Trial-by-Trial Adjustments of Cognitive Control Following Errors and Response Conflict are Altered in Pediatric Obsessive Compulsive Disorder

Yanni Liu,William J Gehring,Kate Dimond Fitzgerald,Stephan F Taylor,Daniel H Weissman

doi:10.3389/fpsyt.2012.00041

Abstract

Background: Impairments of cognitive control have been theorized to drive the repetitive thoughts and behaviors of obsessive compulsive disorder (OCD) from early in the course of illness. However, it remains unclear whether altered trial-by-trial adjustments of cognitive control characterize young patients. To test this hypothesis, we determined whether trial-by-trial adjustments of cognitive control are altered in children with OCD, relative to healthy controls. Methods: Forty-eight patients with pediatric OCD and 48 healthy youth performed the Multi-Source Interference Task. Two types of trial-by-trial adjustments of cognitive control were examined: post-error slowing (i.e., slower responses after errors than after correct trials) and post-conflict adaptation (i.e., faster responses in high-conflict incongruent trials that are preceded by other high-conflict incongruent trials, relative to low-conflict congruent trials). Results: While healthy youth exhibited both post-error slowing and post-conflict adaptation, patients with pediatric OCD failed to exhibit either of these effects. Further analyses revealed that patients with low symptom severity showed a reversal of the post-conflict adaptation effect, whereas patients with high symptom severity did not show any post-conflict adaptation. Conclusion: Two types of trial-by-trial adjustments of cognitive control are altered in pediatric OCD. These abnormalities may serve as early markers of the illness.

Highlights

Patients with obsessive compulsive disorder (OCD) often have difficulty controlling intrusive thoughts and behaviors despite realizing that they do not “make sense” (American Psychiatric Association, 2000)
DATA ANALYSIS Our analyses focused on determining whether post-error slowing and/or post-conflict adaptation differed among healthy youth and patients with pediatric OCD
We investigated whether patients with pediatric OCD exhibit abnormal trial-by-trial adjustments of cognitive control, relative to healthy controls

Summary

Introduction

Patients with obsessive compulsive disorder (OCD) often have difficulty controlling intrusive thoughts (obsessions) and behaviors (compulsions) despite realizing that they do not “make sense” (American Psychiatric Association, 2000). One framework for interpreting these deficits posits that they arise from impaired cognitive control: the ability to voluntarily control behavior, monitor the consequences of one’s actions, and make behavioral adjustments when necessary (Norman and Shallice, 1986) Consistent with this view, OCD has been linked to disturbances of cognitive control in response inhibition (Rosenberg et al, 1997; Bannon et al, 2002; Aycicegi et al, 2003; Watkins et al, 2004; Chamberlain et al, 2006) and negative priming (Enright and Beech, 1993) paradigms. Impairments of cognitive control have been theorized to drive the repetitive thoughts and behaviors of obsessive compulsive disorder (OCD) from early in the course of illness. It remains unclear whether altered trial-by-trial adjustments of cognitive control characterize young patients. These abnormalities may serve as early markers of the illness

Methods

Results

Conclusion