New study out on external proxies in OCD

Read more journal club articles here

One of Rücklab’s favorite research groups has done it again.

Lazarov, A., Dar, R., Liberman, N., & Oded, Y. (2012). Obsessive-compulsive tendencies and undermined confidence are related to reliance on proxies for internal states in a false feedback paradigm. Journal of behavior therapy and experimental psychiatry, 43(1), 556–564. doi:10.1016/j.jbtep.2011.07.007


The researchers in this study have previously (reported in the Rucklab journal club) investigated the association of obsessive-compulsive (OC) tendencies with a general lack of subjective conviction regarding internal states. Results showed that this in turn leads to compensatory seeking of and reliance on external proxies for these states.

This article was further investigation on external proxies and was divided in two sub studies. In the first study, high and low OC participants were presented with a pre-programmed false biofeedback showing either increasing or decreasing levels of muscle tension. Results showed that high OC participants were more affected by false biofeedback when judging their own level of muscle tension compared to low OC participants.

In the second study, 50% of a non-selected sample received instructions that undermined their confidence in the ability to assess the level of relaxation. The other 50% was not induced by any undermined confidence.  Results showed that undermined confidence participants were more affected by false biofeedback when judging their own level of relaxation as compared to control participants.

How is this relevant to clinicians?

The authors have a really nice focus on this: “Therapists can use this framework to discuss with patients the difficulties they have in trusting their own internal states and feelings. SPIS (Seeking Proxies for Internal States) conceptualization can be used to explain to patients how these doubts and uncertainties can lead to compensatory compulsive behaviors such as excessive reliance on norms, rules and rituals and to seeking external validation from others. Therapists can use SPIS terminology to explain the patients the ironic effect of using and relying on proxies for internal states, which may lead to vicious circles that end up further reducing their confidence in those states.”

Read the full text version here

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