Obsessive-compulsive tendencies and undermined confidence are related to reliance on proxies for internal states in a false feedback paradigm

Background and objectives: We have previously hypothesized that obsessive-compulsive (OC) tendencies are associated with a general lack of subjective conviction regarding internal states, which leads to compensatory seeking of and reliance on more discernible substitutes (proxies) for these states (Lazarov, A., Dar, R., Oded, Y., & Liberman, N. (2010). Behaviour Research and Therapy, 48, 516-523). This article presents two studies designed to provide further support to this hypothesis by using false biofeedback as a proxy for internal states. Methods: In Study 1 we presented high and low OC participants with pre-programmed false feedback showing either increasing or decreasing levels of muscle tension. In Study 2 we presented similar false feedback on level of relaxation to non-selected participants, half of which received instructions that undermined their confidence in their ability to assess their own level of relaxation. Results: In Study 1, high OC participants were more affected by false biofeedback when judging their own level of muscle tension than were low OC participants. In Study 2, undermined confidence participants were more affected by false biofeedback when judging their own level of relaxation as compared to control participants. Limitations: Our findings are based on a non-clinical, highly functioning, largely female student sample and their generalization to OCD requires replication with a sample of OCD patients. Conclusions: These results provide converging evidence for our hypothesis by replicating and extending our previous findings. We discuss the implication of our hypothesis for the understanding and treatment of OCD and outline directions for future research.