TY - CHAP
T1 - Cognitive Inflexibility in OCD and Related Disorders
AU - Chamberlain, Samuel R.
AU - Solly, Jeremy E.
AU - Hook, Roxanne W.
AU - Vaghi, Matilde M.
AU - Robbins, Trevor W.
N1 - Funding Information:
Dr. Chamberlain’s research is funded by a Wellcome Trust Clinical Fellowship (110,049/Z/15/ Z). Professor Robbins’ research is funded by a Wellcome Trust Grant (104,631/Z/14/Z). Professor Robbins undertakes consulting work for Cambridge Cognition, Unilever, and Greenfield Bioventures; he has received research grants from Shionogi, GlaxoSmithKline, and Small Pharma; he receives royalties from Cambridge Cognition; and has 484 received editorial honoraria from Springer Nature and Elsevier. The other authors 485 have no disclosures.
Funding Information:
Dr. Chamberlain?s research is funded by a Wellcome Trust Clinical Fellowship (110,049/Z/15/ Z). Professor Robbins? research is funded by a Wellcome Trust Grant (104,631/Z/14/Z). Professor Robbins undertakes consulting work for Cambridge Cognition, Unilever, and Greenfield Bioventures; he has received research grants from Shionogi, GlaxoSmithKline, and Small Pharma; he receives royalties from Cambridge Cognition; and has 484 received editorial honoraria from Springer Nature and Elsevier. The other authors 485 have no disclosures.
Publisher Copyright:
© 2021, Springer Nature Switzerland AG.
PY - 2021
Y1 - 2021
N2 - Cognitive inflexibility is suggested by the hallmark symptoms of obsessive-compulsive disorder (OCD), namely the occurrence of repetitive thoughts and/or behaviours that persist despite being functionally impairing and egodystonic to the individual. As well as being implied by the top-level symptoms, cognitive inflexibility in OCD, and some related conditions, has also been objectively quantified in case–control studies using computerised cognitive tasks. This chapter begins by considering the objective measurement of different aspects of cognitive flexibility using neuropsychological paradigms, with a focus on neural and neurochemical substrates. It moves on to conduct a systematic review and meta-analysis of findings from a widely deployed flexibility task: the Intra-Dimensional/Extra-Dimensional Set-Shift Task (IDED). By pooling data from 11 studies (335 OCD patients and 311 controls), we show that Extra-Dimensional (ED) shift deficits are a robust and reproducible finding (effect size medium–large) in OCD across the literature, and that this deficit is not attributable to group differences in age or IQ. The OCD ED deficit is then discussed in terms of dysfunction of fronto-striatal pathways (as exemplified, for example, by functional connectivity data), and the putative role of different neurotransmitters. We consider evidence that impaired ED shifting constitutes a candidate vulnerability marker (or ‘endophenotype’) for OCD. The available literature is then surveyed as to ED findings in other obsessive-compulsive (OC) related disorders (e.g. hoarding, body-dysmorphic disorder, and trichotillomania), as well as in non-OC disorders (schizophrenia and anxiety symptoms in general). Lastly, we consider more recent, emerging developments in the quantification of compulsivity using cognitive tasks and questionnaires, as well as key directions for future research, including the need to refine compulsivity and its composite cognitive processes.
AB - Cognitive inflexibility is suggested by the hallmark symptoms of obsessive-compulsive disorder (OCD), namely the occurrence of repetitive thoughts and/or behaviours that persist despite being functionally impairing and egodystonic to the individual. As well as being implied by the top-level symptoms, cognitive inflexibility in OCD, and some related conditions, has also been objectively quantified in case–control studies using computerised cognitive tasks. This chapter begins by considering the objective measurement of different aspects of cognitive flexibility using neuropsychological paradigms, with a focus on neural and neurochemical substrates. It moves on to conduct a systematic review and meta-analysis of findings from a widely deployed flexibility task: the Intra-Dimensional/Extra-Dimensional Set-Shift Task (IDED). By pooling data from 11 studies (335 OCD patients and 311 controls), we show that Extra-Dimensional (ED) shift deficits are a robust and reproducible finding (effect size medium–large) in OCD across the literature, and that this deficit is not attributable to group differences in age or IQ. The OCD ED deficit is then discussed in terms of dysfunction of fronto-striatal pathways (as exemplified, for example, by functional connectivity data), and the putative role of different neurotransmitters. We consider evidence that impaired ED shifting constitutes a candidate vulnerability marker (or ‘endophenotype’) for OCD. The available literature is then surveyed as to ED findings in other obsessive-compulsive (OC) related disorders (e.g. hoarding, body-dysmorphic disorder, and trichotillomania), as well as in non-OC disorders (schizophrenia and anxiety symptoms in general). Lastly, we consider more recent, emerging developments in the quantification of compulsivity using cognitive tasks and questionnaires, as well as key directions for future research, including the need to refine compulsivity and its composite cognitive processes.
KW - Cognitive flexibility
KW - Compulsivity
KW - Endophenotype
KW - Intra-dimensional/extra-dimensional set-shift task
KW - Obsessive-compulsive disorder
KW - Obsessive-compulsive related disorders
KW - OCD
KW - Set-shifting
UR - http://www.scopus.com/inward/record.url?scp=85109938822&partnerID=8YFLogxK
U2 - 10.1007/7854_2020_198
DO - 10.1007/7854_2020_198
M3 - Chapter
C2 - 33547598
AN - SCOPUS:85109938822
SN - 978-3-030-75395-5
SN - 978-3-030-75392-4
T3 - Current Topics in Behavioral Neurosciences
SP - 125
EP - 145
BT - The Neurobiology and Treatment of OCD: Accelerating Progress
A2 - Fineberg, Naomi A.
A2 - Robbins, Trevor W.
PB - Springer
ER -