Memory Deficits In Obsessive-compulsive Disorder Research Articles

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

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. Results revealed that maintenance and updating (top-down) and perceptual integration (bottom-up) predicted memory performance generally, and specifically in those with clinical OCD. Exploratory analyses suggested that this effect may be somewhat different among subclinical OCD groups; however, these findings should be considered with conceptual and analytical caveats in mind. We explain these results via deficient sensory (perceptual integration) and working memory (maintenance and updating) gating mechanisms and propose a model to accommodate their expression in OC symptoms. In conclusion, our meta-analysis has expanded understanding of cognitive performance in OCD and identifies the possibility of untapped cognitive targets for intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Decreased memory confidence in obsessive-compulsive disorder for scenarios high and low on responsibility: is low still too high?

Previous research suggests that patients with obsessive-compulsive disorder (OCD), particularly checkers, display an inflated sense of responsibility. For the present study, we tested whether memory confidence in OCD is reduced under conditions of heightened responsibility and/or reflects poor memory vividness. A computerized task designed to modulate perceived responsibility was administered to 26 OCD patients (12 checkers) and 21 healthy controls. In the experimental condition (high responsibility), participants had to allocate daily medications to ten fictive patients in a hospital emergency ward, whereas in the control condition (low responsibility) participants had to allocate bath essences for ten hotel guests. Participants' response time and accuracy were recorded as well as their memory confidence, memory vividness, and subjective success. Irrespective of the condition, OCD patients performed as accurately as healthy controls, but appraised their performance as worse than that of controls. Memory confidence was decreased in patients, particularly checkers. No group differences emerged on vividness, and none of the effects were moderated by the condition (high versus low responsibility). The relationship between responsibility and OCD behavior is complex. Results suggest metamemory problems in OCD checkers, even when induced responsibility is low. The findings speak against "cold" memory deficits in OCD, as patients did not differ from controls on accuracy, reaction time, or vividness. Future research should focus on idiosyncratic beliefs and scenarios that inflate responsibility and elicit cognitive biases.

Examining procedural working memory processing in obsessive-compulsive disorder

Previous research has suggested that a deficit in working memory might underlie the difficulty of obsessive-compulsive disorder (OCD) patients to control their thoughts and actions. However, a recent meta-analyses found only small effect sizes for working memory deficits in OCD. Recently, a distinction has been made between declarative and procedural working memory. Working memory in OCD was tested mostly using declarative measurements. However, OCD symptoms typically concerns actions, making procedural working-memory more relevant. Here, we tested the operation of procedural working memory in OCD. Participants with OCD and healthy controls performed a battery of choice reaction tasks under high and low procedural working memory demands. Reaction-times (RT) were estimated using ex-Gaussian distribution fitting, revealing no group differences in the size of the RT distribution tail (i.e., τ parameter), known to be sensitive to procedural working memory manipulations. Group differences, unrelated to working memory manipulations, were found in the leading-edge of the RT distribution and analyzed using a two-stage evidence accumulation model. Modeling results suggested that perceptual difficulties might underlie the current group differences. In conclusion, our results suggest that procedural working-memory processing is most likely intact in OCD, and raise a novel, yet untested assumption regarding perceptual deficits in OCD.

Assessing neurocognitive function in psychiatric disorders: A roadmap for enhancing consensus

It has been challenging to identify core neurocognitive deficits that are consistent across multiple studies in patients with Obsessive Compulsive Disorder (OCD). In turn, this leads to difficulty in translating findings from human studies into animal models to dissect pathophysiology. In this article, we use primary data from a working memory task in OCD patients to illustrate this issue.Working memory deficiencies have been proposed as an explanatory model for the evolution of checking compulsions in a subset of OCD patients. However, findings have been mixed due to variability in task design, examination of spatial vs. verbal working memory, and heterogeneity in patient populations. Two major questions therefore remain: first, do OCD patients have disturbances in working memory? Second, if there are working memory deficits in OCD, do they cause checking compulsions?In order to investigate these questions, we tested 19 unmedicated OCD patients and 23 matched healthy controls using a verbal working memory task that has increased difficulty/task-load compared to classic digit-span tasks. OCD patients did not significantly differ in their performance on this task compared to healthy controls, regardless of the outcome measure used (i.e. reaction time or accuracy). Exploratory analyses suggest that a subset of patients with predominant doubt/checking symptoms may have decreased memory confidence despite normal performance on trials with the highest working memory load.These results suggest that other etiologic factors for checking compulsions should be considered. In addition, they serve as a touchstone for discussion, and therefore help us to generate a roadmap for increasing consensus in the assessment of neurocognitive function in psychiatric disorders.

Underlying mechanisms of verbal memory deficits in obsessive-compulsive disorder and major depression – The role of cognitive self-consciousness

Background and ObjectivesPrevious studies have demonstrated that some individuals suffering from obsessive-compulsive disorder (OCD) are impaired in verbal memory performance. This study was designed to investigate the role of cognitive self-consciousness (CSC) as a putative underlying mechanism of these cognitive deficits. MethodsVerbal memory performance of 36 participants with OCD, 36 individuals with major depression disorder (MDD) and 36 healthy controls was assessed with the California Verbal Learning Test under three different experimental conditions: (1) single-task condition, (2) while simultaneously focusing on their thoughts (CSC condition), (3) while simultaneously focusing on external stimuli (dual-task condition). ResultsMemory performance in the CSC condition and in the dual-task condition was reduced compared to single-task condition but no interaction effect was found. LimitationsIt remains unclear whether CSC and other concepts with an inward self-referential focus of attention (e.g. rumination) differ in the way they influence cognitive performance. ConclusionsThese results confirm the deteriorating influence of heightened CSC on verbal memory encoding but suggest that the effect is not specific to OCD.

Metacognition and episodic memory in obsessive-compulsive disorder

Memory deficits in patients with obsessive-compulsive disorder (OCD) have been frequently reported but are not sufficiently accounted for by cognitive models of OCD. The aim of the study was to identify cognitive mechanisms that might be able to explain memory deficits in OCD. We hypothesized that a self-conscious meta-cognitive style might be responsible for reduced memory performance in OCD. Episodic verbal memory performance was assessed in 23 participants with OCD (DSM-IV criteria) and 22 matched controls. Cognitive self-consciousness was assessed with a self-report measure derived from the Meta-Cognitions Questionnaire (MCQ). Compared to controls, OCD participants showed reduced immediate and delayed recall of complex verbal material and increased self-reported levels of cognitive self-consciousness. Multiple regression analyses indicated that group differences in story recall were significantly mediated by self-reported trait cognitive self-consciousness. Results point to the deteriorating effects of a thought-focused cognitive style on effortful encoding processes in OCD.

C.07.01 Unipolar and bipolar depression: overlapping symptoms, different diagnosis?

To date, only a few studies have examined whether executive dysfunctions in obsessive–compulsive disorder (OCD) are state or trait dependent and almost none of these studies have used functional neuroimaging techniques. We conducted a functional MRI study before and after 12 weeks of pharmacological treatment in 14 psychotropic-free patients with OCD without comorbidity. Subjects performed a spatial variant of a working memory task with four increasing levels of difficulty (n-back task). Responders and non-responders did not differ in clinical and demographical characteristics or brain activation patterns before treatment. Performance improved only in responders and was associated with a change in the overall pattern of brain activity during the task. We found no correlations between (changes in) scores on symptom scales, brain activity and performance. Our preliminary findings suggests that spatial working memory deficits in OCD and their functional anatomical correlates, as assessed with a spatial n-back task, are, at least to some extent, state dependent.

Spatial working memory in obsessive–compulsive disorder improves with clinical response: A functional MRI study

To date, only a few studies have examined whether executive dysfunctions in obsessive–compulsive disorder (OCD) are state or trait dependent and almost none of these studies have used functional neuroimaging techniques. We conducted a functional MRI study before and after 12 weeks of pharmacological treatment in 14 psychotropic-free patients with OCD without comorbidity. Subjects performed a spatial variant of a working memory task with four increasing levels of difficulty (n-back task). Responders and non-responders did not differ in clinical and demographical characteristics or brain activation patterns before treatment. Performance improved only in responders and was associated with a change in the overall pattern of brain activity during the task. We found no correlations between (changes in) scores on symptom scales, brain activity and performance. Our preliminary findings suggests that spatial working memory deficits in OCD and their functional anatomical correlates, as assessed with a spatial n-back task, are, at least to some extent, state dependent.

A check on the memory deficit hypothesis of obsessive–compulsive checking

A number of recent studies have challenged the hypothesis that patients with obsessive-compulsive disorder (OCD) display global memory deficits. An alleviated form of the memory deficit hypothesis posits that OCD patients share deficits to vividly recall memory episodes. According to the latter view, checking rituals can be understood as counter-productive coping strategies to "enrich" memory episodes in order to make them more distinctive. A source memory task was administered to 27 OCD (17 checkers) and 51 healthy participants. Along with confidence judgments, a remember-know procedure was employed to assess whether OCD patients display problems with conscious/vivid recollection. Patients with or without checking compulsions did not exhibit differences to controls on source memory accuracy and meta-memory. Patients forgot more self-generated items, which, however, was related to comorbid depressive but not OCD symptoms. Findings challenge the ubiquity of memory deficits in OCD. To account for the inconclusive pattern of results in the literature, it is suggested that patients mistrust their memories and adopt checking rituals only when perceived responsibility is inflated.

Impact of comorbid depressive symptoms on nonverbal memory and visuospatial performance in obsessive-compulsive disorder

Introduction. Recent research has suggested that some executive dysfunctions in obsessive-compulsive disorder (OCD) represent an epiphenomenon of comorbid depressive symptoms. The present study investigated whether the impact of comorbid depressive symptoms on cognitive dysfunction in OCD extends to nonverbal memory impairment. Methods. A total of 32 OCD patients and 20 healthy controls took part in the study. Participants were administered a neurocognitive battery with a focus on nonverbal memory and visuospatial functions. Results. While evidence was provided that neurocognitive processes necessitating visuospatial transformation and visuoconstruction are deficient in OCD patients regardless of comorbid depressive symptoms, nonverbal memory dysfunctions were only apparent for patients with elevated scores in the Hamilton Depression (HDRS) Rating Scale (total score S 8). Correlations with subscores of the HDRS revealed that core depressive symptoms are related to nonverbal memory deficits in OCD. Mental rotation, middle discrimination, and position discrimination were found to be unaffected in OCD. Y-BOCS scores, length of illness, onset of illness, number of hospital admissions, and checking compulsions were not associated with neurocognitive disturbances. Conclusions. Nonverbal memory is disturbed in only a subgroup of OCD patients displaying elevated HDRS scores (HDRS S 8). It is claimed but awaits further empirical testing that differences in depression profile across OCD studies have contributed to inconsistencies in prior investigations on neurocognitive functioning in OCD. Our results are questioning the hypothesis that nonverbal deficits are a causal factor for the development of checking compulsions.

Relation of Neurological Soft Signs to Nonverbal Memory Performance in Obsessive-Compulsive Disorder

Few studies have examined the relation between neurological soft signs (NSS) and neuropsychological performance in Obsessive-Compulsive Disorder (OCD). Thirty outpatients with primary OCD and 30 matched normal controls were administered the Cambridge Neurological Inventory and the Rey-Osterrieth Complex Figure Test (RCFT). A series of multiple regression models tested the relationship between NSS and performance on the RCFT. Patients presented significantly more neurological soft signs than controls on both sides of the body, and were impaired on the free recall and organization scores of the RCFT. Nonverbal memory deficits in OCD were predicted independently by organizational strategies during the copy condition of the RCFT, and neurological soft signs. There might be at least two variables independently mediating nonverbal memory deficits in OCD: (1) a cognitive organization and planning component, and (2) a complex motor regulatory component.

Neuropsychology of obsessive-compulsive disorder: a review and treatment implications

The existing literature examining neuropsychological features of obsessive-compulsive disorder (OCD) is reviewed. The accumulated research points to a deficit in organizational strategies in general, suggesting problems in executive functioning. The available research is inconsistent in identifying memory deficits in OCD. However, memory problems are most evident when tests are used that require an implicit organizational strategy. While the majority of the research reviewed involves adult samples, there is emerging evidence that these deficits are present in children as well. It is suggested here that the interaction between organizational strategy deficits and the effort to recall unstructured information contributes to doubting, an important feature of OCD. Implications of this body of research for behavior therapy are considered.

Strategic processing and episodic memory impairment in obsessive compulsive disorder.

There is evidence that nonverbal memory problems in obsessive compulsive disorder (OCD) are mediated by impaired strategic processing. Although many studies have found verbal memory to be normal in OCD, these studies did not use tests designed to stress organizational strategies. This study examined verbal and nonverbal memory performance in 33 OCD patients and 30 normal control participants with the Rey-Osterrieth Complex Figure Test and the California Verbal Learning Test. OCD patients were impaired on verbal and nonverbal measures of organizational strategy and free recall. Multiple regression modeling indicated that free recall problems in OCD were mediated by impaired organizational strategies used during learning trials. Therefore, verbal and nonverbal episodic memory deficits in OCD are affected by impaired strategic processing. Results are consistent with neurobiological models proposing frontal-striatal system dysfunction in OCD.