Cognitive flexibility in OCD: challenging the paradigm

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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Impaired cognitive plasticity and goal-directed control in adolescent obsessive–compulsive disorder

Psychological Medicine ◽

10.1017/s0033291717003464 ◽

2018 ◽

Vol 48 (11) ◽

pp. 1900-1908 ◽

Cited By ~ 18

Author(s):

Julia Gottwald ◽

Sanne de Wit ◽

Annemieke M. Apergis-Schoute ◽

Sharon Morein-Zamir ◽

Muzaffer Kaser ◽

...

Keyword(s):

Academic Success ◽

Learning And Memory ◽

Obsessive Compulsive Disorder ◽

Cognitive Flexibility ◽

Behavioural Control ◽

Obsessive Compulsive ◽

Cognitive Domains ◽

Compulsive Disorder ◽

Paired Associates ◽

Cognitive Plasticity

BackgroundYouths with obsessive–compulsive disorder (OCD) experience severe distress and impaired functioning at school and at home. Critical cognitive domains for daily functioning and academic success are learning, memory, cognitive flexibility and goal-directed behavioural control. Performance in these important domains among teenagers with OCD was therefore investigated in this study.MethodsA total of 36 youths with OCD and 36 healthy comparison subjects completed two memory tasks: Pattern Recognition Memory (PRM) and Paired Associates Learning (PAL); as well as the Intra-Extra Dimensional Set Shift (IED) task to quantitatively gauge learning as well as cognitive flexibility. A subset of 30 participants of each group also completed a Differential-Outcome Effect (DOE) task followed by a Slips-of-Action Task, designed to assess the balance of goal-directed and habitual behavioural control.ResultsAdolescent OCD patients showed a significant learning and memory impairment. Compared with healthy comparison subjects, they made more errors on PRM and PAL and in the first stages of IED involving discrimination and reversal learning. Patients were also slower to learn about contingencies in the DOE task and were less sensitive to outcome devaluation, suggesting an impairment in goal-directed control.ConclusionsThis study advances the characterization of juvenile OCD. Patients demonstrated impairments in all learning and memory tasks. We also provide the first experimental evidence of impaired goal-directed control and lack of cognitive plasticity early in the development of OCD. The extent to which the impairments in these cognitive domains impact academic performance and symptom development warrants further investigation.

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The Relationship Between Obsessive Belief Level and Cognitive Flexibility in Patients with Obsessive Compulsive Disorder

Nöro Psikiyatri Arşivi ◽

10.5152/npa.2017.21648 ◽

2017 ◽

Author(s):

Hatice Sahin ◽

Ferdi Kosger ◽

Altan Essizoglu ◽

Gokay Aksaray

Keyword(s):

Obsessive Compulsive Disorder ◽

Cognitive Flexibility ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

The Relationship

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No evidence for deficient set-shifting in obsessive-compulsive disorder

European Psychiatry ◽

10.1016/s0924-9338(11)71864-8 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 153-153

Author(s):

E. Fadda ◽

S. Sottocorno ◽

R. Martoni ◽

E. Galimberti ◽

L. Bellodi

Keyword(s):

Obsessive Compulsive Disorder ◽

Cognitive Flexibility ◽

Analysis Of Covariance ◽

Future Research ◽

Healthy Controls ◽

Set Shifting ◽

Neurocognitive Deficits ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Information Sampling

IntroductionVarious neurocognitive deficits have been identified across several domains in Obsessive-Compulsive Disorder (OCD), including memory, response inhibition attentional processing and cognitive flexibility.ObjectiveThe aim of this study was to evaluate Set Shifting in patients with Obsessive-Compulsive Disorder compared with Healthy Controls (HC).Methods44 OCD patients, according to DSM-IV criteria (APA, 1994) and 32 healthy controls (HC) were recruited. Information Sampling Task (IST) selected from Cambridge Neuropsychological Test Automated Battery (CANTAB) was administered to all participants to assess cognitive flexibility. The two IST versions were counterbalanced in the samples. Delta index has been calculated as the difference between the number of the boxes opened in the fixed condition and the number of boxes opened in the decrease condition.ResultsGroup differences in Delta IST were assessed within an analysis of covariance (ANCOVA) model including Groups (control vs. OCD) as between-subject factor and age as a covariate. Results show a no significant main effect for group on IST Delta index (p = 0.26). A significant effect of the covariates (age) on Delta IST(p = 0.027) was found.ConclusionResults suggests that cognitive flexibility, assessed by Information Sampling Task, was not impaired in OCD patients. Future research should evaluate this evidence, taking in account for OCD clinical subtypes.

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