Top-down and bottom-up contributions to memory performance in OCD: A multilevel meta-analysis with clinical implications.

Abstract

Despite extensive coverage of a relationship between memory performance and executive function in the obsessive-compulsive disorder (OCD) literature, the relative contributions of specific aspects of executive control have remained elusive. We, therefore, extend our previous multilevel meta-analysis (Persson et al., 2021), where demand on executive function was the most significant determinant of memory deficits in OCD, and provide a finer-grained analysis of executive control via a segregation into top-down (attentional control, maintenance and updating, planning) and bottom-up (perceptual integration, perceptual salience) contributions. Our multilevel meta-analytic approach allowed us to accommodate the interdependency of 255 effect sizes from 131 studies, totaling 4,101 OCD patients. Results revealed that maintenance and updating (top-down) and perceptual integration (bottom-up) predicted memory performance generally, and specifically in those with clinical OCD. Exploratory analyses suggested that this effect may be somewhat different among subclinical OCD groups; however, these findings should be considered with conceptual and analytical caveats in mind. We explain these results via deficient sensory (perceptual integration) and working memory (maintenance and updating) gating mechanisms and propose a model to accommodate their expression in OC symptoms. In conclusion, our meta-analysis has expanded understanding of cognitive performance in OCD and identifies the possibility of untapped cognitive targets for intervention.

Therapeutic games to reduce anxiety and depression in young people: A systematic review and exploratory meta‐analysis of their use and effectiveness

“…This analysis considers three levels of variance components distributed across the model, including variance between effect sizes from the same study and variance between studies; this therefore allows for an examination of how effect sizes vary between participants (Level 1), outcomes (Level 2) and studies (Level 3; Assink & Wibbelink, 2016). This approach produces a robust analysis and has been successfully implemented in recent meta-analytical research (Harkin et al, 2023;Persson et al, 2021).…”

Altered prefrontal beta oscillatory activity during removal of information from working memory in obsessive-compulsive disorder

“…It may explain why people suffering from unwanted intrusive thoughts are unable to clear their obsessions from working memory. A recent multilevel meta-analysis proposed a model of memory deficits in OCD, with maintenance and updating (top-down) and perceptual integration (bottom-up) predicting the memory performance of OCD patients [ 39 ]. The present findings of impaired inhibitory control (through prefrontal beta power) of no-longer-relevant information in OCD patients support the top-down framework of the model.…”