The role of executive functioning in obsessive compulsive disorder

Abstract

Ongoing literature has found that executive functioning (EF) seems to be the cognitive domain most adversely affected in the presence of obsessive-compulsive disorder (OCD). This has been particularly significant in research addressing updated treatment approaches for OCD, however, results have been inconsistent. Therefore, the purpose of this study was to explore the role of EF in the presentation of OCD using standardised subtests from the Behavioural Assessment of the Dysexecutive Syndrome (BADS, Wilson et al., 1996) and the Delis-Kaplan Executive Functioning Scale (D-KEFS, Delis, Kaplan & Kramer, 2001). A quantitative methodology was adopted for data collection and analysis. OCD-related questionnaires and five EF subtests from the mentioned batteries were administered to a sample of 50 participants. Participants were split into HIGH_OC and LOW_OC groups using the recommended cut-off score of 21 on the OCI-R. Results demonstrated an association between higher scores on the OCD-related questionnaires and subtests from the BADS. This finding revealed an association between difficulties in set shifting and inhibitory control and the presence of an inflated sense of responsibility and perceived threat of harm. It was also indicative of an association between difficulties in planning and performance monitoring and the presence of over-importance of thoughts and the need to control thoughts. No associations were found between OCD and the subtests on the D-KEFS. Moreover, no differences were found between the HIGH_OC and LOW_OC groups on the EF subtests. Findings from this study indicated that the BADS might be more sensitive in the presence of OCD, due to its high ecological validity. This implied the possibility of using domain-specific neuro-rehabilitative strategies in treatment plans.