Exploring metacognitive components of confidence and control in individuals with obsessive-compulsive tendencies

Background and objectives: Obsessive-compulsive (OC) patients typically display reduced metacognitive confidence, but findings regarding the scope of this phenomenon and factors that mediate it have been inconsistent. This study aimed to further the understanding of reduced metacognitive confidence in obsessive-compulsive disorder (OCD) by exploring the relationship between metacognitive processes and OC tendencies. Methods: High and low OC participants answered a general-knowledge questionnaire, rated their confidence in each answer, and decided whether or not to report each answer. Results: High and low OC participants did not differ either in their performance (general knowledge) or in their subjective estimations or confidence regarding their performance. The two groups also did not differ in the effectiveness of their metacognitive monitoring or in the relationship between monitoring and report-control decisions (control sensitivity). However, the two groups did differ in response criterion, with high OC participants less willing to report answers held with low-to-medium levels of subjective confidence. Limitations: The study was conducted with non-clinical participants, which limits generalization to OCD. Conclusions: These results suggest that conservative response criterion among OC individuals might be the critical factor underlying feelings of doubt and uncertainty endemic in OCD.