都与健康对照组一样准确，但他们对自己的表现评价不如对照组。患者的记忆信心降低，尤其是检查者。在生动性方面，两组之间没有差异，并且没有任何一种效果受到条件（高责任感与低责任感）的调节。责任与 OCD 行为之间的关系很复杂。结果表明，即使在责任感较低的情况下，OCD 检查者也存在元记忆问题。这些发现表明 OCD 中不存在“冷”记忆缺陷，因为患者在准确性、反应时间或生动性方面与对照组没有差异。未来的研究应集中在那些能增强责任感并引起认知偏差的特殊信念和场景上。
