Don’t judge a book by its cover: ADHD-like symptoms in obsessive compulsive disorder

The link between ADHD-like inattention and obsessions and compulsions during treatment of youth with OCD

“…Even though our pediatric sample findings are consistent with recent conclusions about the nature of ADHD symptoms in adults with OCD (Abramovitch et al, 2012; 2013), our results are preliminary in nature and limited by a small sample size and relatively few children diagnosed with ADHD per diagnostic interview ( n = 9/50). Studying a larger number of children who meet diagnostic criteria for both conditions would allow us to draw stronger conclusions regarding changes in clinically meaningful attention problem in children with primary OCD.…”

“…This result suggests that inattention symptoms observed in an assessment of a child with OCD may not indicate a comorbid ADHD diagnosis, but rather a downstream consequence of obsessional thinking. Our findings may reflect the recently proposed concept that clinical obsessions can overload the executive system, resulting in deficits like inattention (Abramovitch et al, 2012; Abramovitch et al, 2013) and extend this pattern of findings to a treatment-seeking group of children and adolescents, a group in which ADHD is especially likely to be diagnosed (Faraone, Biederman, & Mick, 2006). Results suggest that other ADHD symptoms such as impulsivity and hyperactivity, however, may not decrease following OCD treatment.…”

“…Exhaustion of the executive system caused by obsessive thinking could result in behaviors that are phenomenologically similar to symptoms of ADHD (e.g., distractibility, forgetfulness), but instead are related OCD. Indeed, Abramovitch and colleagues (2012; Abramovitch, Dar, Mittelman, & Schweiger 2013) found that while obsessions and compulsions may be linked with ADHD symptoms and executive dysfunction among individuals with OCD, the two constructs seem to be unrelated in people with subclinical levels of obsessive-compulsive symptoms. Finally, numerous studies have demonstrated that adults with OCD are less behaviorally impulsive than healthy controls (Abramovitch & McKay, 2016), though these results have not been replicated with children and adolescents.…”

Intrusive Uncertainty in Obsessive Compulsive Disorder

“…This structure is observed to trigger further activity in the dorsolateral prefrontal cortex, correlated with enhanced cognitive flexibility to changing task demands. 17 Notably, under-activity in the frontostriatal pathway (including the orbitofrontal cortex and anterior cingulate cortex) is observed in ADHD (Abramovitch et al, 2013), suggesting an opposition in the two disorders related to the avoidance of error. resources may well cross a threshold in capturing the full attention of the subject.…”

“…Notably, under‐activity in the frontostriatal pathway (including the orbitofrontal cortex and anterior cingulate cortex) is observed in ADHD (Abramovitch et al , ), suggesting an opposition in the two disorders related to the avoidance of error.…”