Response Inhibition, Cognitive Flexibility and Working Memory in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder

Abstract

This study analyzed response inhibition, cognitive flexibility and working memory in three groups of patients diagnosed with obsessive-compulsive disorder, social anxiety disorder and generalized anxiety disorder, considering some variables that may influence results (nonverbal reasoning, comorbidity, use of pharmacotherapy). Neuropsychological measures were completed using a computerized Wisconsin card sorting test, Stroop color word test, go/no-go task, digits and Corsi. Significant differences were obtained among groups in cognitive flexibility and working memory variables. The obsessive-compulsive disorder (OCD) group showed the worst results. The social anxiety disorder group obtained greater effect sizes in visuospatial memory. However, significant differences between groups in visuospatial memory were no longer present when nonverbal reasoning was controlled. Comorbidity influenced interference in the OCD and generalized anxiety disorder (GAD) groups. In addition, the executive functions were differently influenced by the level of obsessions and anxiety, and the use of pharmacotherapy. Study limitations include a non-random selection of participants, modest sample size and design type (cross-sectional). The OCD group showed the worst results in flexibility cognitive and verbal working memory. Comorbidity, use of pharmacotherapy and level anxiety and obsessions were variables influencing the performance of executive functions.

Obsessive‐compulsive disorder: Etiology, neuropathology, and cognitive dysfunction

“…Cognitive inflexibility entails reduced ability to appropriately shift attention (e.g., Chamberlain et al., 2005). Notably, research suggests that impaired “set shifting” is a possible endophenotype (Chamberlain et al., 2007b) that is a neuromarker in those with a genetic vulnerability, and a key component of the cognitive profile of OCD (for meta‐analyses, see Abramovitch et al., 2013; Bora, 2020; Snyder et al., 2015) (see also Jalal et al., 2018; Martínez‐Esparza et al., 2021; Rosa‐Alcázar et al., 2021).…”

Cognitive Rigidity, Habitual Tendencies, and Obsessive-Compulsive Symptoms: Individual Differences and Compensatory Interactions

“…Experimentally, cognitive flexibility has widely been shown to be impaired in OCD [e.g., ( 9 )], as well as in obsessive-compulsive personality disorder (OCPD) ( 10 , 11 ), the latter being characterized by extreme perfectionism, order and neatness, often associated with anxiety, with a prevalence of 3–8% in adult populations ( 12 ). However, impaired cognitive flexibility has not been demonstrated to such an extent in other obsessive-compulsive spectrum disorders (OCSDs) such as trichotillomania ( 13 ), or other psychiatric disorders such as generalized anxiety disorder ( 14 , 15 ). This suggests that low cognitive flexibility may act as a specific predictor of OCD, providing support for cognitive flexibility accounts of OCD.…”

Cognitive assessment in a sample of Egyptian patients with Generalized Anxiety Disorder

“…According to Rosa-Alcázar et al, [17], the GAD group obtained strong correlations between scores of the Penn State Worry Questionnaire and Stroop colours (r=0.54, p = 0.003), Interference Stroop (r=0.39,p=0.042), Total Digit (r=0.44), and backward Corsi Span (r=0.41; p=0.035).…”