title: Two types of impairments in OCD: obsessions, as problems of thought suppression; compulsions, as behavioral-executive impairment.
abstract: Impairments in executive functioning have been identified as an underlying cause of Obsessive-Compulsive Disorder (OCD). Obsessive patients attempt to suppress certain unwanted thoughts through a mechanism that Wegner referred to as 'chronic thought suppression', whereas compulsive patients are unable to inhibit their rituals. We tested 51 OCD patients using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the White Bear Suppression Inventory (WBSI) and the Dysexecutive Questionnaire (DEX). Executive functions were tested using a cognitive test battery. We found that the total WBSI score was correlated with the Y-BOCS obsessive score but not with the Y-BOCS compulsive score. A stronger correlation was observed between the Y-BOCS obsessive score and the 'unwanted intrusive thoughts' factor based on Blumberg's 3-factor model of the WBSI. The total WBSI score was not correlated with the cognitive test results. The DEX score was significantly correlated with the Y-BOCS compulsive score; however, no correlation was found between the DEX score and the Y-BOCS obsessive score. A stronger correlation was observed between the Y-BOCS compulsive score and the 'inhibition' component of the DEX score, as defined by Burgess's 5-factor model. The DEX scores were correlated with cognitive test results measuring attention, cognitive flexibility and inhibitory processes. We conclude that obsessions indicate a failure of cognitive inhibition but do not involve significant impairment of executive functions, whereas compulsions indicate ineffective behavior inhibition and impaired executive functions.
authors.affiliation: Nyírő Gyula Hospital, II Psychiatric Department, Lehel út 59, 1135 Budapest, Hungary. Electronic address: Harsanyia@hotmail.com.
authors.forename: András
authors.initials: A
authors.lastname: Harsányi
authors.affiliation: Nyírő Gyula Hospital, II Psychiatric Department, Lehel út 59, 1135 Budapest, Hungary.
authors.forename: Katalin
authors.initials: K
authors.lastname: Csigó
authors.affiliation: Nyírő Gyula Hospital, II Psychiatric Department, Lehel út 59, 1135 Budapest, Hungary.
authors.forename: Csaba
authors.initials: C
authors.lastname: Rajkai
authors.affiliation: Department of Cognitive Science, Budapest University of Technology and Economics, Stoczek utca 2, 1111 Budapest, Hungary.
authors.forename: Gyula
authors.initials: G
authors.lastname: Demeter
authors.affiliation: Semmelweis University, Department of Psychiatry, Balassa utca 6, 1083 Budapest, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Németh
authors.affiliation: Department of Cognitive Science, Budapest University of Technology and Economics, Stoczek utca 2, 1111 Budapest, Hungary.
authors.forename: Mihály
authors.initials: M
authors.lastname: Racsmány
mesh_terms: D000328:Adult; D003192:Compulsive Behavior / Q000175:diagnosis / Q000523:psychology; D056344:Executive Function / Q000502:physiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009770:Obsessive Behavior / Q000175:diagnosis / Q000523:psychology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000523:psychology; D010555:Personality Inventory; D011594:Psychometrics; D012094:Repression, Psychology; D011795:Surveys and Questionnaires; D013850:Thinking
keywords: DEX; Dysexecutive syndrome; OCD; Thought suppression; WBSI