Exploring Retrospective Biases in Obsessive-Compulsive Disorder: an Experience-Sampling Study

Abstract

Standard methods of symptom assessment for obsessive-compulsive disorder (OCD) entail retrospective report of symptoms over a specified period (e.g., a week, a month). However, such methods may be subject to recall bias, leading to symptom assessments potentially discrepant from actual patient experience. The current study explored potential recall biases in two domains of symptom severity, distress, and interference, using experience-sampling methods (ESMs). Twenty-one adults with a primary diagnosis of OCD rated distress and interference of their two most upsetting obsessions and compulsions four times daily for 6 to 10 days using a modified version of the Yale-Brown Obsessive Compulsive Scale. After the ESM period, participants provided retrospective estimates of the same symptoms. Overall, participant’s retrospective ratings were significantly greater than their average ESM ratings. Results suggest the presence of recall biases of OCD symptom severity, potentially obscuring detection of symptom change and interfering with progress monitoring. Future directions and implications are discussed.