Verbalizations during compulsions in obsessive-compulsive disorder

•Verbalizing during compulsions was common.•Verbalizing most often took the form of reassurance.•Verbalizing was associated with greater memory confidence.•Verbalizing was associated with better memory.

Research on memory in obsessive-compulsive disorder (OCD) suggests that people with OCD lack confidence in their memory and that repetition of an action actively erodes confidence in memory for it. Meanwhile, research on general memory processes suggests that when people say aloud the material they seek to remember, just once, memory is improved (MacLeod, Gopie, Hourihan, Neary, & Ozubko, 2010). It could prove useful to examine the extent to which people with OCD verbalize during their compulsions in order to better recall them later, and to examine the effectiveness of verbalizing when it is repeated. However, we do not know whether people with OCD speak aloud during compulsions. This study examined the frequency, purpose, and impact of verbalization on self-reported memory accuracy and confidence in people with OCD (N=35). Over half reported speaking aloud while engaging in their compulsions, most often to improve confidence that the action had been done properly. Tendency to verbalize was associated with better self-reported memory for the action and greater memory confidence, but not with urge to repeat the action. These data suggest that research on memory strategies may be usefully brought to bear on our understanding of the persistence of compulsions.