An Investigation of the Experience of Control Through the Sense of Agency in People with Obsessive-Compulsive Disorder: A Review and Meta-Analysis

Davide Fausto Borrelli*, Matteo Tonna, Reuven Dar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective The construct of Sense of Agency (SoA) has proven useful for understanding mechanisms underlying obsessive-compulsive disorder (OCD) phenomenology, especially in explaining the apparent dissociation in OCD between actual and perceived control over one's actions. Paradoxically, people with OCD appear to experience both diminished SoA (feeling unable to control their actions) and inflated SoA (having "magical" control over events). The present review investigated the extent to which the SoA is distorted in OCD, in terms of both implicit (i.e., inferred from correlates and outcomes of voluntary actions) and explicit (i.e., subjective judgment of one's control over an outcome) measures of SoA. Method Our search resulted in 15 studies that met the criteria for inclusion in a meta-analysis, where we examined also the potential moderating effects of the type of measure (explicit vs. implicit) and of the actual control participants had over the outcome. Results We found that participants with OCD or with high levels of OCD symptoms show lower implicit measures of SoA and at the same time tend to overestimate their control in situations where they do not actually have it. Conclusion Together, these findings support the hypothesized dissociation in OCD between actual and perceived control over one's actions.

Original languageEnglish
JournalCNS Spectrums
DOIs
StateAccepted/In press - 2024

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