Impaired cognitive plasticity and goal-directed control in adolescent obsessive–compulsive disorder
Open accessAbstract
Background: Youths with obsessive–compulsive disorder (OCD) experience severe distress and impaired functioning at school and at home. Critical cognitive domains for daily functioning and academic success are learning, memory, cognitive flexibility and goal-directed behavioural control. Performance in these important domains among teenagers with OCD was therefore investigated in this study. Methods: A total of 36 youths with OCD and 36 healthy comparison subjects completed two memory tasks: Pattern Recognition Memory (PRM) and Paired Associates Learning (PAL); as well as the Intra-Extra Dimensional Set Shift (IED) task to quantitatively gauge learning as well as cognitive flexibility. A subset of 30 participants of each group also completed a Differential-Outcome Effect (DOE) task followed by a Slips-of-Action Task, designed to assess the balance of goal-directed and habitual behavioural control. Results: Adolescent OCD patients showed a significant learning and memory impairment. Compared with healthy comparison subjects, they made more errors on PRM and PAL and in the first stages of IED involving discrimination and reversal learning. Patients were also slower to learn about contingencies in the DOE task and were less sensitive to outcome devaluation, suggesting an impairment in goal-directed control. Conclusions: This study advances the characterization of juvenile OCD. Patients demonstrated impairments in all learning and memory tasks. We also provide the first experimental evidence of impaired goal-directed control and lack of cognitive plasticity early in the development of OCD. The extent to which the impairments in these cognitive domains impact academic performance and symptom development warrants further investigation.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with OCD perform less well than healthy controls on the Paired Associates Learning test (PAL).
“A number of studies have shown that patients with OCD perform less well than healthy controls on the PAL”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Gottwald et al., 2018
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Children's Yale-Brown Obsessive Compulsive Scale: Reliability and Validity
SCAHILL, L., RIDDLE, M. A., McSWIGGIN-HARDIN, M., ORT, S. I., KING, R. A., GOODMAN, W. K., CICCHETTI, D., & LECKMAN, J. F. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199706000-00023 · Cited by 2,045 · see citing works
Sheehan, D. V., Sheehan, K. H., Shytle, R. D., Janavs, J., Bannon, Y., Rogers, J. E., Milo, K. M., Stock, S. L., & Wilkinson, B. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05305whi · Cited by 1,730 · see citing works
Gillan, C. M., Papmeyer, M., Morein-Zamir, S., Sahakian, B. J., Fineberg, N. A., Robbins, T. W., & de Wit, S. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10071062 · Cited by 609 · see citing works
Self-citationStress and memory in humans: twelve years of progress?
Wolf, O. T. (2009) · Brain Research · doi:10.1016/j.brainres.2009.04.013 · Cited by 456 · see citing works
The neuropsychology of adult obsessive–compulsive disorder: A meta-analysis
Abramovitch, A., Abramowitz, J. S., & Mittelman, A. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.09.004 · Cited by 444 · see citing works
Chamberlain, S. R., Fineberg, N. A., Menzies, L. A., Blackwell, A. D., Bullmore, E. T., Robbins, T. W., & Sahakian, B. J. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.2.335 · Cited by 438 · see citing works
Self-citationShifting ability predicts math and reading performance in children: a meta-analytical study
Yeniad, N., Malda, M., Mesman, J., van IJzendoorn, M. H., & Pieper, S. (2013) · Learning and Individual Differences · doi:10.1016/j.lindif.2012.10.004 · Cited by 420 · see citing works
Goal-directed learning and obsessive-compulsive disorder
Gillan, C. M., & Robbins, T. W. (2014) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2013.0475 · Cited by 348 · see citing works
Self-citationGELLER, D. A., BIEDERMAN, J., FARAONE, S., AGRANAT, A., CRADOCK, K., HAGERMOSER, L., KIM, G., FRAZIER, J., & COFFEY, B. J. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200107000-00009 · Cited by 325 · see citing works
Rubia, K., Cubillo, A., Woolley, J., Brammer, M. J., & Smith, A. (2011) · Human Brain Mapping · doi:10.1002/hbm.21048 · Cited by 98 · see citing works
Abramovitch, A., Abramowitz, J. S., Mittelman, A., Stark, A., Ramsey, K., & Geller, D. A. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12414 · Cited by 88 · see citing works
A study of neuropsychological deficit in children with obsessive-compulsive disorder
Shin, M.-S., Choi, H., Kim, H., Hwang, J.-W., Kim, B.-N., & Cho, S.-C. (2008) · European Psychiatry · doi:10.1016/j.eurpsy.2008.03.010 · Cited by 81 · see citing works
Tryptophan Depletion Promotes Habitual over Goal-Directed Control of Appetitive Responding in Humans
Worbe, Y., Savulich, G., de Wit, S., Fernandez-Egea, E., & Robbins, T. W. (2015) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyv013 · Cited by 64 · see citing works
Self-citationFlessner, C. A., Allgair, A., Garcia, A., Freeman, J., Sapyta, J., Franklin, M. E., Foa, E., & March, J. (2010) · Depression and Anxiety · doi:10.1002/da.20626 · Cited by 62 · see citing works
Flagged first, then by citations
Research works printed but not linked: 38
- Andrés S, Boget T, Lázaro L, Penadés R, Morer A, Salamero M (2007). Neuropsychological performance in children and adolescents with obsessive-compulsive disorder and influence of clinical variables. Biological Psychiatry 61, 946– 951. 17157271
- Andrés S, Lázaro L, Salamero M, Boget T, Penadés R and Castro-Fornieles J (2008) Changes in cognitive dysfunction in children and adolescents with obsessive-compulsive disorder after treatment. Journal of Psychiatric Research 42, 507– 514. 17599358
- Beck JS, Beck AT, Jolly JB and Steer RA (2005) Beck Youth Inventories – Second Edition for Children and Adolescents. NCS Pearson, Inc.: San Antonio, TX.
- Beers SR, Rosenberg DR, Dick EL, Williams T, O'Hearn KM, Birmaher B (1999) Neuropsychological study of frontal lobe function in psychotropic-naive children with obsessive-compulsive disorder. The American Journal of Psychiatry 156, 777– 779. 10327915
- Britton JC, Rauch SL, Rosso IM, Killgore WDS, Price LM, Ragan J (2010) Cognitive inflexibility and frontal-cortical activation in pediatric obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry 49, 944– 953. 20732630 PMC4196669
- Chang SW, McCracken JT and Piacentini JC (2007). Neurocognitive correlates of child obsessive compulsive disorder and Tourette syndrome. Journal of Clinical and Experimental Neuropsychology 29, 724– 733. 17896198
- de Wit S and Dickinson A (2009) Associative theories of goal-directed behaviour: a case for animal-human translational models. Psychological Research 73, 463– 476. 19350272 PMC2694930
- de Wit S, Watson P, Harsay HA, Cohen MX, van de Vijver I and Ridderinkhof KR (2012) Corticostriatal connectivity underlies individual differences in the balance between habitual and goal-directed action control. The Journal of Neuroscience 32, 12066– 12075. 22933790 PMC6621537
- Downes JJ, Roberts AC, Sahakian BJ, Evenden JL, Morris RG and Robbins TW (1989) Impaired extra-dimensional shift performance in medicated and unmedicated Parkinson's disease: evidence for a specific attentional dysfunction. Neuropsychologia 27, 1329– 1343. 2615934
- Engel de Abreu PMJ, Abreu N, Nikaedo CC, Puglisi ML, Tourinho CJ, Miranda MC (2014) Executive functioning and reading achievement in school: a study of Brazilian children assessed by their teachers as ‘poor readers’. Frontiers in Psychology 5, 550. 24959155 PMC4050967
- Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G (2002) The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment 14, 485– 496. 12501574
- Gathercole SE and Pickering SJ (2000) Working memory deficits in children with low achievements in the national curriculum at 7 years of age. The British Journal of Educational Psychology 70, 177– 194. 10900777
- Geller DA, Abramovitch A, Mittelman A, Stark A, Ramsey K, Cooperman A (2017) Neurocognitive function in paediatric obsessive-compulsive disorder. The World Journal of Biological Psychiatry 1– 10. https://www.ncbi.nlm.nih.gov/pubmed/28090807. PMC5555842 28090807
- Gruner P, Vo A, Ikuta T, Mahon K, Peters BD, Malhotra AK (2012) White matter abnormalities in pediatric obsessive-compulsive disorder. Neuropsychopharmacology 37, 2730– 2739. 22871914 PMC3473339
- Huyser C, Veltman DJ, Wolters LH, De Haan E and Boer F (2010) Functional magnetic resonance imaging during planning before and after cognitive-behavioral therapy in pediatric obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry 49, 1238– 1248.e5. 21093773
- Hybel KA, Mortensen EL, Lambek R, Thastum M and Thomsen PH (2017) Cool and hot aspects of executive function in childhood obsessive-compulsive disorder. Journal of Abnormal Child Psychology 45, 1195– 1205. 27838893
- Isik Taner Y, Erdogan Bakar E and Oner O (2011) Impaired executive functions in paediatric obsessive-compulsive disorder patients. Acta Neuropsychiatrica 23, 272– 281. 25380038
- Kodaira M, Iwadare Y, Ushijima H, Oiji A, Kato M, Sugiyama N (2012) Poor performance on the Iowa gambling task in children with obsessive-compulsive disorder. Annals of General Psychiatry 11, 25. 23062199 PMC3508952
- Lewin AB, Larson MJ, Park JM, McGuire JF, Murphy TK and Storch EA (2014) Neuropsychological functioning in youth with obsessive compulsive disorder: an examination of executive function and memory impairment. Psychiatry Research 216, 108– 115. 24508366
- Micali N, Heyman I, Perez M, Hilton K, Nakatani E, Turner C (2010) Long-term outcomes of obsessive-compulsive disorder: follow-up of 142 children and adolescents. British Journal of Psychiatry 197, 128– 134. 20679265
- Morein-Zamir S, Craig KJ, Ersche KD, Abbott S, Muller U, Fineberg NA (2010) Impaired visuospatial associative memory and attention in obsessive compulsive disorder but no evidence for differential dopaminergic modulation. Psychopharmacology 212, 357– 367. 20661550
- Nedeljkovic M and Kyrios M (2007) Confidence in memory and other cognitive processes in obsessive-compulsive disorder. Behaviour Research and Therapy 45, 2899– 2914. 17868642
- Ornstein TJ, Arnold P, Manassis K, Mendlowitz S and Schachar R (2010) Neuropsychological performance in childhood OCD: a preliminary study. Depression and Anxiety 27, 372– 380. 19960527
- Otto AR, Gershman SJ, Markman AB and Daw ND (2013a). The curse of planning: dissecting multiple reinforcement-learning systems by taxing the central executive. Psychological Science 24, 751– 761. 23558545 PMC3843765
- Otto AR, Raio CM, Chiang A, Phelps EA and Daw ND (2013b). Working-memory capacity protects model-based learning from stress. Proceedings of the National Academy of Sciences 110, 20941– 20946. PMC3876216 24324166
- Peris TS, Rozenman M, Bergman RL, Chang S, O'Neill J and Piacentini J (2017) Developmental and clinical predictors of comorbidity for youth with obsessive compulsive disorder. Journal of Psychiatric Research 93, 72– 78. 28601668
- Piacentini J, Bergman RL, Keller M and McCracken J (2003) Functional impairment in children and adolescents with obsessive-compulsive disorder. Journal of Child and Adolescent Psychopharmacology 13, 61– 69. 12880501
- Purcell R, Maruff P, Kyrios M and Pantelis C (1998) Neuropsychological deficits in obsessive-compulsive disorder. Archives of General Psychiatry 55, 415– 423. 9596044
- Rasmussen SA and Eisen JL (1989) Clinical features and phenomenology of obsessive compulsive disorder. Psychiatric Annals 19, 67– 73.
- Russ SJ, Herbert J, Cooper P, Gunnar MR, Goodyer I, Croudace T (2012) Cortisol levels in response to starting school in children at increased risk for social phobia. Psychoneuroendocrinology 37, 462– 474. 21852051
- Sahakian BJ, Morris RG, Evenden JL, Heald A, Levy R, Philpot M (1988) A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease. Brain 111, 695– 718. 3382917
- Schwabe L and Wolf OT (2011) Stress-induced modulation of instrumental behavior: from goal-directed to habitual control of action. Behavioural Brain Research 219, 321– 328. 21219935
- Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R and Dunbar GC (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59, 22– 33. 9881538
- Storch EA, Milsom VA, Merlo LJ, Larson M, Geffken GR, Jacob ML (2008) Insight in pediatric obsessive-compulsive disorder: associations with clinical presentation. Psychiatry Research 160, 212– 220. 18556071
- Tolin DF, Abramowitz JS, Brigidi BD, Amir N, Street GP and Foa EB (2001) Memory and memory confidence in obsessive-compulsive disorder. Behaviour Research and Therapy 39, 913– 927. 11480832
- van Grootheest DS, Cath DC, Beekman AT and Boomsma DI (2005) Twin studies on obsessive-compulsive disorder: a review. Twin Research and Human Genetics 8, 450– 458. 16212834
- Zandt F, Prior M and Kyrios M (2009) Similarities and differences between children and adolescents with autism spectrum disorder and those with obsessive compulsive disorder. Autism 13, 43– 57. 19176576
- Zitterl W, Urban C, Linzmayer L, Aigner M, Demal U, Semler B (2001) Memory deficits in patients with DSM-IV obsessive-compulsive disorder. Psychopathology 34, 113– 117. 11316955
Cited by
Sorted by citations
Obsessive-compulsive disorder: Puzzles and prospects
Robbins, T. W., Vaghi, M. M., & Banca, P. (2019) · Neuron · doi:10.1016/j.neuron.2019.01.046 · Cited by 510 · see citing works
Self-citationKanen, J. W., Ersche, K. D., Fineberg, N. A., Robbins, T. W., & Cardinal, R. N. (2019) · Psychopharmacology · doi:10.1007/s00213-019-05325-w · Cited by 101 · see citing works
Self-citationObsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction
Jalal, B., Chamberlain, S. R., & Sahakian, B. J. (2023) · Brain and Behavior · doi:10.1002/brb3.3000 · Cited by 111 · see citing works
“The Paired Associates Learning test (PAL; Sahakian et al., 1988) is a sensitive marker of visuospatial memory, in which participants have to remember the location of various distinct abstract shapes.”
BackgroundSelf-citationCognitive inflexibility in OCD and related disorders
Chamberlain, S. R., Solly, J. E., Hook, R. W., Vaghi, M. M., & Robbins, T. W. (2021) · Current Topics in Behavioral Neurosciences · doi:10.1007/7854_2020_198 · Cited by 82 · see citing works
Self-citationManning, E. E., Dombrovski, A. Y., Torregrossa, M. M., & Ahmari, S. E. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-018-0307-2 · Cited by 79 · see citing works
Marzuki, A. A., Pereira de Souza, A. M. F. L., Sahakian, B. J., & Robbins, T. W. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.12.010 · Cited by 39 · see citing works
Self-citationThe Role of Stress in Obsessive-Compulsive Disorder: A Narrative Review
Raposo-Lima, C., & Morgado, P. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000274 · Cited by 37 · see citing works
Marzuki, A. A., Tomić, I., Ip, S. H. Y., Gottwald, J., Kanen, J. W., Kaser, M., Sule, A., Conway-Morris, A., Sahakian, B. J., & Robbins, T. W. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.36195 · Cited by 32 · see citing works
Self-citationThe development of cognitive flexibility and its implications for mental health disorders
Tong, K., Fu, X., Hoo, N. P., Kean Mun, L., Vassiliu, C., Langley, C., Sahakian, B. J., & Leong, V. (2024) · Psychological Medicine · doi:10.1017/s0033291724001508 · Cited by 23 · see citing works
Self-citationCognitive inflexibility, obsessive-compulsive symptoms and traits and poor post-pandemic adjustment
Frota Lisboa Pereira de Souza, A. M., Pellegrini, L., & Fineberg, N. A. (2024) · Neuroscience Applied · doi:10.1016/j.nsa.2024.104073 · Cited by 8 · see citing works
Morand-Beaulieu, S., Aardema, F., O'Connor, K. P., & Lavoie, M. E. (2021) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.110061 · Cited by 9 · see citing works
- Authors
- Gottwald, J., de Wit, S., Apergis-Schoute, A. M., Morein-Zamir, S., Kaser, M., Cormack, F., Sule, A., Limmer, W., Morris, A. C., Robbins, T. W., & Sahakian, B. J.
- Affiliations
- University of Cambridge (GB)
- Cambridge Cognition (United Kingdom) (GB)
- Cambridgeshire and Peterborough NHS Foundation Trust (GB)
- Corresponding author
- Gottwald, Julia
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-01-22
- Volume
- 48
- Issue
- 11
- Pages
- 1900-1908
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC6088771
- OpenAlex
- W2784093442
- Cited by
- 64
- References
- 14
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 9 · 2023: 7 · 2022: 8 · 2021: 9 · 2020: 12 · 2019: 6 · 2018: 4
- FWCI
- 9.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Anglia Ruskin Research Online (Anglia Ruskin University) (submittedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Apollo
- Funders
- Wellcome Trust (089589/Z/09/Z, 104631/Z/14/Z, 089589, G00001354, 104631, 093875/Z/10/Z)
- National Institute for Health and Care Research (CL-2016-14-003)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (452-13-006)
- Shionogi
- Servier
- H. Lundbeck A/S
- Medical Research Council (G00001354, 089589/Z/09/Z)
- 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, adolescents, cognitive plasticity, goal-directed control, cognitive flexibility, learning and memory impairment, pattern recognition memory, paired-associate learning, set-shifting, outcome devaluation, habitual behavior
- MeSH terms
- Adolescent, Adult, Association Learning, Child, Female, Humans, Learning, Male, Obsessive-Compulsive Disorder, Pattern Recognition, Visual, Reversal Learning, Recognition, Psychology, Young Adult, Executive Function, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
