Cognitive deficits are a matter of emotional context: inflexible strategy use mediates context-specific learning impairments in OCD

TY - JOUR

T1 - Cognitive deficits are a matter of emotional context: inflexible strategy use mediates context-specific learning impairments in OCD

AU - Zetsche, Ulrike

AU - Rief, Winfried

AU - Westermann, Stefan

AU - Exner, Cornelia

PY - 2015

Y1 - 2015

N2 - The present study examines the interplay between cognitive deficits and emotional context in obsessive-compulsive disorder (OCD) and social phobia (SP). Specifically, this study examines whether the inflexible use of efficient learning strategies in an emotional context underlies impairments in probabilistic classification learning (PCL) in OCD, and whether PCL impairments are specific to OCD. Twenty-three participants with OCD, 30 participants with SP and 30 healthy controls completed a neutral and an OCD-specific PCL task. OCD participants failed to adopt efficient learning strategies and showed fewer beneficial strategy switches than controls only in an OCD-specific context, but not in a neutral context. Additionally, OCD participants did not show any explicit memory impairments. Number of beneficial strategy switches in the OCD-specific task mediated the difference in PCL performance between OCD and control participants. Individuals with SP were impaired in both PCL tasks. In contrast to neuropsychological models postulating general cognitive impairments in OCD, the present findings suggest that it is the interaction between cognition and emotion that is impaired in OCD. Specifically, activated disorder-specific fears may impair the flexible adoption of efficient learning strategies and compromise otherwise unimpaired PCL. Impairments in PCL are not specific to OCD.

AB - The present study examines the interplay between cognitive deficits and emotional context in obsessive-compulsive disorder (OCD) and social phobia (SP). Specifically, this study examines whether the inflexible use of efficient learning strategies in an emotional context underlies impairments in probabilistic classification learning (PCL) in OCD, and whether PCL impairments are specific to OCD. Twenty-three participants with OCD, 30 participants with SP and 30 healthy controls completed a neutral and an OCD-specific PCL task. OCD participants failed to adopt efficient learning strategies and showed fewer beneficial strategy switches than controls only in an OCD-specific context, but not in a neutral context. Additionally, OCD participants did not show any explicit memory impairments. Number of beneficial strategy switches in the OCD-specific task mediated the difference in PCL performance between OCD and control participants. Individuals with SP were impaired in both PCL tasks. In contrast to neuropsychological models postulating general cognitive impairments in OCD, the present findings suggest that it is the interaction between cognition and emotion that is impaired in OCD. Specifically, activated disorder-specific fears may impair the flexible adoption of efficient learning strategies and compromise otherwise unimpaired PCL. Impairments in PCL are not specific to OCD.

KW - Adult

KW - Case-Control Studies

KW - Cognition

KW - Emotions

KW - Female

KW - Humans

KW - Learning

KW - Male

KW - Neuropsychological Tests

KW - Obsessive-Compulsive Disorder/psychology

KW - Phobic Disorders/psychology

KW - Psychiatric Status Rating Scales

U2 - 10.1080/02699931.2014.911144

DO - 10.1080/02699931.2014.911144

M3 - SCORING: Journal article

C2 - 24801151

VL - 29

SP - 360

EP - 371

JO - COGNITION EMOTION

JF - COGNITION EMOTION

SN - 0269-9931

IS - 2

ER -