Stop signal reaction time deficits in a lifetime obsessive-compulsive disorder sample
Open accessAbstract
Objectives: Several studies have found impaired response inhibition, measured by a stop-signal task (SST), in individuals who are currently symptomatic for obsessive-compulsive disorder (OCD). The aim of this study was to assess stop-signal reaction time (SSRT) performance in individuals with a lifetime diagnosis of OCD, in comparison to a healthy control group. This is the first study that has examined OCD in participants along a continuum of OCD severity, including approximately half of whom had sub-syndromal symptoms at the time of assessment. Methods: OCD participants were recruited primarily from within the OCD clinic at a psychiatric hospital, as well as from the community. Healthy controls were recruited from the community. We used the stop signal task to examine the difference between 21 OCD participants (mean age, 42.95 years) and 40 healthy controls (mean age, 35.13 years). We also investigated the relationship between SST and measures of OCD, depression, and anxiety severity. Results: OCD participants were significantly slower than healthy controls with regard to mean SSRT. Contrary to our prediction, there was no correlation between SSRT and current levels of OCD, anxiety, and depression severity. Conclusions: Results support prior studies showing impaired response inhibition in OCD, and extend the findings to a sample of patients with lifetime OCD who were not all currently above threshold for diagnosis. These findings indicate that response inhibition deficits may be a biomarker of OCD, regardless of current severity levels. (JINS, 2016, 22, 785–789)
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- Findingown data
The overall effect size for the stop-signal reaction time difference between OCD participants and healthy controls was medium to large.
“Effect sizes were medium to large (partial eta squared = 0.171).”
Quote in the paperSubstantial claim - Findingown data
In exploratory analyses, the OCD subgroup with YBOCS scores below 16 had a longer mean stop-signal reaction time than the subgroup with YBOCS scores of 16 or higher.
“Exploratory analyses showed that the OCD subgroup with YBOCS scores 16 or over (n = 11) had a mean SSRT of 196.83 (SD of 54.16), the OCD subgroup with YBOCS scores below 16 (n = 10) had a mean SSRT of 254.67 (SD of 53.24), and, as noted in Table 1, the HC group had a mean SSRT of 190.10 (SD of 40.13).”
- Also stated in: § DISCUSSION · hedged
“In fact, although the subgroups were small, and results should be interpreted with caution, the mean SSRT for the patients with YBOCS scores below what is considered threshold for OCD (YBOCS < 16) was surprisingly longer than those above threshold (YBOCS ≥ 16).”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · hedged
- Findingown data
OCD participants were significantly older than healthy controls.
“Groups did not differ with regard to education, but the OCD group was significantly older than the healthy control group (t(59) = −2.12; p = .038); thus, age was included as a covariate in the analyses.”
Quote in the paperSubstantial claim - Findingown data
OCD participants had multiple comorbid conditions.
“OCD participants also had multiple comorbidities, indicating that this deficit may not be specific to OCD.”
Quote in the paperSubstantial claim - Findingown data
The groups did not differ in education.
“Groups did not differ with regard to education, but the OCD group was significantly older than the healthy control group (t(59) = −2.12; p = .038); thus, age was included as a covariate in the analyses.”
Quote in the paperNot a substantial claim
- Findingown data
Seventy percent of OCD participants were taking multiple psychiatric medications.
“Ninety percent of the OCD participants were also on medications, and 70% were on multiple psychiatric medications.”
Quote in the paperNot a substantial claim - Premisecitation
Studies have not supported significant stop-signal reaction time impairment in depression.
“In addition, studies have failed to support significant impairment in SSRT in depression, the most common comorbidity in this sample (Lipszyc & Schachar, 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Lipszyc & Schachar, 2010
Not checked in the free run.
- Premisecitation
Several studies have indicated that inhibitory control is impaired in OCD.
“Within the past several years, response inhibition has been investigated more frequently in patients with OCD, and several studies have indicated that inhibitory control, or the ability to suppress irrelevant/interfering stimuli or behaviors, is impaired in OCD (Lipszyc & Schachar, 2010; Rao et al., 2008; van Velzen, Vriend, de Wit, & van den Heuvel, 2014).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Lipszyc & Schachar, 2010
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- cites Rao et al., 2008
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- cites van Velzen, Vriend, de Wit, & van den Heuvel, 2014
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- Interpretationown data
The findings extend to a sample of patients with a lifetime OCD diagnosis who were not all currently above the diagnostic threshold.
“Results support prior studies showing impaired response inhibition in OCD, and extend the findings to a sample of patients with lifetime OCD who were not all currently above threshold for diagnosis.”
Quote in the paperSubstantial claim - Interpretationcitation
Difficulty inhibiting rituals is likely to worsen therapy outcomes.
“Thus, the inability to inhibit rituals is likely to negatively impact therapy outcomes, and response inhibition likely represents a key mechanism in not just the emergence, but also the persistence of OCD symptoms.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Benito, Conelea, Garcia, & Freeman, 2012
Not checked in the free run.
- Rests on an assumption: Exposure and response/ritual prevention is considered the standard treatment for OCD; it entails confronting feared stimuli and then inhibiting rituals.
- Rests on an assumption: The most effective treatment for OCD, exposure with response/ritual prevention, relies at least partly on the ability to inhibit compulsive behaviors.
- Premisecitation
Studies have not supported changes in stop-signal reaction time with SRI medication use in controls.
“Studies have failed to support changes in SSRT with SRI medication use in controls (Chamberlain et al., 2006; Drueke et al., 2010).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Chamberlain et al., 2006
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- cites Drueke et al., 2010
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- Interpretationown data
The stop-signal reaction time may reflect a trait of the disorder rather than a state effect.
“This may indicate that SSRT represents a trait, rather than a state effect of the disorder.”
Quote in the paperSubstantial claim - Interpretationreasoning
The medication use is likely related to the sampling frame.
“This is likely related to the sampling frame, as most of the OCD participants were recruited from a hospital OCD clinic and were in psychiatric treatment.”
Quote in the paperNot a substantial claim - Premisecitation
No evidence supports a direct link between OCD severity and stop-signal reaction time impairment.
“In addition, there is no evidence of a direct relationship between OCD severity and SSRT impairment (Chamberlain et al., 2005, 2007; de Wit et al., 2012).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Chamberlain et al., 2005, 2007
Not checked in the free run.
- cites de Wit et al., 2012
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- Premisecitation
Multiple studies have shown stop-signal reaction time impairments in OCD samples.
“Multiple studies have demonstrated SSRT impairments in OCD samples (Lipszyc & Schachar, 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Lipszyc & Schachar, 2010
Not checked in the free run.
- Interpretationown data
The results support earlier studies that found impaired response inhibition in OCD.
“Results support prior studies showing impaired response inhibition in OCD, and extend the findings to a sample of patients with lifetime OCD who were not all currently above threshold for diagnosis.”
Quote in the paperSubstantial claim - Premisecitation
OCD participants with undifferentiated subtypes have slower stop-signal reaction time than healthy controls.
“Studies have indicated that OCD participants (undifferentiated subtypes) have slower SSRT as compared to healthy controls (Boisseau et al., 2012; de Wit et al., 2012; Menzies et al., 2007).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Boisseau et al., 2012
Not checked in the free run.
- cites de Wit et al., 2012
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- cites Menzies et al., 2007
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- Interpretationown data
Response inhibition deficits may serve as a biomarker of OCD regardless of current symptom severity.
“These findings indicate that response inhibition deficits may be a biomarker of OCD, regardless of current severity levels.”
Quote in the paperSubstantial claim - Premisecitation
In OCD, those with contamination and checking symptoms show slower stop-signal reaction time than controls.
“OCD participants with contamination and checking symptoms have slower SSRT than controls (Chamberlain, Blackwell, Fineberg, Robbins, & Sahakian, 2005; Chamberlain et al., 2007).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Chamberlain, Blackwell, Fineberg, Robbins, & Sahakian, 2005
Not checked in the free run.
- cites Chamberlain et al., 2007
Not checked in the free run.
- May combine two claims. 13
- Classified as probably not a substantial claim. 7
- The quote only partly states this claim. 2
May combine two claims.
FindingreasoningThe majority of OCD participants came from a hospital OCD clinic and were receiving psychiatric treatment.
“This is likely related to the sampling frame, as most of the OCD participants were recruited from a hospital OCD clinic and were in psychiatric treatment.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn the OCD group, mean stop-signal reaction time showed no significant correlation with current OCD symptom severity, depression severity, or anxiety severity, in either block.
“Contrary to our prediction, there was no correlation between SSRT and current levels of OCD, anxiety, and depression severity.”
- Also stated in: § RESULTS · plain
“Mean SSRT did not significantly correlate with measures of OCD current severity (YBOCS total score), depression (HDRS total score), or anxiety (HARS total score) in either block.”
- Also stated in: § DISCUSSION · plain
“There was no relationship between SSRT and measures of depression, anxiety, or OCD severity.”
Quote in the paperSubstantial claim- Also stated in: § RESULTS · plain
May combine two claims.
Findingown dataThe OCD group had higher levels of OCD symptoms, depression, and general anxiety than the healthy control group.
“There were significant group differences with regard to OCD symptomology (YBOCS), depression (HDRS), and general anxiety (HARS), with the OCD group showing higher levels of clinical symptoms as compared to the healthy controls.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataNearly half of the OCD participants (48%) had sub-syndromal symptoms, which the study defined as a YBOCS score under 16.
“Forty-eight percent of OCD participants had “sub-syndromal” symptoms, classified as a YBOCS score below 16.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataNinety percent of OCD participants were taking medication.
“Ninety percent of OCD participants were receiving medication.”
- Also stated in: § DISCUSSION · plain
“Ninety percent of the OCD participants were also on medications, and 70% were on multiple psychiatric medications.”
Quote in the paperNot a substantial claim- Also stated in: § DISCUSSION · plain
May combine two claims. The quote only partly states this claim.
Findingown dataParticipants with obsessive-compulsive disorder had a significantly longer mean stop-signal reaction time than healthy controls, after controlling for age, across both task blocks.
“OCD participants were significantly slower than healthy controls with regard to mean SSRT.”
- Also stated in: § RESULTS · plain
“There were significant differences in mean SSRT for both blocks (F(2,61) = 6.00; p = .004), with OCD participants having slower reaction times as compared to healthy controls.”
- Also stated in: § DISCUSSION · boosted
“Consistent with these findings, we found that OCD participants demonstrate impairments in SSRT in the absence of differences in mean reaction time or errors.”
Quote in the paperSubstantial claim- Also stated in: § RESULTS · plain
Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.
Findingown dataThe most frequently prescribed medications were SSRIs.
“The most common medications were SSRIs.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe effect size for the stop-signal reaction time difference between the below-threshold OCD subgroup and healthy controls was large, whereas the effect size for the above-threshold OCD subgroup versus healthy controls was small.
“Effect size for the above-threshold OCD group versus the HC group were small (partial eta squared = 0.004), and effect size for the below-threshold OCD group versus the HC group was large (partial eta squared = 0.274).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe groups did not differ in mean direction errors, go-trial reaction time, or the percentage of successful inhibitions on stop trials.
“Analysis of covariance showed no between-group differences in mean direction errors, “go” reaction time, or percent inhibition on “stop” trials.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationCognitive research in OCD most often reports primary executive-function deficits, which align with frontal-subcortical dysfunction.
“Cognitive studies in OCD most consistently find primary executive functioning deficits, consistent with frontal-subcortical dysfunction (Penades, Catalan, Andres, Salamero, & Gasto, 2005; Rao, Reddy, Kumar, Kandavel, & Chandrashekar, 2008).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Penades, Catalan, Andres, Salamero, & Gasto, 2005
Not checked in the free run.
- cites Rao, Reddy, Kumar, Kandavel, & Chandrashekar, 2008
Not checked in the free run.
May combine two claims.
PremisecitationRelatives of OCD patients who are unaffected have also shown slower stop-signal reaction time than healthy controls, with no difference from OCD participants.
“Unaffected relatives of OCD patients have also shown slower SSRT as compared to healthy controls, with no difference from OCD participants (Chamberlain et al., 2007; Menzies et al., 2007).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Chamberlain et al., 2007
Not checked in the free run.
- cites Menzies et al., 2007
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationOne study found no differences between relatives of OCD patients, OCD participants, and healthy controls.
“However, one study did not find any differences between relatives of OCD patients compared to OCD participants and healthy controls (de Wit et al., 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites de Wit et al., 2012
Not checked in the free run.
May combine two claims.
InterpretationreasoningResponse inhibition is likely a key mechanism in both the emergence and persistence of OCD symptoms.
“Thus, the inability to inhibit rituals is likely to negatively impact therapy outcomes, and response inhibition likely represents a key mechanism in not just the emergence, but also the persistence of OCD symptoms.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Benito, Conelea, Garcia, & Freeman, 2012
Not checked in the free run.
- Rests on an assumption: Exposure and response/ritual prevention is considered the standard treatment for OCD; it entails confronting feared stimuli and then inhibiting rituals.
- Rests on an assumption: An inability to inhibit compulsive behaviors when an anxiety cue is present is a core feature of OCD.
- Rests on an assumption: The most effective treatment for OCD, exposure with response/ritual prevention, relies at least partly on the ability to inhibit compulsive behaviors.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationNoradrenaline reuptake inhibition may preferentially affect stop-signal reaction time in rats and humans.
“Alternatively, although the majority of patients were not on medications that have a large impact on noradrenaline, reuptake inhibition of this chemical may preferentially impact SSRT in rats (Bari, Eagle, Mar, Robinson, & Robbins, 2009) and humans (Chamberlain et al., 2006).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Bari, Eagle, Mar, Robinson, & Robbins, 2009
Not checked in the free run.
- cites Chamberlain et al., 2006
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataThe analyses adjusted for age as a covariate.
“Groups did not differ with regard to education, but the OCD group was significantly older than the healthy control group (t(59) = −2.12; p = .038); thus, age was included as a covariate in the analyses.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningSeveral limitations-modest sample size, lack of independent replication, and missing information on how recently OCD had remitted-mean the results should be interpreted cautiously.
“Given several limitations to this study (modest sample size, lack of independent replication, lack of information about how recently OCD has remitted), results should be interpreted with caution.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThe sample size was small, especially in the OCD group, but significant findings emerged nonetheless.
“Although the sample size was small, particularly in the OCD group, significant findings were demonstrated regardless.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningThe sample was representative of a typical OCD sample, because OCD rarely occurs alone.
“However, our sample was representative of a typical OCD sample, as OCD rarely exists alone.”
Quote in the paperNot a substantial claim- Rests on an assumption: OCD rarely occurs alone.
May combine two claims.
InterpretationreasoningThe stop-signal reaction time deficit may not be specific to OCD because the OCD participants had multiple comorbidities.
“OCD participants also had multiple comorbidities, indicating that this deficit may not be specific to OCD.”
Quote in the paperSubstantial claim
The paper relies on this without support.
Before this study, no research had examined lifetime-diagnosed OCD patients spanning a range of current symptom severity.
“To our knowledge, no one has examined a sample of OCD patients with a lifetime diagnosis of OCD across a range of current symptom severity.”
The paper relies on this without support.
Exposure and response/ritual prevention is considered the standard treatment for OCD; it entails confronting feared stimuli and then inhibiting rituals.
“The construct of inhibition is particularly relevant to OCD, in that the gold standard therapy for OCD is exposure and response/ritual prevention (ERP), which involves exposure to feared stimuli, with subsequent inhibition of rituals.”
The paper relies on this without support.
An inability to inhibit compulsive behaviors when an anxiety cue is present is a core feature of OCD.
“The inability to inhibit compulsive behaviors in the presence of an anxiety cue is a hallmark feature of OCD.”
The paper relies on this without support.
The most effective treatment for OCD, exposure with response/ritual prevention, relies at least partly on the ability to inhibit compulsive behaviors.
“The most effective treatment for OCD, exposure with response/ritual prevention (ERP), relies, at least in part, on this ability.”
The paper relies on this without support.
OCD rarely occurs alone.
“as OCD rarely exists alone”
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?
Impairment in later inhibitory processes of action restraint and action cancelation has not been previously associated with symptom severity.
“Even though the impairment in later inhibitory processes of action restraint and action cancelation has not been previously associated with symptom severity (14, 15), it was suggested that the slower reaction times in similar tasks are related to the “not just right experience” reported by the patients (14).”
From Functional connectivity changes in obsessive-compulsive disorder correspond to interference control and obsessions severity (2020) · cites this paper as [15]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Age difference is called significant despite its p-value
MinorThe age comparison has p = .038, which does not meet the paper's stated p < .01 threshold for statistical significance.
“the OCD group was significantly older than the healthy control group (t(59) = −2.12; p = .038)”
“For all analyses, statistical significance was defined as p < .01.”
Reported SST degrees of freedom exceed the sample size
MinorThe final sample contains 61 people. An ANCOVA using that sample cannot have 61 residual degrees of freedom, and the reported Block 2 test cannot have 72 numerator degrees of freedom.
“Block 1: (F(2,61)) = 4.27; p = .019; Block 2: (F(72,61)) = 4.76; p = .012”
“We used the stop signal task to examine the difference between 21 OCD participants (mean age, 42.95 years) and 40 healthy controls (mean age, 35.13 years).”
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Self-citation
- Authors
- McLaughlin, N. C. R., Kirschner, J., Foster, H., O’Connell, C., Rasmussen, S. A., & Greenberg, B. D.
- Affiliations
- Brown University (US)
- University of Rochester Medicine (US)
- Stanford Medicine (US)
- Corresponding author
- McLaughlin, Nicole C.R.
- Venue
- Journal of the International Neuropsychological Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2016-06-23
- Volume
- 22
- Issue
- 7
- Pages
- 785-789
- ISSN
- 1355-6177 (ISSN-L)
- 1469-7661
- PMC
- PMC7418076
- OpenAlex
- W2472173593
- Cited by
- 40
- References
- 23
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 2 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 2
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the International Neuropsychological Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p50mh086400-05)
- National Institute of Mental Health (P-50-MH-086400, K23MH100607, P50MH106435)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- obsessive-compulsive disorder, stop-signal reaction time, response inhibition, OCD severity, depression, anxiety, biomarkers, executive function
- MeSH terms
- Adult, Humans, Inhibition, Psychological, Middle Aged, Obsessive-Compulsive Disorder, Psychomotor Performance, Executive Function
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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.
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