Cognitive inflexibility specificity for individuals with high levels of obsessive-compulsive symptoms

Abstract

Obsessive and compulsive symptoms are only partially explained by current cognitive-behavioral models. A complementary proposal, behavioral dysregulation, considers cognitive inflexibility (a malfunction of the capacity of switching between mental processes in order to generate appropriate behavioral responses) as an endophenotype of OCD. However, it is unclear whether deficits in cognitive flexibility are specific to individuals with OCD, or whether cognitive underperformance in OCD should instead be explained by nonspecific factors. Here, we probed cognitive flexibility by using symptom-related stimuli in a probabilistic reversal learning task. We compared performance of individuals with two closely related OCD-related phenomena: OC symptoms and Not Just Right Experiences. Data were analyzed through computational models of reinforcement learning. Academic achievement was used for comparison as an unrelated learning task. Our results support the inflexibility specificity hypothesis, but only for the processing of symptom-related triggers. Clinical implications are discussed in relation to contemporary CBT models.