The characteristics of obsessional thinking: Difficulty demonstrating the obvious?

Abstract

Clinical observations suggest that attention to detail, indecision, and doubt, are reliably associated with obsessive‐compulsive disorder and obsessional personality disorder. Several experimental investigations have sought to demonstrate the cognitive substrates of these clinical features. Category formation, decision making, and mnestic impairment have been the principal foci of academic interest. A critical review of this literature suggests that results are inconsistent, attributable to mood, or undemonstrated in clinical populations. Further work correcting for previous methodological weaknesses is necessary. Suggestions are made with respect to new areas worthy of investigation. The administration of neuropsychological tests of frontal lobe functioning to obsessional patients is recommended. Further, investigations of ‘epistemological sense’ are recommended. Finally, a new treatment strategy for compulsive checkers—inspired by the mnestic deficit hypothesis—is described. Continued investigation of the cognitive substrates of obsessional illness is considered to be a worthwhile endeavour. Such investigations extend the remit of cognitive clinical psychology, compliment advances in biological psychiatry, and suggest novel treatment interventions.