Modeling a multidimensional model of memory performance in obsessive-compulsive disorder: A multilevel meta-analytic review.

Abstract

Even though memory performance is a commonly researched aspect of Obsessive-Compulsive Disorder (OCD), a coherent and unified explanation of the role of specific cognitive factors has remained elusive. To address this, the present meta-analysis examined the predictive validity of Harkin and Kessler's (2011) Executive Function, Binding Complexity and Memory Load (EBL) Classification System concerning affected versus unaffected memory performance in OCD. We employed a multi-level meta-analytic approach (Viechtbauer, 2010) to accommodate the interdependent nature of the EBL model and interdependency of effect sizes (305 effect sizes from 144 studies, including 4424 OCD patients). Results revealed that the EBL model predicted memory performance; i.e., as EBL demand increases, those with OCD performed progressively worse on memory tasks. Executive function was the driving mechanism behind the EBL's impact on OCD memory performance, as it negated binding complexity, memory load, and visual or verbal task differences. Comparisons of sub-task effect sizes were also generally in accord with the cognitive parameters of the EBL taxonomy. We conclude that standardised coding of tasks along individual cognitive dimensions and multi-level meta-analyses provide a new approach to examine multidimensional models of memory and cognitive performance in OCD and other disorders.

Top-down and bottom-up contributions to memory performance in OCD: A multilevel meta-analysis with clinical implications.

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Despite extensive coverage of a relationship between memory performance and executive function in the obsessive-compulsive disorder (OCD) literature, the relative contributions of specific aspects of executive control have remained elusive. We, therefore, extend our previous multilevel meta-analysis (Persson et al, 2021), where demand on executive function was the most significant determinant of memory deficits in OCD, and provide a finer-grained analysis of executive control via a segregation into top-down (attentional control, maintenance and updating, planning) and bottom-up (perceptual integration, perceptual salience) contributions. Our multilevel meta-analytic approach allowed us to accommodate the interdependency of 255 effect sizes from 131 studies, totaling 4,101 OCD patients.

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“…The search terms used to access literature were "(wash* OR check* OR hoard* OR obsessivecompulsive* OR OCD OR clean*) AND (executive OR bind* OR load* OR visual OR verbal) AND (memory)." Previous literature informed the selection of the keywords, for example, Leopold and Backenstrass (2015) and Persson et al (2021). In January 2021, the completed database search identified 7,632 studies and 100 from additional sources (including an ancestry search).…”

“…In January 2021, the completed database search identified 7,632 studies and 100 from additional sources (including an ancestry search). A full-text examination of 350 articles identified 131 suitable for the final review (see S13 in the online supplemental materials for comparison to Persson et al, 2021). Figure 1 provides an overview of the PRISMA flowchart with full methodological and descriptive details provided in S2-S7 in the online supplemental materials.…”

“…In contrast, when we observe poor memory performance in OCD, it is consistently "related to executive functioning and less with memory impairment per se" (Abramovitch et al, 2013(Abramovitch et al, , p. 1168). An assertion that is well supported, via excellent individual papers (e.g., Perna et al, 2019;Purcell et al, 1998), thorough reviews (e.g., Greisberg & McKay, 2003;Kuelz et al, 2004;Olley et al, 2007) and detailed meta-analyses (e.g., Del Casale et al, 2016;Persson et al, 2021; N. Y. Shin et al, 2014;Snyder et al, 2015).…”

“…For tasks with high (e.g., RCFT, n-back, complex story recall) versus low (e.g., neutral word recall, verbal recognition, basic Delayed-Match-to Sample [DMTS] tasks) executive demands, we observed impaired versus relatively intact memory performance in OCD, respectively. For reference, we present the EBL figure as developed by Harkin & Kessler (2011a) and Persson et al (2021) in the online supplemental materials (S14). This we propose justifies the present finer-grained analysis of individual dimensions of executive function and their relationship to memory performance in OCD.…”