The role of compulsivity in body-focused repetitive behaviors

Grant, Jon E.; Chamberlain, Samuel R.

doi:10.1016/j.jpsychires.2022.05.001

Cited by 1 publication

(1 citation statement)

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“…Many psychiatric disorders are characterized by repetitive compulsive behaviors (including, for example, alcohol and substance use disorders, schizophrenia, autism spectrum disorders, eating disorders, gambling disorder, trichotillomania, and skin-picking disorder). [1][2][3][4][5][6][7] Obsessivecompulsive disorder (OCD) may reflect the most extreme version of repetitive behavior problems, but the complaint of having to do the same thing over and over again despite negative consequences (ie, being cognitively inflexible, which can be considered an important facet of compulsivity) is also commonly reported in other disorders too. [8][9][10] OCD is currently regarded, in the Diagnostic and Statistical Manual Version 5 (DSM-5), as part of a spectrum of OC-related conditions, which also includes hair-pulling disorder, skin-picking disorder, hoarding disorder, and body dysmorphic disorder.…”

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confidence: 99%

Impaired cognitive flexibility across psychiatric disorders

Grant

Chamberlain

2023

CNS Spectr.

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Objective Problems with cognitive flexibility have been associated with multiple psychiatric disorders, but there has been little understanding of how cognitive flexibility compares across these disorders. This study examined problems of cognitive flexibility in young adults across a range of psychiatric disorders using a validated computerized trans-diagnostic flexibility paradigm. We hypothesized that obsessive-compulsive spectrum disorders (eg, obsessive-compulsive disorder, trichotillomania, and skin-picking disorder) would be associated with pronounced flexibility problems as they are most often associated with irrational or purposeless repetitive behaviors. Methods A total of 576 nontreatment seeking participants (aged 18-29 years) were enrolled from general community settings, provided demographic information, and underwent structured clinical assessments. Each participant undertook the intra-extra-dimensional task, a validated computerized test measuring set-shifting ability. The specific measures of interest were total errors on the task and performance on the extra-dimensional (ED) shift, which reflects the ability to inhibit and shift attention away from one stimulus dimension to another. Results Participants with depression and PTSD had elevated total errors on the task with moderate effect sizes; and those with the following had deficits of small effect size: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), antisocial personality disorder, and binge-eating disorder. For ED errors, participants with PTSD, GAD, and binge-eating disorder exhibited deficits with medium effect sizes; those with the following had small effect size deficits: depression, social anxiety disorder, OCD, substance dependence, antisocial personality disorder, and gambling disorder. Conclusions These data indicate cognitive flexibility deficits occur across a range of mental disorders. Future work should explore whether these deficits can be ameliorated with novel treatment interventions.

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