Metacognition and episodic memory in obsessive-compulsive disorder.

Memory deficits in patients with obsessive-compulsive disorder (OCD) have been frequently reported but are not sufficiently accounted for by cognitive models of OCD. The aim of the study was to identify cognitive mechanisms that might be able to explain memory deficits in OCD. We hypothesized that a self-conscious meta-cognitive style might be responsible for reduced memory performance in OCD. Episodic verbal memory performance was assessed in 23 participants with OCD (DSM-IV criteria) and 22 matched controls. Cognitive self-consciousness was assessed with a self-report measure derived from the Meta-Cognitions Questionnaire (MCQ). Compared to controls, OCD participants showed reduced immediate and delayed recall of complex verbal material and increased self-reported levels of cognitive self-consciousness. Multiple regression analyses indicated that group differences in story recall were significantly mediated by self-reported trait cognitive self-consciousness. Results point to the deteriorating effects of a thought-focused cognitive style on effortful encoding processes in OCD.