ArticleResearch square2025
The metacognitive paradox of OCD: confidence is globally reduced but shows increased sensitivity to local evidence.
Article in Research square, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
Funding
Abstract
Confidence is a critical metacognitive signal that guides performance. Biases in confidence, such as excessive doubt, are hallmark features of mental health disorders, especially obsessive-compulsive disorder (OCD). Yet, the underlying neurocognitive mechanisms and how they link to learning and decision-making remain elusive. We asked patients with OCD and matched healthy controls to perform a novel rule-shifting task incorporating trial-by-trial confidence ratings. Using a Bayes-optimal model, we identified two distinct confidence biases: while patients with OCD indicated lower overall confidence, their trial-by-trial confidence ratings more accurately tracked task-relevant information, rendering their confidence reports more Bayes-optimal than those of controls. These findings challenge the idea of a simple, unified metacognitive impairment in OCD. Instead, they suggest that OCD is linked to an enhanced responsiveness to environmental evidence and feedback during decision-making.
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