Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis

Reuven Dar*, Noam Sarna, Gal Yardeni, Amit Lazarov

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


People with obsessive-compulsive disorder (OCD) tend to distrust their memory, perception, and other cognitive functions, and many OCD symptoms can be traced to diminished confidence in one's cognitive processes. For example, poor confidence in recall accuracy can cause doubt about one's memory and motivate repeated checking. At the same time, people with OCD also display performance deficits in a variety of cognitive tasks, so their reduced confidence must be evaluated in relation to their actual performance. To that end, we conducted an exhaustive review and meta-analysis of studies in which OCD participants and non-clinical control participants performed cognitive tasks and reported their confidence in their performance. Our search resulted in 19 studies that met criteria for inclusion in the quantitative analysis, with all studies addressing either memory or perception. We found that both performance and reported confidence were lower in OCD than in control participants. Importantly, however, confidence was more impaired than performance in participants with OCD. These findings suggest that people with OCD are less confident in their memory and perception than they should be, indicating a genuine under-confidence in this population. We discuss potential mechanisms that might account for this finding and suggest avenues for further research into under-confidence and related meta-cognitive characteristics of OCD.

Original languageEnglish
Pages (from-to)2404-2412
Number of pages9
JournalPsychological Medicine
Issue number13
StatePublished - 18 Oct 2022


  • Confidence
  • doubt
  • memory
  • metacognition
  • obsessive-compulsive disorder
  • perception


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