Strategy implementation in obsessive-compulsive disorder and trichotillomania
Open accessAbstract
Background. The use of strategies to aid performance when undertaking neuropsychological tasks is dependent on intact fronto-striatal circuitry, and growing evidence suggests impaired spontaneous use of strategies in patients with obsessive–compulsive disorder (OCD). However, studies to date have not examined the effects of strategy training on task performance in OCD or in trichotillomania (compulsive hair-pulling, a condition that has been argued to share overlap with OCD in terms of phenomenology and co-morbidity). Method. The ability to generate novel visuospatial sequences using a computer interface was examined before and after undertaking optimal strategy training in 20 OCD patients, 17 trichotillomania patients, and 20 controls (matched for age, education, and IQ). Results. OCD patients failed to improve ability to generate novel sequences above baseline despite successfully completing strategy training to the same extent as other groups. In contrast, performance of trichotillomania patients improved significantly after training to the same extent as controls. Groups did not differ on memory span, trial-by-trial action monitoring, or ability to generate novel visuospatial sequences prior to strategy training. Conclusions. Strategy implementation deficits, suggestive of cognitive inflexibility and fronto-striatal dysfunction, appear integral to the neurocognitive profile of OCD but not trichotillomania. Future research should investigate cognitive flexibility in obsessive–compulsive spectrum disorders using a variety of paradigms, and clarify the contribution of specific neural structures and transmitter systems to deficits reported.
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Alterations proposed in OCD include both inhibitory control and cognitive flexibility processes.
“However, alterations proposed in OCD include both inhibitory control (inhibition of motor responses in means of increased impulsivity and/or compulsivity) and the cognitive flexibility processes defined as an ability to shift the focus of attention (6, 7) and/or recognize and handle conflicting information (competition of relevant and irrelevant stimuli) (8).”
From Functional connectivity changes in obsessive-compulsive disorder correspond to interference control and obsessions severity (2020) · cites this paper as [7]
Impaired inhibitory control has been reported in OCD patients on all three stages.
“Impaired inhibitory control has been reported in OCD patients on all three stages (10), assessed mostly by variants of the Stroop color–word test (SCWT) (7, 11–13), or alternatively by the Go/No-go tasks [e.g., (14)] and the Stop signal tasks [e.g., (15)], measuring interference control, action restraint, and action cancellation, respectively.”
From Functional connectivity changes in obsessive-compulsive disorder correspond to interference control and obsessions severity (2020) · cites this paper as [7]
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- Authors
- CHAMBERLAIN, S. R., BLACKWELL, A. D., FINEBERG, N. A., ROBBINS, T. W., & SAHAKIAN, B. J.
- Affiliations
- University of Cambridge (GB)
- Queen Elizabeth II Hospital (GB)
- Corresponding author
- CHAMBERLAIN, SAMUEL R.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2005-10-05
- Volume
- 36
- Issue
- 1
- Pages
- 91-97
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC1867316
- OpenAlex
- W2075050067
- Cited by
- 46
- References
- 32
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 5 · 2015: 5 · 2014: 1 · 2013: 1 · 2012: 3
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- Wellcome Trust (019407, 076274)
- Medical Research Council
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, trichotillomania, strategy training, strategy implementation, cognitive flexibility, frontostriatal circuits, compulsive hair pulling, neuropsychological performance, action monitoring
- MeSH terms
- Adult, Cognition Disorders, Corpus Striatum, Demography, Female, Frontal Lobe, Humans, Male, Obsessive-Compulsive Disorder, Perceptual Disorders, Space Perception, Trichotillomania, Visual Perception, Diagnostic and Statistical Manual of Mental Disorders
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