Insight, obsession and checking behavior in obsessive-compulsive disorder

Introduction. - The role of insight in the symptomatic expression of obsessive-compulsive disorder (OCD) remains controversial. We sought to better investigate this issue and assessed potential relationships between the level of insight and some cognitive determinants of OCD symptoms. For this purpose, we used a behavioral task (the checking behavioral task) that allowed the expression of repetitive checking behaviors in OCD patients. Methods. - The level of insight was assessed in 20 checking OCD patients with the Brown Assessment of Beliefs Scale (BABS). Patients were subjected to the checking behavioral task during which we assessed the "uncertainty cost" at the time of decision-making that lead to checking behavior. Results. - We found a positive correlation between the level of insight and the uncertainty cost during decision-making leading to the performance of checking behaviors. Conclusion. - These first experimental findings suggest the existence of a relationship between insight and cognitive determinants underlying OCD symptoms. (C) 2011 Elsevier Masson SAS. All rights reserved.