Contents lists available at ScienceDirect Journal of Obsessive-Compulsive and Related Disorders journal homepage: www.elsevier.com/locate/jocrd Intentional binding and obsessive-compulsive tendencies: A dissociation between indirect and direct measures of the sense of agency Ela Oren a , Baruch Eitam b , Reuven Dar a, ⁎ a School of Psychological Sciences, Tel Aviv University, 63404 Tel Aviv, Israel b Department of Psychology, University of Haifa, Haifa 3498838, Israel ARTICLE INFO Keywords: Sense of agency Agent OCD Intentional binding Action selection ABSTRACT This study examined whether obsessive-compulsive (OC) tendencies are related to an impaired sense of agency (SoA). We examined agency using both indirect (“implicit”) and direct (“explicit”) measures, aiming to tap into different aspects of the sense of agency. We measured the SoA of participants with high vs. low scores on a measure of OC symptoms indirectly using a task that assesses the intentional binding effect, i.e., the subjective compression of the temporal interval between a voluntary action and its external sensory consequence. We also measured participants' "illusory" SoA using a direct question about their SoA in conditions in which control was objectively absent. As predicted, high OC individuals’ levels of intentional binding were lower, whereas their levels of illusory control were higher than those of low OC individuals. We discuss the contributions of these findings to the understanding of obsessive-compulsive disorder (OCD), stressing the importance of distinguishing between direct and indirect indices of the SoA when studying and/or treating OC individuals. 1. Introduction The sense of agency (SoA) was recently defined by Synofzik, Vosgerau, and Voss (2013) as "the registration that I am the initiator of my actions". The process of perceiving oneself as the agent of his/her actions is based on the integration of external (e.g., seeing the limbs move) and internal cues of proprioception, movement (e.g., feeling the movement itself) and interoception (e.g., physiological arousal (Synofzik et al., 2013; Synofzik, Vosgerau, & Lindner, 2009; Synofzik, Vosgerau, & Newen, 2008)). The weight given to the different cues in the integration process that leads to SoA depends on the relative pre- cision of the each cue (Gentsch & Synofzik, 2014). Aberrant SoA in people with obsessive-compulsive (OC) tendencies and with obsessive-compulsive disorder (OCD) can be explained by the Seeking Proxies for Internal States (SPIS) model of OCD (Lazarov, Cohen, Liberman, & Dar, 2015; Lazarov, Dar, Liberman, & Oded, 2012a, 2012b; Lazarov, Dar, Oded, & Liberman, 2010; Lazarov, Liberman, Hermesh, & Dar, 2014; Liberman & Dar, 2009). The model accounts for OC individuals' doubt and compulsive rituals by postulating that OC individuals have difficulty accessing their own internal states, such as interoceptive/proprioceptive signals, sense of time, bodily states, preferences, emotions, memory, and feeling of knowing. Therefore, when OC individuals are faced with a question related to an internal state, they tend to rely on more discernible proxies for this internal state. The SPIS model has received substantial empirical support in recent years. In one series of studies, biofeedback served as an external proxy for the internal states of relaxation and muscle tension. Participants were high and low scorers on a measure of OC symptoms (Lazarov et al., 2010, 2012a, 2012b) or individuals with OCD who were com- pared to individuals with anxiety disorders and non-clinical controls (Lazarov et al., 2014). In these studies, OC symptoms and OCD were related to uncertainty and impaired performance in relation to the in- ternal states of relaxation and muscle tension. This was demonstrated by increased reliance on both genuine and false biofeedback for these internal states and impaired performance in ability to relax and to produce specific levels of muscle tension without the aid of biofeed- back. Importantly, the clinical study showed that the attenuation of internal states is specific to OCD rather than attributable to anxiety, as the performance of participants with anxiety disorders was identical to that of non-clinical participants and very different from that of OCD participants (Lazarov et al., 2014). Additionally, Dar, Lazarov, and Liberman (2016) found that OCD symptoms were related to attenuated access to affective states. Specifically, OCD tendencies were related to lower scores on the Experiential Branch of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT; Mayer, 2002). According to the SPIS model, various rules, procedures, behaviors or environmental sti- muli can be used as proxies (Liberman & Dar, 2009). As the SoA in a https://doi.org/10.1016/j.jocrd.2017.11.002 Received 18 June 2017; Received in revised form 8 November 2017; Accepted 9 November 2017 ⁎ Corresponding author. E-mail addresses: ela.oren@gmail.com (E. Oren), beitam@psy.haifa.ac.il (B. Eitam), ruvidar@tauex.tau.ac.il (R. Dar). Journal of Obsessive-Compulsive and Related Disorders xxx (xxxx) xxx–xxx 2211-3649/ © 2017 Published by Elsevier Inc. Please cite this article as: Oren, E., Journal of Obsessive-Compulsive and Related Disorders (2017), https://doi.org/10.1016/j.jocrd.2017.11.002