Neuropsychological performance in childhood OCD: A preliminary study

Abstract

This preliminary survey indicates that OCD children may have deficits for cognitive flexibility and planning ability and differ from adults with OCD in not presenting with poor response inhibition or memory deficits. Larger, multi-site studies are warranted to help delineate the neurocognitive deficits associated with childhood OCD.

Cognitive flexibility differentiates young adults exhibiting obsessive-compulsive behaviors from controls

“…Cognitive flexibility is defined as the ability to switch attention from one task to another or change behaviors after receiving negative feedback and has been linked to many psychiatric disorders including attention-deficit/hyperactivity disorder (ADHD; Sergeant et al, 2003;Willcutt et al, 2005;Rommelse et al, 2007), obsessive-compulsive and related disorders (e.g., OCD, TTM, pathological skin picking; Deckersbach et al, 2000;Okasha et al, 2000;Kuelz et al, 2004;Bohne et al, 2005;Chamberlain et al, 2005;Bannon et al, 2006;Chamberlain, et al, 2006;Lawrence et al, 2006;Chamberlain et al, 2007a;Chamberlain et al, 2007b;Britton et al, 2010;Odlaug et al, 2010;Ornstein et al, 2010), anorexia nervosa and bulimia nervosa (Tchanturia et al, 2004;Gillberg et al, 2007;Tchanturia et al, 2011;Galimberti et al, 2012), and depression (Marazziti et al, 2010; Meiran et al, 2011;Lee et al, 2012), among others. From a clinical perspective, cognitive flexibility may be particularly beneficial in helping to explain the development of OCBs.…”

Reduced Prefrontal Activation in Pediatric Patients With Obsessive-Compulsive Disorder During Verbal Episodic Memory Encoding

“…The most widely accepted neurobiological hypotheses focus on a dysfunction of the cortico-striatal-thalamic-cortical (CSTC) loop, which integrates the prefrontal cortex (PFC) with different regions in basal ganglia [6][7][8][9][10][11] . Consistent with this model, the literature has shown cognitive deficits related to PFC functioning in both adult 12 and pediatric [13][14][15] OCD samples. One of the most consistent neuropsychological findings is disruption in episodic memory [16][17][18][19][20][21] , which has been recently shown to be the most consistently impaired cognitive function in adults with OCD by two independent meta-analyses 22,23 .…”

“…The fact that we did not find memory or semantic clustering deficits between groups could be explained, at least in part, by the age of the participants and by the fact that PFC is still under development 72 , even in the typically developing control group. It is possible that behavioral differences emerge later in development, converting into deficits in adulthood (after living many years in the presence of symptoms), as hypothesized by Savage and Rauch 72 and confirmed by other pediatric OCD literature 13,15,20,24,[73][74][75] . Therefore, our imaging results could be interpreted as a latent deficit of the disorder that may manifest behaviorally in the future.…”

“…One of the most consistent neuropsychological findings is disruption in episodic memory [16][17][18][19][20][21] , which has been recently shown to be the most consistently impaired cognitive function in adults with OCD by two independent meta-analyses 22,23 . In general, neuropsychological studies with pediatric OCD samples have also found the same pattern of cognitive deficits [13][14][15]20,24 , including memory, that could be related to deficits in the CSTC circuitry.…”

Traumatic and Adverse Attachment Childhood Experiences are not Characteristic of OCD but of Depression in Adolescents

“…Secondly, the rules for inferring childhood experience may not be fully applicable in clinical populations, as all studies of the AAI discriminative validity [53,54] have been conducted in normal populations. A paucity of childhood memories in the AAI may not express defensive exclusion, but a memory deficit as has been shown to occur in paediatric OCD [64,65] or be due to executive functioning problems [64,[66][67][68][69][70]. The absence of such memories may have led to elevated rejection scores and to an underestimation of love scores, given the rules of experience scores in the AAI-CCS.…”