Lower confidence and increased error sensitivity in OCD patients while learning under volatility

This study investigated the discrepancies in previous research on action, confidence, and their coupling in OCD patients compared to healthy controls during a volatile learning process. Using a predictive inference task, the study found that OCD patients exhibited lower confidence than healthy controls, and increased error sensitivity, particularly reacting excessively to small prediction errors. However, no group differences in the coupling between action and confidence were observed. A comparison with high and low compulsive individuals from the general population revealed that high compulsivity was associated with increased confidence and decoupling between action and confidence, correlating with symptom severity. These findings suggest distinct (meta)cognitive profiles associated with obsessive-compulsive symptoms, potentially contingent on clinical versus subclinical presentation.

Monja Hoven, Tosca Mulder, Damiaan Denys, Ruth J. van Holst, Judy Luigjes