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An investigation of the experience of control through the sense of agency in people with obsessive–compulsive disorder: a review and meta-analysis

Published online by Cambridge University Press:  25 March 2024

Davide Fausto Borrelli Open the ORCID record for Davide Fausto Borrelli [Opens in a new window] ,
Matteo Tonna Open the ORCID record for Matteo Tonna [Opens in a new window]  and
Reuven Dar
Davide Fausto Borrelli*
Affiliation:
Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
Matteo Tonna
Affiliation:
Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy Department of Mental Health, Local Health Service, Parma, Italy
Reuven Dar
Affiliation:
School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
*
Corresponding author: Davide Fausto Borrelli; Email: davidefausto.borrelli@unipr.it
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Abstract

The construct of sense of agency (SoA) has proven useful for understanding mechanisms underlying obsessive–compulsive disorder (OCD) phenomenology, especially in explaining the apparent dissociation in OCD between actual and perceived control over one’s actions. Paradoxically, people with OCD appear to experience both diminished SoA (feeling unable to control their actions) and inflated SoA (having “magical” control over events). The present review investigated the extent to which the SoA is distorted in OCD, in terms of both implicit (ie, inferred from correlates and outcomes of voluntary actions) and explicit (ie, subjective judgment of one’s control over an outcome) measures of SoA. Our search resulted in 15 studies that met the criteria for inclusion in a meta-analysis, where we also examined the potential moderating effects of the type of measure (explicit versus implicit) and of the actual control participants had over the outcome. We found that participants with OCD or with high levels of OCD symptoms show lower implicit measures of SoA and at the same time tend to overestimate their control in situations where they do not actually have it. Together, these findings support the hypothesized dissociation in OCD between actual and perceived control over one’s actions.

Keywords

Obsessive-compulsive disorderOCDsense of agencyfeeling of agencysense of controlcompulsive behaviorritual behavior
Type
Review
Information
CNS Spectrums , First View , pp. 1 - 9
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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