Obsessive-compulsive tendencies predict seeking proxies for understanding

Background and objectives: The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) postulates that obsessive-compulsive (OC) individuals have reduced access to their internal states and must therefore seek and rely on external proxies for these states. The present study extended this hypothesis to the feeling of understanding, which had not been examined previously in relation to OCD. Methods: We presented 148 participants with a computerized task requiring them to read and understand a text on medieval architecture. Participants were randomly assigned to an ongoing feedback condition (comprehension quiz and answers provided after each text segment) or no-feedback condition (quiz and answers provided only at the end). Throughout, participants were offered proxies in the form of “learning aids,” which were unrelated to text comprehension. Participants were divided to high vs. low OC tendencies based on a median split on a measure of OCD symptoms. Results: As predicted, lacking feedback on understanding was associated with higher use of proxies and high OC participants used more proxies than low OC participants in the no-feedback condition. Actual understanding, as assessed by comprehension scores, was unrelated to OC tendencies. Limitations: Among other limitations discussed in the article, our results were obtained on a non-selected sample of students varying on OC tendencies. It would be important to replicate these findings with diagnosed OCD participants as compared to both non-clinical and anxiety disorders control participants. Conclusions: These findings extend the SPIS model to the domain of understanding and may have important clinical implications.