Speed and accuracy on tests of executive function in obsessive-compulsive disorder

Slowness in obsessive-compulsive disorder (OCD) has been attributed to intrusive thoughts or meticulousness. Recent research suggests that slowness in OCD may be particularly evident on tests of executive function subserved by frontostriatal circuitry. In the present study, the speed and accuracy of responding on neuropsychological tests of executive functions and psychomotor speed were investigated in 27 non-depressed, unmedicated adults with OCD and 27 healthy controls. The only group difference was that patients took significantly longer to copy a complex geometric design than controls. This finding was unrelated to residual depression or overall OCD symptom severity. Results suggest that slowness in OCD may be most apparent on executive tests requiring self-initiated organizational strategies, consistent with frontostriatal abnormality.     

Processes of inference, schizotypal thinking, and obsessive-compulsive behaviour in a normal sample

Previous research has shown inferential confusion as measured by the Inferential Confusion Questionnaire to be related to obsessive-compulsive symptoms. A total of 108 participants (41 men and 66 women) from a normal population in The Netherlands (M age = 46 yr., SD = 15.5) completed a package of questionnaires measuring inferential confusion, schizotypal symptoms, and obsessive-compulsive behaviour. As expected, scores for both inferential confusion and schizotypal symptoms were significantly related to those for obsessive-compulsive behaviour. In addition, analysis showed that inferential confusion and schizotypal symptoms shared common variance, but both predicted an independent portion of the variance in obsessive-compulsive behaviour while controlling for neuroticism. The present results call for further inquiry into the role of inferential confusion and schizotypal thinking in obsessive-compulsive behaviour.     

Inferential confusion in obsessive-compulsive disorder: the inferential confusion questionnaire

The current article represents the further validation of the construct of inferential confusion amongst clinical samples. Inferential confusion is proposed to be a meta-cognitive confusion particularly relevant to obsessive compulsive disorder (OCD) that leads a person to confuse an imagined possibility with an actual probability. As such, it conceptualizes OCD as a form of belief disorder similar to a delusion or overvalued idea that is a product of distorted reasoning processes. In contrast, other cognitive models of OCD emphasize a phobic model of development in OCD, and thus consider the exaggerated interpretation of intrusions as an essential element in OCD. The present study administered a revised version of the Inferential Confusion Questionnaire, and the Obsessive Belief Questionnaire (OBQ), to a total of 183 participants in three clinical groups and a non-clinical control group. Results suggest that OCD, at least in part, follows a non-phobic model of development with inferential confusion significantly related to obsessive-compulsive symptoms independently of cognitive domains as measured by the OBQ, and mood states. Further, scores on inferential confusion were particularly high in those with OCD and delusional disorder as compared to anxious and non-clinical controls.     

A cognitive-behavioral/psychophysiological model of tic disorders

This article discusses current cognitive behavioral, as well as neurophysiological, accounts of the development and maintenance of tic behavior in chronic (simple or complex) tic disorders. A cognitive psychophysiological model is further elaborated, highlighting the reciprocal interplay of background cognitive and physiological factors preceding tic onset. According to the model, cognitive factors such as perfectionist concerns and heightened sensory awareness and self-attention, as well as physiological factors such as a high level of motor activation and accompanying elevated muscle tension, play a role in tic habits. Negative appraisals of tics and counter-productive coping strategies developed by clients as a means to suppress or to disguise the tic behavior may also locally reinforce tic onset. Neurochemical factors are viewed largely as concomitants of behavioral adaptations or compensations to the tic problem rather than as independent markers or precursors of tic onset. Clinically, the model emphasizes the role of cognitive-behavioral factors in tic onset, and suggests that tic management is best accomplished through cognitive behavioral interventions designed to prevent build up of both tension and pre-monitory urge in tic-affected muscles, rather than reverse the tic at the onset of the premonitory urge. The clinical validity of parts of the model is supported by recent experimental, psychometric and clinical studies. Other parts of the model remain speculative but at least yield testable predictions. A strength of the model is its ability to account for findings over diverse psychological and biological domains.