Did I turn off the stove? Good inhibitory control can protect from influences of repeated checking

The aversiveness of intrusiveness: Evidence from involuntary musical imagery

OBJECTIVE

Intrusive thoughts are characterized by a sense of intrusiveness of foreign entry into cognition. While not always consisting of negative content, intrusive thoughts are almost solely investigated in that context. Involuntary Musical Imagery (INMI) offers a promising alternative, as it is a type of involuntary cognition that can be used to evaluate intrusiveness without negative content.

METHODS

In Study 1, 200 participants completed self-report questionnaires to assess several aspects of intrusiveness: meta-awareness, control, repetitiveness, frequency, and subjective experience of INMI. In Study 2, 203 participants completed self-report questionnaires to explore the clinical characteristics (depression, stress, anxiety, and rumination) which might mediate the connection between INMI frequency and INMI negative experience.

RESULTS

Study 1 revealed, through exploratory factor analysis, that intrusiveness shares variance with the negative experience of INMI but not with INMI frequency. In Study 2, ruminative thinking was found to mediate the relationship between frequent INMI and the negative experience of INMI.

CONCLUSION

These results suggest that INMI might be used to investigate intrusiveness in the lab without the potential confound of negative emotions. In addition, the results suggest that neither the content nor the frequency of intrusive thoughts can solely explain why these thoughts are aversive to some but not others. Ruminative style might be the missing link to explain how and why these intrusive thoughts become aversive and obsessive. In other words, we suggest that the cause for intrusiveness lies not in the thought or repetitiveness, but in the thinker.

Memory confidence and memory accuracy deterioration following repeated checking: A systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

Rachman (2002) proposed a reciprocal detrimental relationship between repeated checking and memory confidence. Many experimental studies have indicated that repeated checking causes memory confidence deterioration while having no or little impact on memory accuracy. Thus, our main objective was to carry out a comprehensive meta-analysis to synthesize the existing research. Investigating the potential heterogeneity across studies using several moderator variables was also of interest.

METHODS

The comprehensive search of several databases yielded 29 studies comprising 67 substudies (N = 2180). Considering the substantial heterogeneity across these (sub)studies, data were analyzed using a random-effects meta-analytic approach. Subgroup analyses and meta-regressions were also carried out to explain some of the heterogeneity across studies.

RESULTS

The pooled effect size (Hedges' g) was equal to 0.870 (95% CI = 0.712-1.027, p < 0.001) for memory confidence and 0.213 (95% CI = 0.118-0.307, p < 0.001) for memory accuracy. However, we found evidence of publication bias in the literature. For both outcome variables, the effect was larger in studies inducing high responsibility or using real stimuli. A greater number of repeated checks was only associated with memory confidence decline.

LIMITATIONS

Results obtained from the analogue samples may have lower generalizability to people with OCD.

CONCLUSIONS

Repeated checking considerably deteriorates memory confidence while having a minor effect on memory accuracy. It is not clear whether memory accuracy contributes to memory confidence deterioration, particularly because memory accuracy declines were moderate in studies inducing high responsibility or using real objects.

The Effect of Symptom-Provocation on Inhibitory Control in Obsessive-Compulsive Disorder Patients Is Contingent upon Chronotype and Time of Day

Studies have shown that alertness can affect inhibitory control, the mechanism responsible for stopping behaviors, thoughts, or emotions. Inhibitory control is particularly important for helping individuals with Obsessive-Compulsive Disorder (OCD) resisting their symptoms. Chronotype is the mechanism governing an individual's fluctuation of alertness throughout the day. Previous studies have shown that individuals with a 'morning' chronotype have worse OCD symptoms in the evening and vice versa. We administered a novel 'symptom-provocation stop signal task' (SP-SST), in which individually tailored OCD triggers were presented and inhibitory control was measured. Twenty-five treatment-seeking OCD patients completed the SP-SST three times per day for seven consecutive days. Stop signal reaction time (SSRT), which measures inhibitory control, was calculated separately for symptom-provocation trials and for neutral trials. Results yielded that: (a) stopping was significantly harder in the symptom-provocation compared to neutral trials, and (b) the chronotype by time-of-day interaction predicts inhibition for both symptom-provocation and neutral trials, indicating better inhibition in the optimal time of day. Furthermore, we concluded that individually tailored OCD triggers have a detrimental effect on inhibitory control. Most importantly, higher alertness levels, which can be predicted by the interaction of chronotype and time of day, affect inhibitory control, both in general and for OCD triggers specifically.

An Integrative Model for Understanding Obsessive-Compulsive Disorder: Merging Cognitive Behavioral Theory with Insights from Clinical Neuroscience

Several models have been proposed for the emergence and maintenance of obsessive-compulsive disorder (OCD). Although these models have provided important insights and inspired treatment development, no single model has yet sufficiently accounted for the complexed phenotype of the disorder. In the current paper, we propose a novel model that integrates elements from cognitive behavioral models of OCD with neurocognitive approaches to the disorder. This Reciprocal Interaction Model (RIM) for OCD is based on two assumptions: (a) similar observed symptoms can stem from different etiological processes; and (b) neuropsychological deficits (such as reduced response inhibition and overreliance on the habit formation system) and cognitive behavioral processes (such as temporary reduction in anxiety after engaging in compulsive behaviors) mutually affect each other such that abnormalities in one system influence the second system and vice-versa-creating a vicious cycle of pathological processes. Indeed, the bidirectional inhibitory connection between anxiety/obsessions and executive control is at the heart of the model. We begin by briefly reviewing the current models for OCD. We then move on to describe the RIM, the supporting evidence for the model, the model's predictions, and potential clinical implications.

Waxing and waning: The roles of chronotype and time of day in predicting symptom fluctuations in obsessive-compulsive disorder using a daily-monitoring design

Obsessive-compulsive disorder (OCD) symptoms fluctuate throughout the day, but scientists are not sure what underlies these fluctuations. One factor which may explain how OCD symptoms wax and wane throughout the day is alertness. Increased alertness is associated with greater inhibitory control, a factor which plays a significant role in patients' ability to overcome their OCD symptoms. The current study examined the relationship between chronotype (morningness/eveningness preference, a measure of alertness) and within-day OCD symptom severity fluctuations. We hypothesized that increased alertness leads to better inhibitory abilities and, therefore, reduced OCD symptoms. OCD Symptoms were measured through 7-days of monitoring in which participants were asked to retrospectively rate their symptoms at several timepoints throughout the day. Chronotype was measured using the Morningness/Eveningness Questionnaire (MEQ). Consistent with our hypotheses, results revealed an interaction between chronotype and time of day, such that those with an eveningness preference tended to have worse symptoms in the morning, and vice versa. In addition, we also report novel findings regarding the effect of bedtime, sleep duration, and sleep quality on symptom severity the next day. Taken together, these findings suggest that alertness may modulate OCD symptom severity throughout the day such that individuals experience more severe symptoms during times of low alertness. The clinical and theoretical implications of these findings are discussed.

Affordances, response conflict, and enhanced-action tendencies in obsessive-compulsive disorder: an ERP study

BACKGROUND

Obsessive-compulsive disorder (OCD) is characterized by recurrent, intrusive thoughts and/or behaviors. OCD symptoms are often triggered by external stimuli. Therefore, it has been suggested that difficulty inhibiting responses to stimuli associated with strong action tendencies may underlie symptoms. The present electrophysiological study examined whether stimuli evoking a strong automatic response are associated with enhanced action tendencies in OCD participants relative to healthy controls.

METHODS

The lateralized readiness potential (LRP) and the N2 event-related potential (ERP) components were used as measures of action tendencies and inhibition, respectively. ERPs were recorded while 38 participants diagnosed with OCD and 38 healthy controls performed a variation of the Stroop task using colored arrows.

RESULTS

The OCD group presented with larger LRP amplitudes than the control group. This effect was found specifically in the incongruent condition. Furthermore, an interaction effect was found between group and congruency such that the OCD group showed a reduced N2 in the incongruent condition compared to the congruent condition, whereas the control group demonstrated the opposite effect. Results support the hypothesis that OCD is characterized by stronger readiness-for-action and impaired inhibitory mechanisms, particularly when the suppression of a dominant response tendency is required. Our results were supported by source localization analyses for the LRP and N2 components. These findings were specific to OCD and not associated with anxiety and depression symptoms.

CONCLUSIONS

The present results support the notion of stronger habitual behavior and embodiment tendencies in OCD and impaired inhibitory control under conditions of conflict.

Momentary Induction of Inhibitory Control and Its Effects on Uncertainty

Deficient inhibitory control and difficulty resolving uncertainty are central in psychopathology. How these factors interact remains unclear. Initial evidence suggests that inducing inhibitory control improves resolution of uncertainty. This may occur only when participants overcome action tendencies, which are dominant tendencies to perform certain behaviors. Our study explored the links between inhibitory control and behavioral responses to uncertainty while manipulating action-tendencies’ strength. In three experiments, 132 undergraduates completed a task that combined induction of momentary changes in inhibitory control level (Stroop task), with responses to uncertainty (visual-search task). We manipulated action-tendencies’ strength by varying uncertainty proportions across experiments. Results indicated that momentary induction of inhibitory control improved resolution of high-uncertainty during mostly low-uncertainty trials but hampered resolution of low-uncertainty during mostly high-uncertainty trials. Identical inhibitory control induction did not affect resolution of uncertainty when uncertainty conditions were equalized. Participants’ subjective uncertainty measures were similar across experiments. Our results suggest that momentary inhibitory control induction modifies behavioral responses to uncertainty and selectively affects trials that require overcoming dominant action tendencies. These findings indicate a potentially unique and multifaceted relationship between inhibitory control and behavioral responses to uncertainty. Clinical implications for models of Obsessive-Compulsive Disorder and experimental implications to post-conflict processes are discussed.

But first, coffee: The roles of arousal and inhibition in the resistance of compulsive cleansing in individuals with high contamination fears

Inhibition plays a crucial role in reducing intrusive thoughts and compulsive behaviors, such as handwashing, in response to the feeling of disgust. The current study examines whether manipulating arousal can facilitate inhibition and the resistance of compulsive cleansing. Forty-seven participants with high contamination fears were recruited for this study. Participants were divided into a caffeine group or a no-caffeine group. Participants touched a potentially contaminated and disgusting stimulus ("dirty" diapers) and were asked to wait as long as they could before washing their hands. Only the caffeine group exhibited greater pre-post stop-signal reaction time improvement in the stop-signal task, indicating improved inhibition. Participants in the caffeine group exhibited significantly lower subjective distress and urges-to-wash their hands both after touching the stimulus and while waiting to engage in the cleansing behavior. Similarly, the caffeine group resisted the urge to compulsively cleanse for about twice as long as those in the no-caffeine group. Time spent washing, subjective distress levels, and urge-to-wash levels after participants washed their hands were similar between groups. The current findings support the notion that increased arousal improves inhibition, which may play a role in improving our ability to resist intrusive disgust and compulsive cleansing behaviors.

Dissociable dopaminergic and pavlovian influences in goal-trackers and sign-trackers on a model of compulsive checking in OCD

RATIONALE

Checking is a functional behaviour that provides information to guide behaviour. However, in obsessive-compulsive disorder (OCD), checking may escalate to dysfunctional levels. The processes underpinning the transition from functional to dysfunctional checking are unclear but may be associated with individual differences that support the development of maladaptive behaviour. We examined one such predisposition, sign-tracking to a pavlovian conditioned stimulus, which we previously found associated with dysfunctional checking. How sign-tracking interacts with another treatment with emerging translational validity for OCD-like checking, chronic administration of the dopamine D₂ receptor agonist quinpirole, is unknown.

OBJECTIVES

We tested how functional and dysfunctional checking in the rat observing response task (ORT) was affected by chronic quinpirole administration in non-autoshaped controls and autoshaped animals classified as sign-trackers or goal-trackers.

METHODS

Sign-trackers or goal-trackers were trained on the ORT before the effects of chronic quinpirole administration on checking were assessed. Subsequently, the effects on checking of different behavioural challenges, including reward omission and the use of unpredictable reinforcement schedules, were tested.

RESULTS

Prior autoshaping increased checking. Sign-trackers and goal-trackers responded differently to quinpirole sensitization, reward omission and reinforcement uncertainty. Sign-trackers showed greater elevations in dysfunctional checking, particularly during uncertainty. By contrast, goal-trackers predominantly increased functional checking responses, possibly in response to reduced discrimination accuracy in the absence of cues signalling which lever was currently active.

CONCLUSIONS

The results are discussed in terms of how pavlovian associations influence behaviour that becomes compulsive in OCD and how this may be dependent on striatal dopamine D₂ receptors.

Pediatric OCD in the era of RDoC

The NIMH Research Domain Criteria (RDoC) initiative was established with the goal of developing an alternative research classification to further research efforts in mental health. While RDoC acknowledges that constructs should be considered within a developmental framework, developmental considerations have not yet been well integrated within the existing RDoC matrix. In this paper, we consider RDoC in relation to pediatric OCD, a paradigmatic example of a neuropsychiatric disorder that often has onset in childhood but is also present across the lifespan. We discuss three RDoC subdomains with relevance to OCD as exemplars, providing for each construct a brief review of normative developmental changes, the state of construct-relevant research in pediatric OCD, and challenges and limitations related to developmental considerations within each subdomain. Finally, we conclude with a brief discussion of how RDoC may continue to evolve with regard to developmental considerations in order to further research in pediatric OCD.

Stopping at a red light: Recruitment of inhibitory control by environmental cues

Environmental cues can influence basic perceptual and attentional processes especially in an emotional context. In the current study, we aimed to investigate the effect of a non-emotional common environmental cue-a traffic light-on a higher cognitive operation-inhibition. In two experiments, we administered a novel version of the stop-signal task, in which the go task was to determine the color of a traffic light. In order to investigate the influence of each of the cues on inhibitory processes, separate tracking procedures (one for each cue) were applied simultaneously to the stop-signal delay. In Experiment 1, we found that reaction time in no-stop-signal trials was faster when a green traffic light was present, whereas stop-signal reaction time was longer when a red traffic light was present. In Experiment 2, neutral control cues were used in addition to a red and green light. The results indicate that the differences between red and green stem from an association between the color red and stop processes (rather than from the green-go association). These results strengthen previous findings showing the effect of environmental cues on attentional processes and go beyond them by showing that the effect is not restricted to emotional cues. Most importantly, the current study results suggest that environmental cues can also influence complex cognitive operations such as inhibitory control. These results might have specific implications for our understanding of the processes that underlie specific psychiatric disorders characterized by inhibitory deficit.

Individuals with high obsessive-compulsive tendencies or undermined confidence rely more on external proxies to access their internal states

BACKGROUND AND OBJECTIVES

The Seeking Proxies for Internal States (SPIS) hypothesis predicts that obsessive-compulsive disorder (OCD) is associated with a deficit in subjective convictions, which may lead to a reliance on external substitutes for the perceptions of an individual's internal states. Two well-designed studies were performed for the present work that adopted a false bio-feedback procedure in a muscle tension task to examine the SPIS hypothesis.

METHODS

The false bio-feedback paradigm was used to investigate our hypothesis. NeXus-10 Mark II hardware and V2011 BioTrace + software (Mind Media B.V., Herten, Netherlands) were utilized to measure the muscle tension of the flexor carpiulnaris muscle, which characterized the target's internal state. In addition, false EMG changes were recorded and displayed on a computer monitor and were considered external proxies.

RESULTS

Study 1 demonstrated that the participants with high obsessive-compulsive (OC) tendencies were more affected by the false bio-feedback and exhibited lower confidence in their judgments regarding their muscle tension compared with the participants with low OC tendencies. These findings indicate that subjects with high OC tendencies were more influenced by self-perception effects. In contrast, the subjects in the undermined confidence group in Study 2 were more easily influenced by the false bio-feedback compared with the control group, which suggests that the subjects in the undermined confidence group were more affected by self-perception effects.

LIMITATIONS

We did not combine the undermined confidence with OC tendencies or OCD symptoms in our paradigm to investigate their joint effects on self-perception.

CONCLUSIONS

Our findings provide further evidence that supports the SPIS hypothesis, which indicates that OC tendencies and the confidence in an individual's recognition of internal states appear to have similar effects on the assessment of internal states and reliance on proxies.

Intolerance of uncertainty, not just right experiences, and compulsive checking: Test of a moderated mediation model on a non-clinical sample

OBJECTIVE

Intolerance of uncertainty (IU) and not just right experiences (NJREs) have been claimed putative vulnerability factors for obsessive-compulsive disorder (OCD). The aim of the present study was to test whether IU could represent a trans-diagnostic construct accountable for OC checking behaviors and whether NJREs could embody an OCD-specific criterion through which IU operates.

METHOD

One hundred and eighty-eight Italian community individuals completed self-report measures of IU, NJREs, OC symptoms, worry, anxiety, and depression. Mediation and moderated mediation models were tested using a bootstrapping approach, wherein IU was included as the independent variable as well as the moderator; checking behaviors were entered as the dependent variable; and NJRE severity was included as a mediator.

RESULTS

The main findings highlighted that NJREs were a mediator of the relationship between IU and checking behaviors; nonetheless, in connection with medium levels of IU, NJREs no longer mediated the path. Furthermore, IU did not emerge to moderate the mediation.

CONCLUSION

Despite their preliminary nature, the present results might be a hint for future research, as theoretical integration may represent a way to go for better understanding OCD etiology and phenomenology.

Stop checking: Repeated checking and its effects on response inhibition and doubt

BACKGROUND

Repeated checking is a common ritual in obsessive-compulsive disorder (OCD). van den Hout and Kindt (2003b) devised a task demonstrating paradoxical reductions in memory confidence following repeated checking. This effect was later found to be contingent upon response inhibition. The current study aims to (1) test an alternative interpretation, whereby repeated-checking effects are caused by viewing multiple exemplars, and (2) test whether repeated checking affects response inhibition.

METHOD

132 students participated in two experiments (66 in Experiment 1 and 66 in Experiment 2). Participants were randomly allocated to a repeated-checking task or a simple-action task that featured similar multiple exemplars without the need for checking. Both tasks were followed by a stop-signal task, measuring response inhibition. Experiment 1 featured a stop-signal task with neutral go-signals while Experiment 2 incorporated familiar and unfamiliar stimuli from the previous task as go-signals.

RESULTS

In both experiments, the repeated-checking group exhibited reduced memory confidence compared to the simple-action group. Groups did not differ in their response inhibition for neutral stimuli (Experiment 1), while familiar go-signals had a detrimental effect on response inhibition (Experiment 2).

LIMITATIONS

Our results examine the association between checking and response inhibition in healthy participants without attention deficit hyperactivity disorder and dyslexia. Replication with clinical samples awaits future studies.

CONCLUSIONS

Repeated checking impairs memory confidence. Increased familiarity of stimuli shortens the time it takes to respond to them while it impairs inhibition response to them. These effects possibly provide initial evidence for the hypothesized role of response inhibition in the maintenance of OCD.

Check, check, double check: Investigating memory deterioration within multiple sessions of repeated checking

BACKGROUND AND OBJECTIVES

Extensive research has shown that repeated checking causes memory distrust. Therefore, it has been suggested that people may subsequently get into a vicious cycle of decreased memory confidence and increased checking behavior, which may play a role in the maintenance and development of OCD. This study investigated in two experiments how repeated checking influences memory distrust over multiple checking episodes.

METHODS

In experiment 1, 70 healthy undergraduates performed two sessions of a virtual checking task with a 30 min break in between. In experiment 2, 41 healthy undergraduates performed two sessions of the checking task on a real kitchen stove and sink.

RESULTS

Results of experiment 1 showed that memory confidence for checking the stove decreased after repeated checking in session 1, and remained low in session 2, but memory vividness and detail decreased in both sessions and recovered in between. In experiment 2, all three meta-memory ratings for checking the stove decreased after repeated checking in both sessions, but recovered in between.

LIMITATIONS

Future research may include patients with OCD. To further investigate the development of memory distrust over time, more checking episodes may be included and the time between sessions may be increased. Although replication is needed, the findings of experiment 2 seem more informative.

CONCLUSIONS

Repeated checking may decrease memory vividness and detail (and, in turn, presumably also decrease memory confidence) each time this counterproductive strategy is used, which may have implications for using this paradigm as a behavioral experiment in cognitive-behavioral therapy.

Stove checking behaviour in people with OCD vs. anxious controls

BACKGROUND AND OBJECTIVES

A growing body of research suggests that the repetition of an action degrades memory for that action, as well as confidence that is has been done correctly. This has important implications for understanding the compulsive repetition of actions characteristic of obsessive compulsive disorder (OCD). At this time, though, much of the research has been conducted on analogue or nonclinical OCD samples in comparison to healthy controls and often using virtual, as opposed to actual, threat stimuli. Furthermore, although it has been argued that people with OCD are overly attentive to threat stimuli, the research on actual attention to threat is scant.

METHODS

People with a principal diagnosis of OCD (n = 30) and people with a clinically significant diagnosis of an anxiety disorder, but no OCD (n = 18) completed measures of memory confidence and responsibility and then underwent a stove-checking task in a functioning kitchen while wearing a portable eye tracking device. Pre- and post-task ratings of harm and responsibility were taken, along with post-task ratings of memory and certainty.

RESULTS

People with OCD did not exhibit poorer memory confidence than the anxious control (AC) group, but did report greater trait and state responsibility for harm. The OCD group checked longer than did the AC group and check duration predicted post-task ratings of harm, but to the same extent in both groups. People with OCD attended to threat items less than did the AC group. Greater visual attention to the stove during the checking period was associated with greater post-task ratings of responsibility and harm and with less certainty in and memory for the check - but only for the AC group.

LIMITATIONS

The sample size was modest, women were over-represented and problems with the eye tracking device reduced the amount of reliable data available for analysis.

CONCLUSIONS

Compulsions are complex actions that are mediated by many trait, state and contextual factors. People with OCD may be able to circumvent self-perpetuating checking processes under certain circumstances. Future research should explore the factors that determine whether or not self-perpetuating mechanisms are activated.

The Termination of Checking and the Role of Just Right Feelings: A Study of Obsessional Checkers Compared with Anxious and Non-clinical Controls

Background: Repeated checking in OCD can be understood from a cognitive perspective as the motivated need to achieve certainty about the outcome of a potentially risky action, leading to the application of Elevated Evidence Requirements (EER) and overuse of subjective criteria. Method: Twenty-four obsessional checkers, 22 anxious controls, and 26 non-clinical controls were interviewed about and rated recent episodes where they felt (a) they needed to check and (b) checked mainly out of habit (i.e. not obsessionally). Results: Both subjective and objective criteria were rated as significantly more important in obsessional checkers than in controls; obsessional checkers also used more criteria overall for the termination of the check, and rated more criteria as “extremely important” than the control groups. The termination of the check was rated as more effortful for obsessional checkers than for the comparison groups. Analysis of the interview data was consistent with the ratings. Feelings of “rightness” were associated with the termination of a check for obsessional checkers but not for controls. Conclusion: Results were consistent with the proposal that the use of “just right feelings” to terminate checking are related to EER.

Patients With Obsessive-Compulsive Disorder Check Excessively in Response to Mild Uncertainty

Patients with obsessive-compulsive disorder (OCD) not only respond to obsessions with perseverative checking, but also engage in more general checking, irrespective of their obsessive concerns. This study investigated whether general checking is specific to OCD and exacerbated when only mild uncertainty is induced. Thirty-one patients with OCD, 26 anxiety- and 31 healthy controls performed a visual search task with eye-tracking and indicated in 50 search displays whether a target was "present" or "absent". Target-present trials were unambiguous, whereas target-absent trials induced mild uncertainty, because participants had to rely on not overlooking the target. Checking behavior was measured by assessing search time and the number of fixations, measured with an eye-tracker. Results showed that in both target-present and target-absent trials patients with OCD searched longer and made more fixations than healthy and anxiety controls. However, the difference in checking behavior between patients with OCD and the control groups was larger in target-absent trials (where mild uncertainty was induced). Anxiety and healthy controls did not differ in checking behavior. Thus, mild uncertainty appears to specifically promote checking in patients with OCD, which has implications for treatment.

Multidimensional measures of impulsivity in obsessive-compulsive disorder: cannot wait and stop

Objective

Although the relationship between obsessive compulsive disorder (OCD) and impulsivity has long been debated, impulsivity has not been systematically examined in clinical samples of OCD. Meanwhile, recent findings suggest that impulsivity is multi-dimensional construct that can be examined through several constructs. Therefore, this study is aimed to evaluate multiple facets of impulsivity in OCD.

Method

The recruitment includes 80 OCD and 76 healthy control participants. Participants completed a test battery comprising three behavioral tasks of stop signal task (SST), delay discounting task (DDT) and balloon analog risk test (BART), and one self-report measure of the Barratt Impulsiveness scale (BIS-11).

Results

OCD subjects showed significantly lower stop signal reaction time of SST reflecting higher action impulsivity and higher delay discounting parameter of DDT suggesting increased choice impulsivity but significantly lower adjusted mean pump of BART implying lower risk taking propensity of BART than healthy control.

Conclusion

Increased Action and choice impulsivity, and decreased risk taking propensities were found in OCD. These findings seem to be consistent with clinical characteristics of OCD such as greater preference for or avoid risky situations (avoidance), inability to wait tension relief may provoke safety behaviors (compulsion) and inability to stop already started behaviors (repetition).

Always on guard: test of high vs. low control conditions in obsessive-compulsive disorder patients

Obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder characterized by recurrent obsessive thoughts and/or compulsive behaviors. It has been shown that OCD patients suffer from deficits in executive control. During Stroop task performance, it was found that cognitive control in healthy participants adjusts adaptively - control is reduced when conflict is less likely. Twenty-four individuals meeting criteria for OCD and 27 controls carried out two blocks of a Stroop task; one with high control (a third of the trials were neutral) and one with low control (75% of the trials were neutral). In the healthy control group, results replicated previous findings showing increased interference and decreased facilitation in the low control condition compared to the high control condition. OCD participants, on the other hand, showed no difference in results between the two blocks. Moreover, in the high control condition, interference was larger and facilitation was smaller compared to healthy controls, indicating less efficient executive control for both the informational and task conflict. We concluded that healthy controls adjust the level of control to changing circumstances whereas OCD patients have difficulties to adaptively make such adjustments. Implications for this novel evidence of deficient executive control of flexibility in OCD patients are discussed.

The dopamine D2/D3 receptor agonist quinpirole increases checking-like behaviour in an operant observing response task with uncertain reinforcement: a novel possible model of OCD

Excessive checking is a common, debilitating symptom of obsessive-compulsive disorder (OCD). In an established rodent model of OCD checking behaviour, quinpirole (dopamine D2/3-receptor agonist) increased checking in open-field tests, indicating dopaminergic modulation of checking-like behaviours. We designed a novel operant paradigm for rats (observing response task (ORT)) to further examine cognitive processes underpinning checking behaviour and clarify how and why checking develops. We investigated i) how quinpirole increases checking, ii) dependence of these effects on D2/3 receptor function (following treatment with D2/3 receptor antagonist sulpiride) and iii) effects of reward uncertainty. In the ORT, rats pressed an 'observing' lever for information about the location of an 'active' lever that provided food reinforcement. High- and low-checkers (defined from baseline observing) received quinpirole (0.5mg/kg, 10 treatments) or vehicle. Parametric task manipulations assessed observing/checking under increasing task demands relating to reinforcement uncertainty (variable response requirement and active-lever location switching). Treatment with sulpiride further probed the pharmacological basis of long-term behavioural changes. Quinpirole selectively increased checking, both functional observing lever presses (OLPs) and non-functional extra OLPs (EOLPs). The increase in OLPs and EOLPs was long-lasting, without further quinpirole administration. Quinpirole did not affect the immediate ability to use information from checking. Vehicle and quinpirole-treated rats (VEH and QNP respectively) were selectively sensitive to different forms of uncertainty. Sulpiride reduced non-functional EOLPs in QNP rats but had no effect on functional OLPs. These data have implications for treatment of compulsive checking in OCD, particularly for serotonin-reuptake-inhibitor treatment-refractory cases, where supplementation with dopamine receptor antagonists may be beneficial.

Letter to the Editor: Recent advances in research on cognition and emotion in OCD: a review

Cognitive theories of obsessive-compulsive disorder (OCD) ascertain that catastrophic (mis)interpretations of normally occurring intrusive thoughts are causal to the onset and maintenance of OCD. Recently, Calkins, Berman and Wilhelm have highlighted research validating the cognitive model. However, the current comment article stresses various findings that challenge basic premises of the cognitive theory. Moreover, a review of clinical studies investigating cognitive and behavioral therapies for OCD questions the added value of cognitive interventions over and above behavior therapy consisting of exposure and response prevention for this disorder. We suggest an alternative, potentially more useful route of investigation, stressing executive (dis)functions as the cause of OCD patients to (automatically) act on internal and external stimuli. We further suggest that dysfunctional beliefs proposed as paramount in the pathogenesis of OCD according to the cognitive model may be less important and specific than formerly believed.