Neuropsychological Functioning in Obsessive-Compulsive Washers: Drug-Naive Without Depressive Symptoms

The relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder: A systematic review and Meta-analysis

BACKGROUND

This systematic review and meta-analysis explored the relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder (OCD).

METHODS

We searched Pubmed, Scopus, Cochrane Library and PsychINFO databases until February 2023 for studies comparing patients with OCD and healthy controls on cognitive tests of compulsivity and impulsivity. The study followed PRISMA guidelines and was pre-registered on PROSPERO (CRD42021299017).

RESULTS

Meta-analyses of 112 studies involving 8313 participants (4289 patients with OCD and 4024 healthy controls) identified significant impairments in compulsivity (g = -0.58, [95%CI -0.68, -0.47]; k = 76) and impulsivity (g = -0.48, [95%CI -0.57, -0.38]; k = 63); no significant difference between impairments. Medication use and comorbid psychiatric disorders were not significantly related to impairments. No associations were revealed with OCD severity, depression/anxiety, or illness duration.

CONCLUSION

Cognitive phenotypes of compulsivity and impulsivity in patients with OCD appear to be orthogonal to clinical variables, including severity of OCD symptomatology. Their clinical impact is poorly understood and may require different clinical assessment tools and interventions.

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

BACKGROUND

This review provides an overview of obsessive-compulsive disorder (OCD) symptoms, including the four partially distinct subtypes of the disorder, current diagnostic criteria, and common comorbidities. Critically, it focuses on the etiology of OCD, including its underlying neuropathology, and examines cognitive dysfunction in OCD.

METHODS

This review study was conducted by library method.

RESULTS

We show how dysfunction in cortico-striato-thalamo-cortical (CSTC) circuits may underpin symptoms; and shed light on the putative neurochemistry within these loops such as the role of serotonin, dopamine, and glutamate systems. We also show how OCD is characterized by cognitive dysfunction including problems in cognitive flexibility, visuospatial memory, response inhibition, and goal-directed behavior, linked to aberrant activity within CSTC circuits.

CONCLUSIONS

In brief, research questions we shed light on include (1) what are the symptoms in OCD; (2) what is the etiology of the disorder and do existing models explain OCD; and (3) what are key cognitive deficits in OCD and do these improve with treatment?

Dysfunctional Beliefs and Cognitive Performance across Symptom Dimensions in Childhood and Adolescent OCD

Although etiological and maintenance cognitive factors have proved effective in predicting the disease course in youths with OCD, their contribution to symptom severity and specific OCD dimensions has been scarcely examined. In a cohort of children and adolescents with OCD (N = 41; mean age = 14; age range = 10-18 yrs.), we investigated whether certain dysfunctional beliefs and cognitive traits could predict symptom severity, and whether they were differentially associated with specific symptom dimensions. We found that self-oriented and socially prescribed perfectionism and intolerance to uncertainty were associated with higher obsession severity, which was not uniquely related to any neuropsychological variable. Greater severity of obsessions and compulsions about harm due to aggression/injury/violence/natural disasters was predicted by excessive concerns with the expectations of other people. Severity in this dimension was additionally predicted by decreasing accuracy in performing a problem-solving, non-verbal reasoning task, which was also a significant predictor of severity of obsessions about symmetry and compulsions to count or order/arrange. Apart from corroborating both the belief-based and neuropsychological models of OCD, our findings substantiate for the first time the specificity of certain dysfunctional beliefs and cognitive traits in two definite symptom dimensions in youth. This bears important clinical implications for developing treatment strategies to deal with unique dysfunctional core beliefs, and possibly for preventing illness chronicity.

Effect of Occupation Performance Coaching with Four-Quadrant Model of Facilitated Learning on Children with Specific Learning Disorder

Background

Children with a specific learning disability (SLD) have deficits in everyday occupations along with executive function in addition to academic issues.

Objective

The present study is aimed at investigating the effectiveness of Occupational Performance Coaching (OPC) and the Four-Quadrant Model of Facilitated Learning (4QM) interventions on the participation in occupational performance and executive function skills in children with SLD.

Method

This study was a single-case experimental design (multiple baselines) in which six children with SLD were randomly assigned to three groups. In the baseline phase, three groups of children underwent repeated executive function assessments using the Stroop Color and Word Test (SCWT) and the Wisconsin Card Sorting Test (WCST) in the multiple baselines. In the intervention phase, all six mothers of children with SLD individually received OPC and 4QM interventions once a week for 14 sessions of 60 minutes and during this period, children were evaluated six more times for executive function skills according to SCWT and WCST. In addition, The Canadian Occupational Performance Measure (COPM) and Behavior Rating Inventory of Executive Function (BRIEF) at the beginning and the end of the baseline phase and the end of the intervention phase were completed by mothers of children with SLD.

Results

More than 50% PND of the SCWT and WCST in the visual analysis graph's information along with significant changes in COPM scores and large effect size of BRIEF subscales (Cohen's d ≥ 0.8) in pre- and postintervention showed the effectiveness of OPC and 4QM on the participation in occupational performance and executive function skills in children with SLD.

Conclusion

The results of the study support the effectiveness of OPC and 4QM interventions on children with SLD. However, research with more participants and experimental methods can provide further evidence.

OCD Influences Evidence Accumulation During Decision Making in Males but Not Females During Perceptual and Value-Driven Choice

Individuals with obsessive-compulsive disorder (OCD) often have difficulty making decisions. Valuation and value-based judgements are particularly difficult. The mechanisms underlying these impairments are still poorly understood. Previous work has suggested that individuals with OCD require more information prior to making a choice during perceptual discrimination tasks. Little previous work has examined value-guided choice in OCD. Here we examined perceptual and value-based decision making in adults with OCD, using a novel task in which the two types of decision are tested in parallel using the same individually calibrated sets of visual stimuli (Perceptual and Value-based decision-making task, PVDM). Twenty-seven unmedicated participants with OCD (16 female) and thirty-one healthy controls (15 female) were tested. Data were analyzed using hierarchical drift-diffusion modeling (HDDM). Decision formation was altered in OCD, but differentially between genders: males with OCD, but not females, accumulated more information (i.e., were more cautious) and were less effective in evidence accumulation than age- and IQ-matched healthy males. Furthermore, males with OCD, but not females, were less likely than controls to adjust the process of evidence accumulation across decision contexts. These unexpectedly gender-dimorphic effects suggest that more attention should be paid to gender differences in studies of OCD, and of pathophysiology more broadly.

Baseline executive functions and receiving cognitive rehabilitation can predict treatment response in people with opioid use disorder

BACKGROUND

Impaired cognitive functions, particularly executive function, predicts poor treatment success in people with substance use disorders. The current study investigated the effect of receiving adjunct cognitive rehabilitation and baseline executive function (EF) measures on treatment response among people with opioid use disorder (OUD).

METHOD

The analysis sample consisted of 113 participants with OUD who were discharged from a compulsory court-mandated methadone maintenance treatment (MMT) and followed for 3 months. We used the Backward digit span/Auditory verbal learning, Stroop, and Trail making tests to assess the three measures of EF, including working memory, inhibition, and shifting, respectively. Treatment response was operationalized as (1) treatment retention and (2) the number of positive urine tests for morphine during 3-month follow-up periods. The study used Cox's proportional hazards model and linear mixed model to identify predictive factors.

RESULTS

Lower Stroop interference scores predicted increased length of stay in treatment (χ² = 33.15, P < 0.001). The linear mixed model showed that scores on auditory verbal learning test and group intervention predicted the number of positive urine tests during a 3-month follow-up.

CONCLUSION

Working memory and inhibitory control, as well as receiving cognitive rehabilitation, could be potentially considered as predictors of treatment response for newly MMT admitted patients with OUD. Assessment of EF before treatment initiation may inform treatment providers about patient's cognitive deficits that may interfere with therapeutic interventions.

Executive Functioning and Clinical Variables in Patients with Obsessive-Compulsive Disorder

Background: Cognitive flexibility, response inhibition, and working memory are considered the main mechanisms responsible for executive control. This study examined differences in cognitive flexibility, inhibition, and working memory in patients with obsessive–compulsive disorder (OCD) relative to a control group. Method: A total of 62 obsessive-compulsive participants (OCD = 32; healthy control = 32) aged between 17 and 56 years old (M = 33.16, SD = 9.23) were administered the computerized Wisconsin Card Sorting Test, Stroop Color–Word Test, Go/No-Go Task, Digit Test, and Corsi Block Test. Clinician-rated and self-reported obsessive–compulsive symptom severity, and anxiety, depression, and obsessive beliefs were evaluated. Results: The control group performed better than the OCD group in tasks involving cognitive flexibility, inhibition, and visuospatial working memory. Anxiety and obsessive beliefs influenced the participants’ performance on inhibition and working memory tasks. Similarly, comorbidity also influenced inhibition and working memory. In addition, the use of pharmacotherapy and the degree of OCD symptom severity influenced verbal working memory. Conclusions: Cognitive flexibility, inhibition, and visuospatial working memory deficits may be endophenotypes of OCD but require further examination for specificity. OCD severity, comorbidity patterns, anxiety, and obsessive beliefs may influence performance.

Neuropsychological Decomposing Stroop Interference Into Different Cognitive Monitoring: An Exploratory Factor Analysis

INTRODUCTION

There are two alternative explanations of the Stroop phenomenon. Several studies have revealed that the difference in performance on congruent and incongruent trials can arise from response interference. On the contrary, many authors have claimed that Stroop interference might occur at earlier processing stages related to semantic or conceptual encoding. The present study aims to determine the number and nature of the factors necessary to account for the multiple components of Stroop interference.

METHODS

The sample consisted of 247 undergraduate and postgraduate students. We employed the computerized version of the Stroop task adapted to the Iranian population. An exploratory principal components analysis was conducted on the correlations of 6 variables (reaction time under congruent and incongruent conditions, omission error under congruent and incongruent conditions, and commission error under congruent and incongruent conditions).

RESULTS

Two factors were extracted. The first factor may be semantic interference, and the second factor may be response interference.

CONCLUSION

The findings of this research are consistent with the multiple-stage account, claiming that Stroop interference is because of both semantic and response interferences.

Estimation of Mean Intelligence Quotient with Wechsler Scale in Iran: Systematic Review and Meta-Analysis

The low intelligence quotient (IQ) level is one of the most common and important medical, social, and familial problems in all countries. The current study aimed to estimate mean IQ with the Wechsler scale in Iran by performing a systematic review and meta-analysis. In the current meta-analysis, all articles related to IQ conducted in Iran using the Wechsler scale were deeply searched by reviewing citation databases including Science Direct, PubMed, Scopus, Web of Science, Springer, SID, Magiran, Iranmedex, Medlib, and Google Scholar motor search and using valid keywords without time limits. Due to heterogeneity between studies, a random effects model was used to combine the results of studies. To investigate the heterogeneity of the studies, the I2 index was used. All statistical analyses were performed using STATA software version 11.1. The number of participants in the 51 studies was 5352. The mean total IQ score in Iran was estimated 97.12 (95% confidence interval [CI]: 88.71-105.52), the practical intelligence was 92.84 (95% CI: 79.14-106.55), and the verbal intelligence was 94.50 (95% CI: 83.90-105.10). The total IQ score in the northern, southern, central, eastern, and western regions of Iran was 97.08, 108.90, 92.31, 101.76, and 96.45, respectively. The mean IQ score in Iran in subjects under 20 years of age is 97.73 and in subjects over 20 years of age is 105.61. There is also no significant relationship between the mean total IQ in Iran and two parameters of the year of research and number of research samples. For prevention of decrease IQ and given that proper nutrition and breastfeeding directly contribute to increase IQ, nutrition should be provided free of charge in poorer areas during pregnancy until baby born. Moreover, the media should provide adequate education for breastfeeding and nutrition, because IQ affects people's academic, occupational, personal, and social performance, and also prevents elite immigration with suitable planning and provides conditions for elites to return to the country.

Cognitive Process in Patients With Obsessive-Compulsive Disorder: A Cross-Sectional Analytic Study

Introduction:

In recent studies, deficit in cognitive process has been investigated as one of the etiological hypotheses in a wide range of Obsessive-Compulsive Disorder (OCD). This research aimed to compare cognitive process in patients with OCD and healthy groups.

Methods:

In the current cross-sectional analytic study, 43 patients with OCD and 43 healthy individuals matched with gender, age, educational and marital status were selected by convenience sampling method and assessed by Wisconsin Cart Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The obtained data were analyzed with Chi-square, Independent t test, Mann-Whitney U test and Pearson correlation in SPSS version16.

Results:

There was no difference between the patients with OCD and the healthy group in demographic characteristics (P>0.05). There was a significant differences between two group on the all subscale of WCST test and PASAT3, PASAT2 tests (P<0.01). These findings indicate that the OCD patient’s performance in cognitive process was significantly worse than the healthy controls.

Conclusion:

The findings indicate that individuals with OCD suffer from a deficiency in various aspects of cognitive processes. Therefore, paying attention to these deficiencies can make an important contribution to the treatment of these patients.

Executive functions, selective attention and information processing in patients with obsessive compulsive disorder: A study from west of Iran

Obsessive-compulsive disorder (OCD) is associated with cognitive dysfunction. Deeper and wider knowledge of the cognitive components of these patients can play an important role in better understanding of this disorder. This study aimed to compare executive function, selective attention and information processing in OCD patients and healthy controls. The current study was performed on 54 patients meeting DSM-5 criteria for OCD and 54 healthy subjects who matched with patients in gender, age, marital and educational status. The cognitive functions were assessed by The Stroop test, Wisconsin Cart Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). The performance of the OCD group was significantly worse than the healthy group in comparison with the all subscales of the Stroop and WSCT tests. Also, functions in information processing among two groups were statistically significant for 3- and 2-second PASAT. The results demonstrated that OCD patients have deficits in several aspects of cognitive functions. Hence, the treatment of these patients can be contributed by paying more attention to these deficits.