Neuropsychological investigations in obsessive–compulsive disorder: A systematic review of methodological challenges

Abramovitch, Amitai; Mittelman, Andrew; Tankersley, Amelia P.; Abramowitz, Jonathan S.; Schweiger, Avraham

doi:10.1016/j.psychres.2015.04.025

Cited by 48 publications

(36 citation statements)

References 74 publications

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“…Abramovitch et al, 2015). Meta-analyses have reported increased perseverative errors on the WCST: ( g =−.51; k =21)(Shin et al, 2013) and ( d =.44; k =42)(Snyder et al, 2015).…”

Section: Cognitive Inflexibility In Ocd: Attentional Set Shiftingmentioning

confidence: 99%

Cognitive inflexibility in Obsessive-Compulsive Disorder

Gruner¹,

2017

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Obsessive-Compulsive Disorder (OCD) is characterized by maladaptive patterns of repetitive, inflexible cognition and behavior that suggest a lack of cognitive flexibility. Consistent with this clinical observation, many neurocognitive studies suggest behavioral and neurobiological abnormalities in cognitive flexibility in individuals with OCD. Meta-analytic reviews support a pattern of cognitive inflexibility, with effect sizes generally in the medium range. Heterogeneity in assessments and the way underlying constructs have been operationalized point to the need for better standardization across studies, as well as more refined overarching models of cognitive flexibility and executive function. Neuropsychological assessments of cognitive flexibility include measures of attentional set shifting, reversal and alternation, cued task switching paradigms, cognitive control measures such as the Trail-Making and Stroop tasks, and several measures of motor inhibition. Differences in the cognitive constructs and neural substrates associated with these measures suggest that performance within these different domains should be examined separately. Additional factors, such as the number of consistent trials prior to a shift and whether a shift is explicitly signaled or must be inferred from a change in reward contingencies, may influence performance, and thus mask or accentuate deficits. Several studies have described abnormalities in neural activation in the absence of differences in behavioral performance, suggesting that our behavioral probes may not be adequately sensitive, but also offering important insights into potential compensatory processes. The fact that deficits of moderate effect size are seen across a broad range of classic neuropsychological tests in OCD presents a conceptual challenge, as clinical symptomatology suggests greater specificity. Traditional cognitive probes may not be sufficient to delineate specific domains of deficit in this and other neuropsychiatric disorders; a new generation of behavioral tasks that test more specific underlying constructs, supplemented by neuroimaging to provide greater insight into the underlying processes, may be needed.

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“…Abramovitch et al, 2015). Meta-analyses have reported increased perseverative errors on the WCST: ( g =−.51; k =21)(Shin et al, 2013) and ( d =.44; k =42)(Snyder et al, 2015).…”

Section: Cognitive Inflexibility In Ocd: Attentional Set Shiftingmentioning

confidence: 99%

Cognitive inflexibility in Obsessive-Compulsive Disorder

Gruner¹,

2017

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“…However, there is no consensus that such a deficit exists in OCD with inconsistencies between studies (6) using reversal learning (7,8), task switching (9,10), or intra/extra-dimensional set shifting (11,12) paradigms. Beyond methodological considerations like small sample sizes (13,14), the clinical heterogeneity of OCD patients may have contributed to these discrepant results (15)(16)(17)(18)(19). In contrast, activation of OCD patients' prefrontal regions has been more consistently reported as dysfunctional while performing flexibility tasks, in particular the orbitofrontal cortex (OFC) (20,21).…”

Section: Introductionmentioning

confidence: 99%

A cross-species assessment of behavioral flexibility in compulsive disorders

Benzina

N’Diaye

Pélissolo

et al. 2019

Preprint

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Short running title: Flexibility and compulsive behaviors in mice and menABSTRACT Background: Compulsive behaviors, one of the core symptoms of Obsessive-Compulsive Disorder (OCD), are defined as repetitive behaviors performed through rigid rituals. The lack of behavioral flexibility has been as being one of the primary causes of compulsions, but studies exploring this dimension have shown inconsistencies in different tasks performed in human and animal models of compulsive behavior. The aim of this study was so to assess the involvement of behavioral flexibility in compulsion, with a similar approach across different species sharing a common symptom of compulsivity.Methods: 40 OCD patients, 40 healthy individually matched control subjects, 26 C57BL/6J Sapap3 KO mice and 26 matched wildtype littermates were included in this study. A similar reversal learning task was designed to assess behavioral flexibility in parallel in these two species.Results: When considered as homogeneous groups, OCD patients and KO mice expressing compulsive behaviors did not significantly differ from their controls regarding behavioral flexibility. When clinical subtypes were considered, only patients exhibiting checking compulsions were impaired with more trials needed to reach the reversal criterion. In KO mice, a similarly impaired subgroup was identified. For both species, this impairment did not result in a greater perseveration after reversal, but in a greater lability in their responses in the reversal condition. Moreover, this impairment did not correlate with the severity of compulsive behaviors. Conclusions:In our cross-species study, we found no consistent link between compulsive behaviors and a lack of behavioral flexibility. However, we showed in both species that the compulsive group was heterogeneous in term of performance in our reversal learning task. Among the compulsive subjects, we identified a subgroup with impaired performance not due to perseverative and rigid behaviors as commonly hypothesized, but rather to an increase in response lability.

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“…Indeed, the heterogeneity in findings across studies may be due, at least in part, to differences in OCD symptom presentation across studies. However, almost half of the existing neuropsychological investigations in OCD do not take different symptom dimensions into consideration (Abramovitch, Mittelman, Tankersley, Abramowitz, & Schweiger, ). A growing body of evidence suggests that different symptom dimensions may relate to varying clinical characteristics, neural mechanisms, patterns of neuropsychological performance, and treatment response (Mataix‐Cols, do Rosario‐Campos, & Leckman, ).…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, the heterogeneity in findings across studies may be due, at least in part, to differences in OCD symptom presentation across studies. However, almost half of the existing neuropsychological investigations in OCD do not take different symptom dimensions into consideration (Abramovitch, Mittelman, Tankersley, Abramowitz, & Schweiger, 2015 . Authors of a recent meta-analysis took this heterogeneity into account by comparing neuropsychological functioning in discrete OCD groups of "washers" versus "checkers" (Leopold & Backenstrass, 2015).…”

Section: Introductionmentioning

confidence: 99%