Cognitive Rigidity, Habitual Tendencies, and Obsessive-Compulsive Symptoms: Individual Differences and Compensatory Interactions

Abstract

Recent theories have posited a range of cognitive risk factors for obsessive-compulsive disorder (OCD), including cognitive inflexibility and a maladaptive reliance on habits. However, empirical and methodological inconsistencies have obscured the understanding of whether inflexibility and habitual tendencies indeed shape OCD symptoms in clinical and sub-clinical populations, and whether there are notable interactions amongst these traits. The present investigation adopted an interactionist individual differences approach to examine the associations between behaviorally-assessed cognitive flexibility and subclinical OCD symptomatology in a healthy population. It also explored the nature of the interactions between cognitive flexibility and habitual tendencies, and the degree to which these cognitive traits predict subclinical OCD symptomatology. Across two studies, including a preregistration, Bayesian and regression analyses revealed that cognitive inflexibility and compulsive habitual tendencies act as unique and independent predictors of subclinical OCD symptomatology in healthy populations. Furthermore, there was a significant interaction between cognitive rigidity and habitual compulsivity, which accounted for 49.4% of the variance in subclinical OCD symptomatology in Study 1, and 37.3% in Study 2. In-depth analyses revealed a compensatory effect between cognitive inflexibility and habitual compulsivity such that both are necessary for OCD symptomatology, but neither is sufficient. These results imply that in order to generate reliable and nuanced models of the endophenotype of OCD symptomatology, it is essential to account for interactions between psychological traits. Moreover, the present findings have important implications for theories on the cognitive roots of OCD, and potentially in the development of interventions that target both cognitive inflexibility and habitual compulsivity.

Temporal dynamics of autonomic nervous system responses under cognitive‐emotional workload in obsessive‐compulsive disorder

“…The reduced PA reactions increased with the severity of OCD symptoms. These findings are consistent with previous studies demonstrating that patients with severe OCD symptoms tend to exhibit greater rigidity in their nervous system functioning (Gruner & Pittenger, 2017; Ramakrishnan et al., 2022; Remijnse et al., 2013). Alongside HR dynamics, the reduced PA changes during continuous emotional or cognitive effort could serve as indicators of OCD and may be further employed for reliable diagnosis and predicting disease progression.…”

Action sequence learning, habits, and automaticity in obsessive-compulsive disorder

“…Second, OCD patients self-reported greater habitual tendencies in both the ‘routine’ and ‘automaticity’ subscales. Previous studies have reported that subjective habitual tendencies are associated with compulsive traits ( Ersche et al, 2019 ; Wuensch et al, 2022 ) and act, in addition to cognitive inflexibility, as a predictor of subclinical OCD symptomatology in healthy populations ( Ramakrishnan et al, 2022 ). There is an apparent discrepancy between self-reported ‘automaticity’ and the objective measure of automaticity we provided.…”

Action-sequence learning, habits and automaticity in obsessive-compulsive disorder

“…Secondly, OCD patients self-reported greater habitual tendencies in both the ‘routine’ and ‘automaticity’ subscales. Previous studies have reported that subjective habitual tendencies are associated with compulsive traits (Ersche et al, 2019; Wuensch et al, 2022) and act, in addition to cognitive inflexibility, as a predictor of subclinical OCD symptomatology in healthy populations (Ramakrishnan et al, 2022). There is an apparent discrepancy between self-reported ‘automaticity’ and the objective measure of automaticity we provided.…”