Disentangling Within- and Between-Person Effects During Response Inhibition in Obsessive-Compulsive Disorder

Background: Obsessive-compulsive disorder (OCD) has been related to worse performance, abnormal brain activity, and functional connectivity during response inhibition. Whether these findings are indications of stable traits that contribute to the development of the disorder, or whether they are a result of the state severity of obsessions and anxiety, remains unclear since previous research mainly has employed cross-sectional designs. The present study aimed to assess longitudinal between- and within-person relationships between symptoms, task performance, right inferior frontal gyrus brain activation, and connectivity between the right amygdala and the right pre-supplementary motor area in 29 OCD patients before and after concentrated exposure and response prevention treatment.Method: Patients received exposure and response prevention delivered during 4 consecutive days, following the Bergen 4-day Treatment format. Patients performed a Stop Signal Task during 3T functional Magnetic Resonance Imaging the day before treatment, as well as 1 week and 3 months after treatment completion. Multilevel models were used to analyze disaggregated within- and between-person effects over time. Independent variables were scores on the symptom severity scales for OCD, anxiety, depression, and state distress during scanning. Dependent variables were reaction time for go trials, stop signal response time, task-related brain activation and connectivity.Results: A positive between-person effect was found for obsessive-compulsive, anxiety, and depressive symptom severity on go trial reaction time, indicating that patients with higher symptom scores on average respond slower during accurate go trials. We also found no significant between- or within-person relations between symptom severity and task-related activation or fronto-limbic connectivity.Conclusions: The between-person findings may point toward a general association between slower processing speed and symptom severity in OCD. Longitudinal studies should disaggregate between- and within-person effects to better understand variation over time.

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Punishment promotes response control deficits in obsessive-compulsive disorder: evidence from a motivational go/no-go task

Psychological Medicine ◽

10.1017/s0033291712001018 ◽

2012 ◽

Vol 43 (2) ◽

pp. 391-400 ◽

Cited By ~ 21

Author(s):

S. Morein-Zamir ◽

M. Papmeyer ◽

C. M. Gillan ◽

M. J. Crockett ◽

N. A. Fineberg ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Response Inhibition ◽

Symptom Severity ◽

Response Style ◽

Obsessive Compulsive ◽

Response Control ◽

Commission Errors ◽

Compulsive Disorder ◽

Axis I ◽

Reward And Punishment

BackgroundObsessive-compulsive disorder (OCD) has been associated with response inhibition deficits under motivationally neutral contingencies. We examined response inhibition performance in the presence of reward and punishment. We further investigated whether the hypothesized difficulties in flexibly updating behaviour based on external feedback in OCD would also lead to a reduced ability to adjust to changes in the reward and punishment contingencies.MethodParticipants completed a go/no-go task that used punishments or rewards to promote response activation or suppression. The task was administered to OCD patients free of current Axis-I co-morbidities including major depression (n = 20) and a group of healthy controls (n = 32).ResultsCompared with controls, patients with OCD had increased commission errors in punishment conditions, and failed to slow down immediately after receiving punishment. The punishment-induced increase in commission errors correlated with self-report measures of OCD symptom severity. Additionally, patients did not differ from controls in adapting their overall response style to the changes in task contingencies.ConclusionsIndividuals with OCD showed reduced response control selectively under punishment conditions, manifesting in an impulsive response style that was related to their current symptom severity. This stresses failures of cognitive control in OCD, particularly under negative motivational contingencies.

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Differential patterns of brain activation between hoarding disorder and obsessive-compulsive disorder during executive performance

Psychological Medicine ◽

10.1017/s0033291719000515 ◽

2019 ◽

Vol 50 (4) ◽

pp. 666-673

Author(s):

Maria Suñol ◽

Ignacio Martínez-Zalacaín ◽

Maria Picó-Pérez ◽

Clara López-Solà ◽

Eva Real ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Brain Activation ◽

Anterior Cingulate ◽

Error Processing ◽

Obsessive Compulsive ◽

Hoarding Disorder ◽

Compulsive Disorder ◽

Executive Performance ◽

Response Switching ◽

The Right

AbstractBackgroundPreliminary evidence suggests that hoarding disorder (HD) and obsessive-compulsive disorder (OCD) may show distinct patterns of brain activation during executive performance, although results have been inconclusive regarding the specific neural correlates of their differential executive dysfunction. In the current study, we aim to evaluate differences in brain activation between patients with HD, OCD and healthy controls (HCs) during response inhibition, response switching and error processing.MethodsWe assessed 17 patients with HD, 18 patients with OCD and 19 HCs. Executive processing was assessed inside a magnetic resonance scanner by means of two variants of a cognitive control protocol (i.e. stop- and switch-signal tasks), which allowed for the assessment of the aforementioned executive domains.ResultsOCD patients performed similar to the HCs, differing only in the number of successful go trials in the switch-signal task. However, they showed an anomalous hyperactivation of the right rostral anterior cingulate cortex during error processing in the switch-signal task. Conversely, HD patients performed worse than OCD and HC participants in both tasks, showing an impulsive-like pattern of response (i.e. shorter reaction time and more commission errors). They also exhibited hyperactivation of the right lateral orbitofrontal cortex during successful response switching and abnormal deactivation of frontal regions during error processing in both tasks.ConclusionsOur results support that patients with HD and OCD present dissimilar cognitive profiles, supported by distinct neural mechanisms. Specifically, while alterations in HD resemble an impulsive pattern of response, patients with OCD present increased error processing during response conflict protocols.

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Controlled trial of exposure and response prevention in obsessive–compulsive disorder

The British Journal of Psychiatry ◽

10.1192/bjp.171.2.135 ◽

1997 ◽

Vol 171 (2) ◽

pp. 135-139 ◽

Cited By ~ 114

Author(s):

Merran Lindsay ◽

Rocco Crino ◽

Gavin Andrews

Keyword(s):

Obsessive Compulsive Disorder ◽

Symptom Severity ◽

Controlled Trial ◽

Response Prevention ◽

Control Group ◽

Exposure And Response Prevention ◽

Obsessive Compulsive ◽

Anxiety Management ◽

General Anxiety ◽

Compulsive Disorder

BackgroundExposure and response prevention is considered a treatment of choice for obsessive–compulsive disorder (OCD). Yet there have been very few randomised controlled trials employing credible placebo conditions. This study compares exposure and response prevention with a general anxiety management intervention.MethodEighteen patients meeting DSM–IV criteria for OCD were randomly assigned to either exposure and response prevention or anxiety management. Both treatments involved approximately 15 hours of therapy over a three-week period.ResultsThere was a significant reduction in obsessive–compulsive symptoms following treatment with exposure and response prevention, while no change occurred in the control group. This was found to be statistically significant using a composite measure of OCD symptom severity, patient ratings of interference and therapist ratings of symptom severity.ConclusionsThese findings suggest that the symptom reductions associated with behaviour therapy for OCD are a result of the specific techniques of exposure and response prevention, rather than non-specific aspects of the therapy process. General anxiety management techniques are not effective in the treatment of OCD.

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Obsessive Compulsive Disorder and Response Inhibition: Meta-analysis of the Stop-Signal Task

10.1101/2021.07.16.452538 ◽

2021 ◽

Author(s):

Kendall Mar ◽

Parker Townes ◽

Petros Pechlivanoglou ◽

Paul Arnold ◽

Russell James Schachar

Keyword(s):

Reaction Time ◽

Obsessive Compulsive Disorder ◽

Response Inhibition ◽

Meta Analysis ◽

Stop Signal ◽

Mean Difference ◽

Stop Signal Task ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Stop Signal Reaction Time

This systematic review and meta-analysis updates evidence pertaining to deficient response inhibition in obsessive-compulsive disorder (OCD) as measured by the stop-signal task (SST). We conducted a meta-analysis of the literature to compare response inhibition in patients with OCD and healthy controls, meta-regressions to determine relative influences of age and sex on response inhibition impairment, and a risk of bias assessment for included studies using the Newcastle-Ottawa Scale (NOS). Stop-signal reaction time (SSRT), which estimates the latency of the stopping process deficit, was significantly longer in OCD samples than in controls, reflecting inferior inhibitory control (Raw mean difference = 23.43ms; p = <0.001; 95% CI = [17.42, 29.45]). We did not observe differences in mean reaction time (MRT) in OCD compared to controls (Raw mean difference = 2.51ms; p = 0.755; 95% CI = [-13.27, 18.30]). Age impacted effect size of SSRT, indicating a greater deficit in older patients than younger ones. We did not observe a significant effect of sex on SSRT or MRT scores.

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Stop Signal Reaction Time Deficits in a Lifetime Obsessive-Compulsive Disorder Sample

Journal of the International Neuropsychological Society ◽

10.1017/s1355617716000540 ◽

2016 ◽

Vol 22 (7) ◽

pp. 785-789 ◽

Cited By ~ 15

Author(s):

Nicole C.R. McLaughlin ◽

Jason Kirschner ◽

Hallee Foster ◽

Chloe O’Connell ◽

Steven A. Rasmussen ◽

...

Keyword(s):

Reaction Time ◽

Obsessive Compulsive Disorder ◽

Response Inhibition ◽

Stop Signal ◽

Stop Signal Task ◽

Control Group ◽

Healthy Controls ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Stop Signal Reaction Time

AbstractObjectives: Several studies have found impaired response inhibition, measured by a stop-signal task (SST), in individuals who are currently symptomatic for obsessive-compulsive disorder (OCD). The aim of this study was to assess stop-signal reaction time (SSRT) performance in individuals with a lifetime diagnosis of OCD, in comparison to a healthy control group. This is the first study that has examined OCD in participants along a continuum of OCD severity, including approximately half of whom had sub-syndromal symptoms at the time of assessment. Methods: OCD participants were recruited primarily from within the OCD clinic at a psychiatric hospital, as well as from the community. Healthy controls were recruited from the community. We used the stop signal task to examine the difference between 21 OCD participants (mean age, 42.95 years) and 40 healthy controls (mean age, 35.13 years). We also investigated the relationship between SST and measures of OCD, depression, and anxiety severity. Results: OCD participants were significantly slower than healthy controls with regard to mean SSRT. Contrary to our prediction, there was no correlation between SSRT and current levels of OCD, anxiety, and depression severity. Conclusions: Results support prior studies showing impaired response inhibition in OCD, and extend the findings to a sample of patients with lifetime OCD who were not all currently above threshold for diagnosis. These findings indicate that response inhibition deficits may be a biomarker of OCD, regardless of current severity levels. (JINS, 2016, 22, 785–789)

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