Executive dysfunctions in Anorexia Nervosa patients, obsessive-compulsive patients and their unaffected relatives: searching for a new intermediate phenotype

IntroductionSome authors suggested that Anorexia Nervosa (AN) could be part of Obsessive-Compulsive Spectrum. Evidences suggested that Obsessive-Compulsive Disorder (OCD) could be characterized by an impaired neuropsychological profile, referring particularly to cognitive flexibility, decision making and planning. It's possible that these deficits could represent possible endophenotypes that characterizes OCD spectrum.ObjectivesThe aim of this study was compared, cognitive flexibility, decision making and planning in 38 patients with OCD, in 21 patients with AN and in their first degree unaffected relatives (OCD relatives: 46; AN relatives: 21). Results have been also compared to a sample of 41 healthy controls (HC) and their unaffected first degree relatives (43).MethodAll participants have been assessed by a neuropsychological battery composed by the Iowa Gambling Task (IGT), the Wisconsin Sorting Card Test (WISC) and the Hanoi Tower (TH).ResultsResults showed an impaired cognitive flexibility only in OCD patients and their relatives. Patients with AN and their relatives didn’t seem to be characterized by a deficit in this area. Results obtained from the TH scores showed an impaired planning ability both in OCD and AN patients. The same deficit has been also observed in OCD relatives. Impaired decision making seemed to characterize both AN and OCD patients, compared HC. Moreover, OCD and AN relatives showed a deficit performance, suggesting an impairment in this function.ConclusionResults regarding planning and decision making seem to be in line with the hypothesis that this two domains could represent possible endophenotypes of obsessive compulsive spectrum.

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Investigating executive functions in youth with OCD and hoarding symptoms

Bulletin of the Menninger Clinic ◽

10.1521/bumc.2021.85.4.335 ◽

2021 ◽

Vol 85 (4) ◽

pp. 335-357

Author(s):

Melissa Elgie ◽

Duncan H. Cameron ◽

Karen Rowa ◽

Geoffrey B. Hall ◽

Randi E. McCabe ◽

...

Keyword(s):

Decision Making ◽

Executive Functions ◽

Obsessive Compulsive Disorder ◽

Inhibitory Control ◽

Cognitive Flexibility ◽

Primary Diagnosis ◽

Obsessive Compulsive ◽

Compulsive Disorder

Executive functions (EF) deficits are hypothesized to be a core contributor to hoarding symptoms. EF have been studied in adult hoarding populations, but studies in youth are lacking. The current study compared multiple EF subdomains between youth with obsessive-compulsive disorder (OCD) and youth with OCD and hoarding symptoms. Forty youth (8–18 years old) with a primary diagnosis of OCD were recruited. Participants were divided by hoarding severity on the Child Saving Inventory (CSI) into either the “hoarding group” (upper 33.3%) or the “low-hoarding group” (lower 66.7%). Groups were compared on EF tasks of cognitive flexibility, decision-making, and inhibitory control. Youth in the hoarding group exhibited significantly higher cognitive flexibility and lowered perseveration than the low-hoarding group. Hoarding and low-hoarding groups did not differ in any other EF subdomain. Hoarding symptoms in youth with OCD were not associated with deficits in EF subdomains; instead, youth who hoard exhibited higher cognitive flexibility compared to youth with low hoarding symptoms.

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Obsessive-Compulsive Disorder and Decision Making under Ambiguity: A Systematic Review with Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11020143 ◽

2021 ◽

Vol 11 (2) ◽

pp. 143

Author(s):

Veronica Nisticò ◽

Andrea De Angelis ◽

Roberto Erro ◽

Benedetta Demartini ◽

Lucia Ricciardi

Keyword(s):

Systematic Review ◽

Decision Making ◽

Obsessive Compulsive Disorder ◽

Clinical Manifestation ◽

Iowa Gambling Task ◽

Meta Analysis ◽

Healthy Controls ◽

Gambling Task ◽

Obsessive Compulsive ◽

Compulsive Disorder

In the last decade, decision-making has been proposed to have a central role in obsessive-compulsive disorder (OCD) aetiology, since patients show pathological doubt and an apparent inability to make decisions. Here, we aimed to comprehensively review decision making under ambiguity, as measured by the Iowa Gambling Task (IGT), in OCD, using a meta-analytic approach. According to PRISMA Guidelines, we selected 26 studies for a systematic review and, amongst them, 16 studies were included in a meta-analysis, comprising a total of 846 OCD patients and 763 healthy controls (HC). Our results show that OCD patients perform significantly lower than HC at the IGT, pointing towards the direction of a decision making impairment. In particular, this deficit seems to emerge mainly in the last three blocks of the IGT. IGT scores in OCD patients under the age of 18 were still significantly lower than in HC. Finally, no difference emerged between medicated and unmedicated patients, since they both scored significantly lower at the IGT compared to HC. In conclusion, our results are in line with the hypothesis according to which decision making impairment might represent a potential endophenotype lying between the clinical manifestation of OCD and its neurobiological aetiology.

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Addicted to compulsion: assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder

CNS Spectrums ◽

10.1017/s1092852919000993 ◽

2019 ◽

Vol 25 (3) ◽

pp. 392-401 ◽

Cited By ~ 2

Author(s):

Giacomo Grassi ◽

Nikos Makris ◽

Stefano Pallanti

Keyword(s):

Decision Making ◽

Obsessive Compulsive Disorder ◽

Gambling Disorder ◽

Iowa Gambling Task ◽

Reward System ◽

Anxiety Symptoms ◽

Self Report ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Olfactory Test

ObjectiveSeveral studies suggested that obsessive-compulsive disorder (OCD) patients display increased impulsivity, impaired decision-making, and reward system dysfunction. In a Research Domain Criteria (RDoC) perspective, these findings are prototypical for addiction and have led some authors to view OCD as a behavioral addiction. Thus, the aim of this study was to investigate similarities and differences on impulsivity, decision-making, and reward system, as core dimensions of addiction, across OCD and gambling disorder (GD) patients.MethodsForty-four OCD patients, 26 GD patients, and 40 healthy controls (HCs) were included in the study. Impulsivity was assessed through the Barratt Impulsiveness Scale, decision-making through the Iowa Gambling Task, and reward system through a self-report clinical instrument (the Shaps-Hamilton Anhedonia Scale) assessing hedonic tone and through an olfactory test assessing hedonic appraisal to odors.ResultsBoth OCD and GD patients showed increased impulsivity when compared to HCs. More specifically, the OCD patients showed cognitive impulsivity, and the GD patients showed both increased cognitive and motor impulsivity. Furthermore, both OCD and GD patients showed impaired decision-making performances when compared to HCs. Finally, GD patients showed increased anhedonia and blunted hedonic response to pleasant odors unrelated to gambling or depression/anxiety symptoms, while OCD patients showed only increased anhedonia levels related to OC and depression/anxiety symptoms.ConclusionOCD patients showed several similarities and some differences with GD patients when compared to HCs on impulsivity, decision-making, and reward system, three core dimensions of addiction. These results could have relevant implications for the research of new treatment targets for OCD.

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Pick a Card, Any Card: The Relationship Between Anxiety, Obsessive-Compulsive Symptoms and Decision-Making

Behaviour Change ◽

10.1017/bec.2016.1 ◽

2016 ◽

Vol 33 (1) ◽

pp. 27-43 ◽

Cited By ~ 1

Author(s):

Angelina Leonello ◽

Mairwen K. Jones

Keyword(s):

Decision Making ◽

Iowa Gambling Task ◽

Clinical Sample ◽

Experimental Manipulation ◽

Control Group ◽

Obsessive Compulsive ◽

Anxious Arousal ◽

Compulsive Disorder ◽

The Relationship ◽

Anxiety Condition

Specific deficits in decision-making have been demonstrated in patients with obsessive-compulsive disorder (OCD). The experience of anxious arousal in obsessive-compulsive (OC) patients has been posited to be responsible for disrupting the cognitive processes that lead to efficacious decision-making (Sachdev & Malhi, 2005). In spite of this, research has neglected to examine explicitly the effect of anxiety on the relationship between decision-making and OCD. The current study investigates whether decision-making differences on the Iowa Gambling Task (IGT) occur as a function of OC symptomatology in a non-clinical sample (n = 110). Participants were randomly allocated to either an anxiety condition (n = 58) or control condition (n = 52). Anxious arousal was induced in the anxiety condition via an experimental manipulation prior to commencing the IGT. Participants in the anxiety condition performed significantly worse than those in the control group on the IGT. However, OC symptomatology did not significantly predict IGT performance. The experience of anxiety did not significantly moderate the relationship between OC symptomatology and IGT performance. These findings indicate that decision-making differences do not occur as a function of OC symptomatology in a non-clinical sample; however, they do suggest that the experience of anxiety significantly impairs decision-making performance. The theoretical and practical applications of the findings are discussed.

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Decision-making impairment in obsessive-compulsive disorder as measured by the Iowa Gambling Task

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2011000500013 ◽

2011 ◽

Vol 69 (4) ◽

pp. 642-647 ◽

Cited By ~ 31

Author(s):

Felipe Filardi da Rocha ◽

Nathália Bueno Alvarenga ◽

Leandro Malloy-Diniz ◽

Humberto Corrêa

Keyword(s):

Decision Making ◽

Obsessive Compulsive Disorder ◽

Iowa Gambling Task ◽

Demographic Characteristics ◽

Healthy Controls ◽

Gambling Task ◽

Obsessive Compulsive ◽

Homogeneous Groups ◽

Compulsive Disorder

OBJECTIVE: This study aims to evaluate the process of decision-making in patients with obsessive-compulsive disorder (OCD) using the Iowa Gambling Task (IGT). In addition, we intend to expand the understanding of clinical and demographic characteristics that influence decision-making. METHOD: Our sample consisted of 214 subjects (107 diagnosed with OCD and 107 healthy controls) who were evaluated on their clinical, demographic and neuropsychological features. Moreover, the Iowa Gambling Task (IGT), a task that detects and measures decision-making impairments, was used. RESULTS: We found that OCD patients performed significantly worse on the IGT. Furthermore, features such as symptoms of anxiety did not influence IGT performance. CONCLUSION: Impaired decision-making seems to be a key feature of OCD. Given that OCD is a complex heterogeneous disorder, homogeneous groups are necessary for an accurate characterization of our findings.

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