A Pilot Study of Metacognitive Training in U.S. Republican Leaners: Reducing Polarization Toward LGBTIQ+ Persons.

Negative attitudes and stigmatization toward sexual minorities is a cause of minority stress of non-heterosexual persons on an individual level and has a negative impact on democratic coexistence in postmodern, plural society on a societal level. Derived from clinical research, we developed a short metacognitive training (MCT) intended to induce doubt toward inaccurate beliefs about LGBTIQ+ persons. We expected this MCT to reduce homonegativity, threat perceptions of LGBTIQ+ persons, and to foster extended outgroup tolerance compared to an education and a no-treatment control condition. We tested this hypothesis in U.S. Republican leaners who represent a social group that is likely to hold homonegative attitudes. We randomly assigned 490 U.S. Republican leaners to an MCT condition comprising 16 questions and respective answers (n = 166) vs. an education control condition (n = 164) vs. a no-treatment control condition (n = 160). We found that Republican leaners after receiving MCT (1) had a significant reduction of homonegativity (ds ≥ 0.28), (2) significantly perceived LGBTIQ+ persons as less threatening (ds ≥ 0.30), and (3) were significantly more tolerant of various outgroups such as LGBTIQ+ persons, feminists, liberals, and climate activists (ds ≥ 0.23) relative to both control conditions. The small effects of this short intervention and the possibility of systematically applying MCT in social discourse to reduce homonegativity with its potential significance for LGBTIQ+ individuals' mental health are discussed. Furthermore, we highlight this pilot study's significance toward intervention possibilities regarding political division and polarization in postmodern, democratic societies.

The effects of non-diagnostic information on confidence and decision making.

Many decision-making tasks are characterized by a combination of diagnostic and non-diagnostic information, yet models of responding and confidence almost exclusively focus on the contribution of diagnostic information (e.g., evidence associated with stimulus discriminability), largely ignoring the contribution of non-diagnostic information. An exception is Baranski and Petrusic's Journal of Experimental Psychology: Human Perception and Performance, 24(3), 929-945, (1998) doubt-scaling model, which predicts a negative relationship between non-diagnostic information and confidence, and between non-diagnostic information and accuracy. In two perceptual-choice tasks, we tested the effects of manipulating non-diagnostic information on confidence, accuracy and response time (RT). In Experiment 1, participants viewed a dynamic grid consisting of flashing blue, orange and white pixels and indicated whether the stimulus was predominantly blue or orange (using a response scale ranging from low-confidence blue to high-confidence orange), with the white pixels constituting non-diagnostic information. Increasing non-diagnostic information reduced both confidence and accuracy, generally slowed RTs, and led to an increase in the speed of errors. Experiment 2 replicated these results for a decision-only task, providing further support for the doubt-scaling model of confidence.

Agents of scientific uncertainty: Conflicts over evidence and expertise in gender-affirming care bans for minors.

Globally, as medical and mental health associations increasingly have expressed support for the gender-affirming care model for trans and gender expansive youth, this model has been paradoxically banned across the United States. Ban proponents have deemed the science behind gender-affirming care to be dangerously uncertain. Examining the first gender-affirming care ban for minors, Arkansas's Save Adolescents from Experimentation (SAFE) Act of 2021, we addressed the following two questions: 1) who are the scientists, clinicians, and political organizations that promote SAFE and similar bans?; and 2) what are the scientific arguments they make to defend SAFE in federal court? First, we developed a typology of the various "agents of scientific uncertainty" behind these bans, drawing on literature from the sociology and history of science and medicine as well as the political economy of scientific doubt. Second, we created and qualitatively analyzed a dataset featuring 375 unique citations referenced throughout federal litigation over SAFE to identify these agents of scientific uncertainty's arguments. We sorted these arguments into eight categories, which reveal how agents distorted scientific evidence and exaggerated real uncertainties and risks in gender-affirming care. This case study establishes a frame for understanding the growing prevalence and legal impact of scientific arguments against gender-affirming care.

Career self-efficacy as a mediator between career-specific parental behaviors and school career support on career doubt.

This study evaluates whether career-specific parental behaviors and school career supports predict career doubt via the mediation of career self-efficacy. 227 participants aged between 18 and 25 completed an online questionnaire. Structural equation model (SEM) analysis showed that school career support was significantly related to career doubt via the mediation of career self-efficacy. However, the hypothesized mediation of career self-efficacy between career-specific parental behaviors and career doubt was not supported. Limitation and implications are discussed.

'Am I a good enough therapist?': Self-doubt among speech and language therapists.

BACKGROUND: The therapeutic process is fraught with various feelings. This research focused on a specific type of negative feeling, namely self-doubt (SD). AIM: To explore and characterize the nature of SD among speech and language therapists (SLTs) (the frequency of SD, situations that trigger SD, emotions and thoughts related to SD, and coping strategies) in various stages of occupational experience. METHODS & PROCEDURES: A total of 267 SLTs answered an online survey. Respondents represented SLTs in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed situations that trigger SD, thoughts, and emotions associated with SD and the background information of the respondents. Frequency distributions of the responses of the participants were determined, and independent-samples Kruskal-Wallis tests were conducted to examine if there were differences between groups that differed in their occupational experience on the frequency of SD, attitudes towards SD and emotions related to SD. OUTCOMES & RESULTS: Differences were found between SLTs in various stages of professional development in several aspects of SD. Novice SLTs reported significantly higher levels of SD compared with experienced SLTs. In the face of SD, novice SLTs consider career abandonment significantly more than do experienced SLTs. They perceive themselves as a failure when experiencing SD to a significantly greater extent than do more experienced SLTs. In addition, SD is associated with various negative emotions. CONCLUSIONS & IMPLICATIONS: Self-doubt is a natural professional feeling. It may be harmful especially in the early stages of professional development. Our findings call for support and guidance in the face of SD. WHAT THIS PAPER ADDS: What is already known on the subject Healthcare professionals report feeling SD. This feeling may have deleterious effects on well-being and career satisfaction and is especially harmful in young therapists. What this paper adds to existing knowledge This study characterizes the nature of SD among SLTs in various stages of occupational experience. Our findings indicate that SD is reported among SLTs at all career stages, especially in novice SLTs. Self-doubt is associated with a range of negative thoughts and emotions, and it may be triggered by various situations. Nonetheless, it is a topic that our respondents rarely learn about. What are the potential or actual clinical implications of this work? Normalising and validating SD is important to SLTs' resilience and may facilitate coping. This may be achieved by learning about the subject of SD in graduate programmes. In addition, mentors should create a safe learning culture to allow sharing SD and challenging situations, especially in the first years of occupational experience.

What's your religious coping profile? Differences in religious orientation and subjective sleep among religious coping groups in the United States.

OBJECTIVES: To determine various profiles/subgroups of religious copers based on indices of positive and negative religious coping; and to determine whether religious copers differ in their religious orientations, subjective sleep characteristics, and strategies used to cope with sleep problems. METHOD: Six hundred and ninety-five adults (77.3% female, 70.4% White) in the United States completed a 20-minute online questionnaire in January 2020. RESULTS: Results of a latent profile analysis, based on 8 indicators of positive and negative religious coping, indicated a 5-class solution: (i) "Absent" (n = 101, 14.5%); (ii) "Anxious" (n = 122, 17.6%); (iii) "Ambivalent" (n = 101, 14.5%); (iv) "Secure" (n = 200, 28.8%); and (v) "Conflicted" copers (n = 171, 24.6%). Results of MANOVA tests indicated that Secure copers reported the least religious doubt and highest religious-based social support. Conflicted and Anxious copers had the worst sleep quality, while Secure, Ambivalent, and Absent copers had healthier sleep profiles. In terms of strategies used to cope with sleep problems, Secure and Conflicted copers reported the greatest use of prayer and meditation, while the use of technology was most prevalent among Conflicted and Anxious copers. CONCLUSIONS: Individuals differ in their combined use of positive and negative religious coping, which is related to differences in their religious orientation, sleep characteristics, and strategies used to cope with sleep problems. Religious leaders should be mindful of the diverse ways in which religious coping strategies are harnessed to effectively cater to the unique religious and sleep needs of their members.

Determination of server location in emergency care systems: an index proposal using data envelopment analysis and the hypercube queuing model.

The objective of this article is to propose a new composite index (CI) that helps to determine the most effective location of servers in an Emergency Care System (ECS), using Benefit of the Doubt (BoD)/Data Envelopment Analysis (DEA) and the Hypercube queuing model. The CI proposed was developed in four stages: (1) definition of a number of possible ECS configurations through the application of mathematical partitions and permutations; (2) application of the hypercube queuing model to determine performance parameters for each ECS configuration; (3) application of DEA/BoD to build the CI and generate performance rankings, and (4) evaluation of the rankings obtained to define the best configuration for the ECS analyzed. Data from two real cases from Brazil were used to assess the CI proposal. The results obtained confirm that: (a) the hypercube model could, relatively quickly, determine the configuration parameters generated; (b) the application of an appropriate DEA/BoD model enabled the different configurations to be ranked with good discrimination; (c) a pattern in the relationship between ambulance concentration and configuration effectiveness could be identified; and (d) the CI proposed would benefit ECS managers who are making resource location decisions.

The Seeking Proxies for Internal States (SPIS) Model of OCD - A Comprehensive Review of Current Findings and Implications for Future Directions.

The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) explains symptoms of OCD as stemming from attenuated access to internal states, which is compensated for by using proxies, which are indices of these states that are more discernible or less ambiguous. Internal states in the SPIS model are subjective states that are not accessible to others, encompassing physiological states, motivations, preferences, memories, and emotions. Compensatory proxies in OCD include fixed rules and rituals as well as seeking and relying on external information. In the present review, we outline the SPIS model and describe its basic tenets. We then use the SPIS conceptualization to explain two pivotal OCD-related phenomena - obsessive doubt and compulsive rituals. Next, we provide a detailed overview of current empirical evidence supporting the SPIS in several domains, including physiological states, emotions, sense of understanding, decision-making, and sense of agency. We conclude by discussing possible neural correlates of the difficulty in accessing internal states, focusing on the anterior insular cortex (AIC) and highlighting potential clinical implications of the model to the treatment of OCD.

The Logic and Value of the Presumption of Doli Incapax (Failing That, an Incapacity Defence).

Children who do not understand the serious wrongness of their actions lack criminal capacity and cannot be convicted. At common law, children under seven are deemed to lack criminal capacity, children over 14 possess full capacity and children between seven and 14 are rebuttably presumed to lack capacity; the prosecution must prove capacity beyond reasonable doubt. Australia has increased the minimum age of criminal responsibility (MACR) to 10 and is considering a further increase. England & Wales and Northern Ireland have raised the MACR to 10 but have abolished the rebuttable presumption: at age 10, all children are assigned full criminal capacity. This article agrees with international calls for the MACR to be raised but argues that it is more important that the rebuttable presumption should be retained and extended. Children's brains and decision-making capacities continue to develop throughout their teenage years at different rates. The rebuttable presumption provides individualised justice for children facing developmental difficulties. To wrongfully convict a child who lacks capacity will unjustly damage their life chances. Where a child does have capacity, a variety of evidence may be available to the prosecution to prove it. If the prosecution fails to discharge the burden, the child should be acquitted. The acquittal may be mistaken, but this error is far less harmful than a wrongful conviction.

Long-term practice of intuitive inquiry meditation modulates EEG dynamics during self-schema processing.

Objective: Intuitive inquiry meditation is a unique form of Buddhist Zen/Chan practice in which individuals actively and intuitively utilize the cognitive functions to cultivate doubt and explore the concept of the self. This event-related potential (ERP) study aimed to investigate the neural correlates by which long-term practice of intuitive inquiry meditation induces flexibility in self-schema processing, highlighting the role of doubt and belief processes in this exploration. Methods: Twenty experienced and eighteen beginner meditators in intuitive inquiry meditation were recruited for this ERP study. The interactions of doubt and belief processes with concepts of the self and Buddha were investigated. A 128-channel electroencephalography (EEG) system was used to collect EEG data. The ERP data were processed and analyzed using EEGLAB. Results: The data showed a double dissociation between beginners and experienced meditators (monks) in the concepts of the self and Buddha: intuitive inquiry meditation reduced the brain activity of beginners when viewing Buddha image but not when viewing a picture of themselves. However, in experienced meditators, intuitive inquiry meditation reduced brain activity when they viewed images of themselves but not when they viewed Buddha image. Further event-related spectral perturbation (ERSP) analysis revealed that experienced meditators had a greater theta spectral power and higher intertrial coherence (ITC), indicating that they could more flexibly modulate ongoing cognitive processes than beginner meditators. Conclusion: Intuitive inquiry meditation could help beginner meditators detach from the concept of Buddha but not from that of the self. However, in experienced meditators, the opposite was true. ERSP analysis showed that only experienced meditators exhibited significant alterations in brain activity dynamics during intuitive inquiry meditation, which might enable these practitioners to become spontaneously detached from the concept of the self. These findings revealed the neural mechanism by which long-term practice of intuitive inquiry meditation can influence the doubting process and its effect on self-schema processing.

Absence of Reliable Screening Methods That Prove the Use of Gene Doping in Sports / Ausencia de métodos de tamizaje fiables que demuestren el uso del dopaje genético en el deporte / Falta de métodos de triagem confiáveis para provar o uso de doping genético no esporte

Abstract: Sport raises the level of human physical activity within the limits of genetic traits. The results of gene therapy have attracted some to think of using its technologies to create an "indomitable athlete." World Anti-Doping Agency (WADA) applies uncertain genetic testing procedures to establish cases of this type of doping. Yet, if the results of these procedures are doubtful, then doubt must be interpreted in favor of the athlete concerned.

Resumen: El deporte eleva el nivel de actividad física humana dentro de los límites de los rasgos genéticos. Los resultados de la terapia génica han atraído a algunos a pensar en utilizar sus tecnologías para crear un 'atleta indomable'. La Agencia Mundial Antidopaje (AMA) aplica procedimientos de pruebas genéticas inciertos para establecer casos de este tipo de dopaje. Sin embargo, si los resultados de estos procedimientos son dudosos, entonces la duda debe interpretarse a favor del atleta en cuestión.

Resumo: O esporte eleva o nível da atividade física humana dentro dos limites dos traços genéticos. Os resultados da terapia genética têm atraído alguns a pensar em usar suas tecnologias para criar um "atleta indomável". A Agência Mundial Antidoping (WADA) aplica procedimentos incertos de testes genéticos para estabelecer casos deste tipo de dopagem. Entretanto, se os resultados desses procedimentos forem incertos, então a incerteza deve ser interpretada em favor do atleta em questão.

The bewitchment of our intelligence: Scepticism about other minds in anthropology.

This article aims at characterizing how the problem of scepticism about other minds appears in anthropology. To do so, I offer a close reading of Nils Bubandt's book, The Empty Seashell (2014), a study of witchcraft and doubt on the North Maluku Island of Halmahera. Through its deep engagement with issues revolving around scepticism, I take the book to be an example of the tendency to consider the problem of sceptical doubt about others as a problem of access to the inner thoughts and feelings of other people. By looking closely at its attempts to respond to this problem, I endeavour to shed light on the ways in which, in working the problem of scepticism out, we may be doing exactly the reverse: giving into the sceptical impulse. How does a certain way of asking questions about scepticism nourish the drive to it? I am interested in the drift towards scepticism that precisely takes the form of a claim against it. In showing that such a drift is prompted by a certain use of language, I hope to elucidate some ways in which scepticism is lived and is thus not merely an intellectual conundrum, but an ordinary human condition.

A study of doubt in obsessive-compulsive disorder.

BACKGROUND AND OBJECTIVES: Obsessive-compulsive disorder (OCD) has been referred to as the "doubting disease," yet there has been little foundational research on its phenomenology and characteristics. Studies of doubt have relied on researchers' idiosyncratic conceptualizations of the construct, resulting in varied assessment methods and different prevalence rates (11-75%). We examined the nature and characteristics of doubt in people with clinical and subclinical OCD so as to identify its nature and characteristics, and factors that may be unique to OCD. METHODS: A semi-structured interview about doubt was administered to people with OCD (N = 44) and with subclinical OCD (N = 21). RESULTS: Doubt was highly prevalent and manifested as a form of obsession, uncertainty about whether a task was done properly, and/or lack of confidence in memory and perceptions. All participants took action to resolve doubt and/or proactively pre-empt or reduce future doubt. Doubt was deeply connected to negative core beliefs about the self. The groups did not differ on their experience of doubt, except that greater symptom severity was associated with greater interference from doubt, less ability to resist it, and less success of proactive, but not reactive, strategies to manage it. LIMITATIONS: We relied on retrospective report, and the subclinical group was relatively small. CONCLUSIONS: In subclinical and clinical OCD, doubt is pervasive, manifests in three domains, is connected to negative core beliefs, and is highly aversive. Continued empirical study of doubt is essential to proper assessment and to development of theories and treatment of OCD.

"Modest doubt is called the beacon of the wise"-Incorporating uncertainty in risk analysis from Shakespeare to today.

"Modest doubt is call'd the beacon of the wise."-William Shakespeare, Troilus and Cressida. Although the character Hector warns his fellow Trojans with this line not to engage in war against the Greeks, Shakespeare's works are replete with characters who do not incorporate modest doubt, or any consideration of uncertainty, in their risk decisions. Perhaps Shakespeare was simply a keen observer of human nature. Although risk science has developed tremendously over the last five decades (and scientific inquiry over five centuries), the human mind still frequently defaults to conviction about certain beliefs, absent sufficient scientific evidence-which has effects not just on individual lives, but on policy decisions that affect many. This perspective provides background on the Shakespearean quote in its literary and historical context. Then, as this quote is the theme of the 2023 Society for Risk Analysis Annual Meeting, we describe how "modest doubt"-incorporating the notion of uncertainty into risk analysis for individual and policy decisions-is still the "beacon of the wise" today.

Religious doubt and depression in later life: gender differences in the buffering role of supportive pastoral relationships.

OBJECTIVES: Research suggests that religious/spiritual (R/S) matters take on increasing importance in later life and tend to be favorably associated with mental health, but religious doubt or uncertainty can undermine this salubrious relationship. Few studies assess whether social relationships, and the support contained within them, can mitigate these negative mental health consequences. The current study focuses on an important yet understudied social relationship in the context of spiritual struggles in later life: informal support from a religious pastor. Members of the clergy occupy a highly prestigious position in the church and are often a trusted resource for older adults as they confront problems. DESIGN/PARTICIPANTS: We use two waves of longitudinal data of Christian older adults in the Religion, Health, and Aging Study (2001-2004) from the United States (N = 639) to test whether support from a pastor attenuates any detrimental mental health effects of carrying religious doubt in later life. RESULTS: Results from lagged dependent variable models suggest that increases in religious doubt are associated with increases in depression over time, and that greater pastoral support attenuates the relationship between increases in religious doubt and depression, but only for men. CONCLUSIONS: We highlight the need for future research to explore this important social relationship with religious clergy for older adults in confronting both spiritual and secular challenges and the importance of considering gender differences in the process. We also suggest several practical implications for religious clergy, family members, and older adults in dealing with or helping others confront spiritual struggles.

Development and application of a composite circularity index.

Resource depletion and environmental pollution are increasingly a matter of concern for their adverse effects on ecosystems, human health, and the economy. Circular Economy (CE) practices can help us address these challenges. This paper proposes a composite circularity index (CI) to assess the level of implementation of CE practices. The main advantage of the proposed index is its ability to combine multiple indicators of circularity for different units operating in a given sector (given as inputs), using a 'Benefit of the Doubt' model. This new model is innovative in the manner it deals with ordinal scales and also by considering both relative and absolute performance indices. These indices are computed using mathematical programming tools, building on ideas from Data Envelopment Analysis models. Although the model can be applied to any sector, this work addresses the hotel industry in particular. The selection of indicators for this CI was based on seven blocks of the Circular Economy Action Plan and a literature review of circular practices. An application of the proposed index is performed by using data from Portuguese and Spanish hotels. The proposed CI allows the identification of the organizations with the best and worst performance in implementing the CE practices and clarifying the benchmarks they could follow to improve their level of circularity. Moreover, the index analysis also provides specific targets for improvement, indicating which circular practices should be improved for the lower performers to reach the implementation levels of the best performers.

Manufactured doubt and the EPA 2020 chrysotile asbestos risk assessment.

While all forms of asbestos have been determined to be carcinogenic to humans by the International Agency for Research on Cancer (IARC) as well as other authoritative bodies, the relative carcinogenic potency of chrysotile continues to be argued, largely in the context of toxic tort litigation. Relatively few epidemiologic studies have investigated only a single form of asbestos; however, one study that included an asbestos textile plant located in Marshville, North Carolina that processed chrysotile asbestos was used by the United States Environmental Protection Agency (EPA) in 2020 to help inform the agency's chrysotile asbestos risk assessment. During the EPA proceedings toxic tort defense consultants submitted comments to the EPA docket and made public presentations asserting that the Marshville plant had processed amphibole asbestos types and should not be used for the chrysotile risk assessment. A detailed evaluation of defense consultant assertions and supporting information and a full assessment of the available information concerning asbestos types used at the Marshville plant was undertaken. The preponderance of evidence continues to support the conclusion that neither amosite nor crocidolite were likely to have been processed in the Marshville textile plant. Defense consultants' assertions about chrysotile use are not supported by the preponderance of evidence and constitute an example of manipulation of information to cast uncertainty and doubt rather than to seek truth and contribute to the body of scientific evidence.

The person of the therapist: therapists' personal characteristics as predictors of alliance and treatment outcomes.

Objective Studies examining the unique contribution that the therapist has on outcomes (i.e., "therapist effects") have increased in recent years. Therapist effects are believed to occur via how the therapist's interpersonal and intrapersonal qualities influence the therapeutic relationship, which in turn influences outcomes. The current study focused on the extent to which professional self-doubt, counseling self-efficacy, and humility are therapist qualities that influence treatment outcomes. Methods: Data were collected from 46 therapists at a multi-site community behavioral health organization. Therapists completed measures of therapist characteristics. Therapists' responses were matched with de-identified archival client data (N = 1, 817) that contained an outcome and alliance measure administered every session. Multilevel modeling was used to determine the extent to which therapists' personal characteristics predicted client outcomes. Results: Results of the unconditional model for the alliance measure indicated a lack of growth in alliance scores across treatment. Approximately 5% of the variance in rate of growth for treatment outcome was between therapists. When controlling for the effects of counseling self-efficacy, professional self-doubt was marginally significant. When counseling-self-efficacy was removed from the model, professional self-doubt was no longer marginally significant. Conclusion: The findings highlight the complexity of therapist effects and the need for future research on this topic.

Check or Go? Impact of Doubt on the Hierarchical Organization of the Mediofrontal Area.

BACKGROUND: Based on numerous imaging and electrophysiological studies, the presupplementary motor area (pre-SMA) and the rostral cingulate motor area are cortical regions considered to be essential to voluntary movement initiation and behavioral control. However, their respective roles and functional interactions remain a long-standing and still debated question. METHODS: Here, we trained 2 rhesus monkeys (Macaca mulatta) in a complex cognitive task to compare the neuronal activity of these 2 regions on the medial wall during both perceptual and internally guided decisions. RESULTS: We confirmed the implication of both areas throughout the decision process. Critically, we demonstrate that instead of a stable invariant role, the pre-SMA and rostral cingulate motor area manifested a versatile hierarchical relationship depending on the mode of movement initiation. Whereas pre-SMA neurons were primarily engaged in decisions based on perceptual information, rostral cingulate motor area neurons preempted the decision process in case of an internally doubt-driven checking behavior, withholding pre-SMA recruitment during the time spent inhibiting the habitual action. CONCLUSIONS: We identified a versatile hierarchical organization of the mediofrontal area that may substantially affect normal and pathological decision processes because adaptive behaviors, such as doubt-checking and its compulsive counterpart, rely on this subtle equilibrium in controlling action initiation.

Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis.

People with obsessive-compulsive disorder (OCD) tend to distrust their memory, perception, and other cognitive functions, and many OCD symptoms can be traced to diminished confidence in one's cognitive processes. For example, poor confidence in recall accuracy can cause doubt about one's memory and motivate repeated checking. At the same time, people with OCD also display performance deficits in a variety of cognitive tasks, so their reduced confidence must be evaluated in relation to their actual performance. To that end, we conducted an exhaustive review and meta-analysis of studies in which OCD participants and non-clinical control participants performed cognitive tasks and reported their confidence in their performance. Our search resulted in 19 studies that met criteria for inclusion in the quantitative analysis, with all studies addressing either memory or perception. We found that both performance and reported confidence were lower in OCD than in control participants. Importantly, however, confidence was more impaired than performance in participants with OCD. These findings suggest that people with OCD are less confident in their memory and perception than they should be, indicating a genuine under-confidence in this population. We discuss potential mechanisms that might account for this finding and suggest avenues for further research into under-confidence and related meta-cognitive characteristics of OCD.