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Impaired cognitive flexibility across psychiatric disorders

Impaired cognitive flexibility across psychiatric disorders
Impaired cognitive flexibility across psychiatric disorders

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.

compulsivity, Flexibility, habit, OCD, rigidity
1092-8529
688-692
Grant, Jon E.
07372bd5-8a0d-42b4-b41b-e376c652acf3
Chamberlain, Samuel R.
8a0e09e6-f51f-4039-9287-88debe8d8b6f
Grant, Jon E.
07372bd5-8a0d-42b4-b41b-e376c652acf3
Chamberlain, Samuel R.
8a0e09e6-f51f-4039-9287-88debe8d8b6f

Grant, Jon E. and Chamberlain, Samuel R. (2023) Impaired cognitive flexibility across psychiatric disorders. CNS Spectrums, 28 (6), 688-692. (doi:10.1017/S1092852923002237).

Record type: Article

Abstract

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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Accepted/In Press date: 23 March 2023
e-pub ahead of print date: 28 April 2023
Additional Information: For the purpose of open access, the author has applied a CC BY public copyright license to any author accepted manuscript version arising from this submission.
Keywords: compulsivity, Flexibility, habit, OCD, rigidity

Identifiers

Local EPrints ID: 492716
URI: http://eprints.soton.ac.uk/id/eprint/492716
ISSN: 1092-8529
PURE UUID: 6aee1403-cb63-4328-9f21-58cf8ce5dfc5
ORCID for Samuel R. Chamberlain: ORCID iD orcid.org/0000-0001-7014-8121

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Date deposited: 12 Aug 2024 16:48
Last modified: 13 Aug 2024 01:58

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Contributors

Author: Jon E. Grant
Author: Samuel R. Chamberlain ORCID iD

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