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Letter to the Editor: Recent Advances in Research on Cognition and Emotion in OCD: A Review

  • Anxiety Disorders (DJ Stein, Section Editor)
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Abstract

Cognitive theories of obsessive-compulsive disorder (OCD) ascertain that catastrophic (mis)interpretations of normally occurring intrusive thoughts are causal to the onset and maintenance of OCD. Recently, Calkins, Berman and Wilhelm have highlighted research validating the cognitive model. However, the current comment article stresses various findings that challenge basic premises of the cognitive theory. Moreover, a review of clinical studies investigating cognitive and behavioral therapies for OCD questions the added value of cognitive interventions over and above behavior therapy consisting of exposure and response prevention for this disorder. We suggest an alternative, potentially more useful route of investigation, stressing executive (dis)functions as the cause of OCD patients to (automatically) act on internal and external stimuli. We further suggest that dysfunctional beliefs proposed as paramount in the pathogenesis of OCD according to the cognitive model may be less important and specific than formerly believed.

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References

  1. Meyer V. Modification of expectations in cases with obsessional rituals. Behav Res Ther. 1966;4:273–80.

    PubMed  CAS  Google Scholar 

  2. Olatunji BO, Davis ML, Powers MB, et al. Cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators. J Psychiatr Res. 2013;47:33–41.

    Article  PubMed  Google Scholar 

  3. Park L, Jefferson J, Greist J. Obsessive-compulsive disorder. CNS Drugs. 1997;7:188–202.

    Article  Google Scholar 

  4. Clark DA. Cognitive behavioral treatment of obsessive-compulsive disorders: a commentary. Cogn Behav Pract. 1999;6:408–15.

    Article  Google Scholar 

  5. Calkins AW, Berman NC, Wilhelm S. Recent advances in research on cognition and emotion in OCD: A review. Curr Psychiatry Rep. 2013;15:357–64.

    Article  PubMed  Google Scholar 

  6. Morein-Zamir S, Fineberg NA, Robbins TW, et al. Inhibition of thoughts and actions in obsessive-compulsive disorder: extending the endophenotype? Psychol Med. 2010;40:263–72.

    Article  PubMed  CAS  Google Scholar 

  7. de Wit SJ, de Vries FE, van der Werf YD, et al. Presupplementary motor area hyperactivity during response inhibition: a candidate endophenotype of obsessive-compulsive disorder. Am J Psychiatry. 2012;169:1100–8.

    Article  PubMed  Google Scholar 

  8. Lennertz L, Rampacher F, Vogeley A, et al. Antisaccade performance in patients with obsessive-compulsive disorder and unaffected relatives: further evidence for impaired response inhibition as a candidate endophenotype. Eur Arch Psychiatry Clin Neurosci. 2012;262:625–34.

    Article  PubMed  Google Scholar 

  9. Obsessive Compulsive Cognitions Working Group. Cognitive assessment of obsessive-compulsive disorder. Behav Res Ther. 1997;35:667–81.

    Article  Google Scholar 

  10. Obsessive Compulsive Cognitions Working Group. Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory: Part I. Behave Res Ther. 2003;41:863–78.

    Article  Google Scholar 

  11. Julien D, Careau Y, O'Connor KP, et al. Specificity of belief domains in OCD: validation of the French version of the Obsessive Beliefs Questionnaire and a comparison across samples. J Anxiety Disord. 2008;22:1029–41.

    Article  PubMed  Google Scholar 

  12. Anholt GE, Emmelkamp PM, Cath DC, et al. Do patients with OCD and pathological gambling have similar dysfunctional cognitions? Behav Res Ther. 2004;42:529–37.

    Article  PubMed  Google Scholar 

  13. Lavender A, Shubert I, de Silva P, et al. Obsessive-compulsive beliefs and magical ideation in eating disorders. Br J Clin Psychol. 2006;45:331–42.

    Article  PubMed  Google Scholar 

  14. Baptista MN, Magna LA, McKay D, et al. Assessment of obsessive beliefs: Comparing individuals with obsessive-compulsive disorder to a medical sample. J Behav Ther Exp Psyiatry. 2011;42:1–5.

    Article  Google Scholar 

  15. Taylor S, Abramowitz JS, McKay D, et al. Do dysfunctional beliefs play a role in all types of obsessive-compulsive disorder? J Anxiety Disord. 2006;20:85–97.

    Article  PubMed  Google Scholar 

  16. Anholt GA, van Oppen P, Cath DC, et al. Sensitivity to change of the Obsessive Beliefs Questionnaire. Clin Psychol Psychother. 2010;17:154–9.

    PubMed  Google Scholar 

  17. Wu KD, Carter SA. Further investigation of the Obsessive Beliefs Questionnaire: factor structure and specificity of relations with OCD symptoms. J Anxiety Disord. 2008;22:824–36.

    Article  PubMed  Google Scholar 

  18. Myers SG, Fisher PL, Wells A. Belief domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44) and their specific relationship with obsessive-compulsive symptoms. J Anxiety Disord. 2008;22:475–84.

    Article  PubMed  Google Scholar 

  19. Tolin DF, Woods CM, Abramowitz JS. Relationship between obsessive beliefs and obsessive–compulsive symptoms. Cogn Ther Res. 2003;27:657–69.

    Article  Google Scholar 

  20. Coles M, Horng B. A prospective test of cognitive vulnerability to obsessive-compulsive disorder. Cognit Ther Res. 2006;12:723–34.

    Article  Google Scholar 

  21. Novara C, Pastore M, Ghisi M, et al. Longitudinal aspects of obsessive compulsive cognitions in a non-clinical sample: a five-year follow-up study. J Behav Ther Exp Psychiatry. 2011;42:317–24.

    Article  PubMed  Google Scholar 

  22. Bortoncello CF, Braga DT, Gomes JB, et al. Psychometric properties of the Brazilian version of the Obsessive Beliefs Questionnaire (OBQ-44). J Anxiety Disord. 2012;26:430–4.

    Article  PubMed  Google Scholar 

  23. Emmelkamp PM, Visser S, Hoekstra RJ. Cognitive therapy vs. exposure in vivo in the treatment of obsessive-compulsives. Cognit Ther Res. 1988;12:103–14.

    Article  Google Scholar 

  24. Emmelkamp PM, Beens H. Cognitive therapy with obsessive-compulsive disorder: a comparative evaluation. Behav Res Ther. 1991;29:293–300.

    Article  PubMed  CAS  Google Scholar 

  25. Van Oppen P, de Haan E, van Balkom AJ, et al. Cognitive therapy and exposure in vivo in the treatment for obsessive-compulsive disorder. Behav Res Ther. 1995;33:379–90.

    Article  PubMed  Google Scholar 

  26. Cottraux J, Note I, Yao SN, et al. A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder. Psychother Psychosom. 2001;70:288–97.

    Article  PubMed  CAS  Google Scholar 

  27. Whittal ML, Thordarson DS, McLean PD. Treatment of obsessive-compulsive disorder: cognitive behavior therapy vs. exposure and response prevention. Behav Res Ther. 2005;43:1559–76.

    Article  PubMed  Google Scholar 

  28. van Oppen P, van Balkom AJ, de Haan E, et al. Cognitive therapy and exposure in vivo alone and in combination with fluvoxamine in obsessive-compulsive disorder: a 5-year follow-up. J Clin Psychiatry. 2005;66:1415–22.

    Article  PubMed  Google Scholar 

  29. Olatunji BO, Rosenfield D, Tart CD, et al. Behavioral versus cognitive treatment of obsessive-compulsive disorder: An examination of outcome and mediators of change. J Consult Clin Psychol. 2013;81:415–28.

    Article  PubMed  Google Scholar 

  30. Rosa-Alcázar AI, Sánchez-Meca J, Gómez-Conesa A, et al. Psychological treatment of obsessive-compulsive disorder: a meta-analysis. Clin Psychol Rev. 2008;28:1310–25.

    Article  PubMed  Google Scholar 

  31. Eddy KT, Dutra L, Bradley R, et al. A multidimensional meta-analysis of pharmacotherapy for obsessive-compulsive disorder. Clin Psychol Rev. 2004;24:1011–30.

    Article  PubMed  Google Scholar 

  32. Fisher PL, Wells A. How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis. Behav Res Ther. 2005;43:1543–58.

    Article  PubMed  Google Scholar 

  33. van Balkom AJ, Emmelkamp PM, Eikelenboom M, et al. Cognitive therapy versus fluvoxamine as a second-step treatment in obsessive-compulsive disorder nonresponsive to first-step behavior therapy. Psychother Psychosom. 2012;81:366–74.

    Article  PubMed  Google Scholar 

  34. Anholt GE, Kempe P, de Haan E, et al. Cognitive versus behavior therapy: processes of change in the treatment of obsessive-compulsive disorder. Psychother Psychosom. 2008;77:38–42.

    Article  PubMed  Google Scholar 

  35. Chamberlain SR, Blackwell AD, Fineberg NA, et al. The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neurosci Biobehav Rev. 2005;29:399–419.

    Article  PubMed  CAS  Google Scholar 

  36. Anholt GE, Linkovski O, Kalanthroff E, et al. If I do it, it must be important: Integrating basic cognitive research findings with cognitive behavior theory of obsessive-compulsive disorder. Psicoterapia Comportamental e Cognitiva. 2012;18:69–79.

    Google Scholar 

  37. Kalanthroff E, Anholt EG, Keren R, et al. What should I (not) do? Control over irrelevant tasks in obsessive-compulsive disorder patients. Clin Neuropsychiatry. 2013;10:37–40.

    Google Scholar 

  38. Linkovski O, Kalanthroff E, Anholt GE, et al. Did I turn off the stove? Good inhibitory control can protect from Influences of repeated checking. J Behav Ther Exp Psychiatry. 2013;44:30–6.

    Article  PubMed  CAS  Google Scholar 

  39. Gillan CM, Papmeyer M, Morein-Zamir S, et al. Disruption in the balance between goal-directed behavior and habit learning in obsessive-compulsive disorder. Am J Psychiatry. 2011;168:718–26.

    Article  PubMed  Google Scholar 

  40. American Psychiatric Association: Diagnostic and statistical manual of mental disorders (4th ed., text rev.), Washington, DC: 2000.

  41. Robbins TW, Gillan CM, Smith DG, et al. Neurocognitive endophenotypes of impulsivity and compulsivity: towards dimensional psychiatry. Trends Cogn Sci. 2012;16:81–91.

    Article  PubMed  Google Scholar 

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Acknowledgment

We would like to thank Prof. Avishai Henik for his useful comments.

Compliance with Ethics Guidelines

Conflict of Interest

Gideon E. Anholt and Eyal Kalanthroff declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Gideon E. Anholt.

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This article is part of the Topical Collection on Anxiety Disorders

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Anholt, G.E., Kalanthroff, E. Letter to the Editor: Recent Advances in Research on Cognition and Emotion in OCD: A Review. Curr Psychiatry Rep 15, 416 (2013). https://doi.org/10.1007/s11920-013-0416-x

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  • DOI: https://doi.org/10.1007/s11920-013-0416-x

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