Obsessive-Compulsive Disorder Is Associated With Broad Impairments in Executive Function

Obsessive-compulsive disorder (OCD) is a serious and often chronically disabling condition. The current dominant model of OCD focuses on abnormalities in prefrontal-striatal circuits that support executive function (EF). Although there is growing evidence for EF impairments associated with OCD, results have been inconsistent, which makes the nature and magnitude of these impairments controversial. The current meta-analysis uses random-effects models to synthesize 110 studies in which participants with OCD were compared with healthy control participants on at least one neuropsychological measure of EF. The results indicate that individuals with OCD are impaired on tasks measuring most aspects of EF, consistent with broad impairment in EF. EF deficits were not explained by general motor slowness or depression. Effect sizes were largely stable across variation in demographic and clinical characteristics of samples, although medication use, age, and gender moderated some effects.

[1]  L. Roemer,et al.  Perceived functions of worry among generalized anxiety disorder subjects: distraction from more emotionally distressing topics? , 1995, Journal of behavior therapy and experimental psychiatry.

[2]  B. Zurowski,et al.  Cognitive functioning in medication-free obsessive-compulsive patients treated with cognitive-behavioural therapy , 2013 .

[3]  M. Bhatia,et al.  Study of neurocognitive endophenotypes in drug‐naïve obsessive–compulsive disorder patients, their first‐degree relatives and healthy controls , 2011, Acta psychiatrica Scandinavica.

[4]  R. Bornstein,et al.  Depression accounts for executive function deficits in obsessive-compulsive disorder. , 2001, Neuropsychiatry, neuropsychology, and behavioral neurology.

[5]  J. Sánchez-Meca,et al.  Testing for Dichotomous Moderators in Meta-Analysis. , 1998 .

[6]  D. Drapier,et al.  Obsessive Compulsive Disorder Networks: Positron Emission Tomography and Neuropsychology Provide New Insights , 2013, PloS one.

[7]  W. Goodman,et al.  The Yale-Brown Obsessive Compulsive Scale. II. Validity. , 1989, Archives of general psychiatry.

[8]  M. Taylor,et al.  Neuropsychological deficits in obsessive-compulsive disorder , 1991 .

[9]  J. Unterrainer,et al.  Neuropsychological Impairment in Obsessive-Compulsive Disorder—Improvement Over the Course of Cognitive Behavioral Treatment , 2006, Journal of clinical and experimental neuropsychology.

[10]  C. R. Mukundan,et al.  Neuropsychological deficits in drug naïve, non-depressed obsessive-compulsive disorder patients. , 2013, Asian Journal of Psychiatry.

[11]  F. Sabb,et al.  Executive Function in Pediatric Bipolar Disorder and Attention-Deficit Hyperactivity Disorder: In Search of Distinct Phenotypic Profiles , 2010, Neuropsychology Review.

[12]  R. Schachar,et al.  Neuropsychological performance in childhood OCD: A preliminary study , 2010, Depression and anxiety.

[13]  L. Hedges,et al.  The Handbook of Research Synthesis and Meta-Analysis , 2009 .

[14]  A. Miyake,et al.  Individual differences in executive functions are almost entirely genetic in origin. , 2008, Journal of experimental psychology. General.

[15]  G. Venkatasubramanian,et al.  Neuropsychological performance in OCD: A study in medication-naïve patients , 2011, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[16]  Adam R. Aron,et al.  Progress in Executive-Function Research , 2008 .

[17]  M. Noroozian,et al.  Neuropsychological and Neurological Deficits in Obsessive-Compulsive Disorder: The Role of Comorbid Depression , 2012, International Journal of Clinical Medicine.

[18]  J. Gorman,et al.  The role of executive functioning in CBT: a pilot study with anxious older adults. , 2005, Behaviour research and therapy.

[19]  S. Haber,et al.  The cortico-basal ganglia integrative network: The role of the thalamus , 2009, Brain Research Bulletin.

[20]  M. Phillips,et al.  Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder. , 2006, Neuropsychology.

[21]  T. Robbins,et al.  Impaired visuospatial associative memory and attention in obsessive compulsive disorder but no evidence for differential dopaminergic modulation , 2010, Psychopharmacology.

[22]  Boll Tj,et al.  Neuropsychological testing in obsessive-compulsive disorder: a clinical review. , 1994 .

[23]  Daniel S Pine,et al.  Cognitive inflexibility and frontal-cortical activation in pediatric obsessive-compulsive disorder. , 2010, Journal of the American Academy of Child and Adolescent Psychiatry.

[24]  S. Galderisi,et al.  Neurocognitive indices of executive hypercontrol in obsessive–compulsive disorder , 2007, Acta psychiatrica Scandinavica.

[25]  J. Jonides,et al.  Interference resolution: Insights from a meta-analysis of neuroimaging tasks , 2007, Cognitive, affective & behavioral neuroscience.

[26]  Bernardus R Coetzer,et al.  Obsessive-Compulsive Disorder following Brain Injury: A Review , 2004, International journal of psychiatry in medicine.

[27]  S. Nolen-Hoeksema,et al.  A Heuristic for Developing Transdiagnostic Models of Psychopathology , 2011, Perspectives on psychological science : a journal of the Association for Psychological Science.

[28]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[29]  L. Bellodi,et al.  Frontal-Lobe Dysfunction in Schizophrenia and Obsessive-Compulsive Disorder - A Neuropsychological Study , 1995, Brain and Cognition.

[30]  Ann M Graybiel,et al.  Toward a Neurobiology of Obsessive-Compulsive Disorder , 2000, Neuron.

[31]  Jae-Hun Kim,et al.  Neural correlates of altered response inhibition and dysfunctional connectivity at rest in obsessive–compulsive disorder , 2013, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[32]  Hannah R. Snyder Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: a meta-analysis and review. , 2013, Psychological bulletin.

[33]  A. Meyer-Lindenberg,et al.  Psychopathology and the Human Connectome: Toward a Transdiagnostic Model of Risk For Mental Illness , 2012, Neuron.

[34]  M. Telch,et al.  Differential performance on the go/no-go task as a function of the autogenous-reactive taxonomy of obsessions: findings from a non-treatment seeking sample. , 2009, Behaviour research and therapy.

[35]  C. Savage,et al.  Motor inhibition in trichotillomania and obsessive-compulsive disorder. , 2008, Journal of psychiatric research.

[36]  J. Bradshaw,et al.  The semantic Simon effect in Tourette’s syndrome and obsessive-compulsive disorder , 2006, Brain and Cognition.

[37]  S. Moritz,et al.  Impact of comorbid depressive symptoms on neuropsychological performance in obsessive-compulsive disorder. , 2001, Journal of abnormal psychology.

[38]  M. Kyrios,et al.  Neuropsychological changes following cognitive-behavioral treatment of obsessive-compulsive disorder (OCD) , 2011 .

[39]  M. Hämäläinen,et al.  Dissociation between MEG alpha modulation and performance accuracy on visual working memory task in obsessive compulsive disorder , 2007, Human brain mapping.

[40]  J. Menchón,et al.  Are There Sex Differences in Neuropsychological Functions Among Patients With Obsessive-Compulsive Disorder? , 2006, Applied neuropsychology.

[41]  Michael J. Frank,et al.  Interactions between frontal cortex and basal ganglia in working memory: A computational model , 2001, Cognitive, affective & behavioral neuroscience.

[42]  Richard J. Harris,et al.  Increased anterior brain activation to correct responses on high-conflict Stroop task in obsessive–compulsive disorder , 2011, Clinical Neurophysiology.

[43]  Thomas E. Hazy,et al.  Towards an executive without a homunculus: computational models of the prefrontal cortex/basal ganglia system , 2007, Philosophical Transactions of the Royal Society B: Biological Sciences.

[44]  Gail Ramsberger,et al.  Commonalities and differences in the working memory components underlying letter and category fluency tasks: a dual-task investigation. , 2002, Neuropsychology.

[45]  P. Falkai,et al.  Antisaccade performance in patients with obsessive–compulsive disorder and unaffected relatives: further evidence for impaired response inhibition as a candidate endophenotype , 2012, European Archives of Psychiatry and Clinical Neuroscience.

[46]  Tor D Wager,et al.  Neuroimaging studies of shifting attention: a meta-analysis , 2004, NeuroImage.

[47]  M. Brammer,et al.  Disorder‐specific dysfunctions in patients with attention‐deficit/hyperactivity disorder compared to patients with obsessive‐compulsive disorder during interference inhibition and attention allocation , 2011, Human brain mapping.

[48]  J. Roiser,et al.  Cognitive impairment in depression: a systematic review and meta-analysis , 2013, Psychological Medicine.

[49]  T. Robbins,et al.  A neuropsychological comparison of obsessive–compulsive disorder and trichotillomania , 2007, Neuropsychologia.

[50]  J. Sánchez-Meca,et al.  TESTING CONTINUOUS MODERATORS IN META-ANALYSIS : A COMPARISON OF PROCEDURES , 1998 .

[51]  T. Robbins,et al.  The profile of executive function in OCD hoarders and hoarding disorder☆ , 2014, Psychiatry Research.

[52]  Steffen Moritz,et al.  Impact of comorbid depressive symptoms on nonverbal memory and visuospatial performance in obsessive-compulsive disorder , 2003, Cognitive neuropsychiatry.

[53]  D. Dickinson,et al.  Meta‐analysis of neuropsychological functioning in euthymic bipolar disorder: an update and investigation of moderator variables , 2011, Bipolar disorders.

[54]  M. Van der Linden,et al.  Investigation of response inhibition in obsessive-compulsive disorder using the Hayling task , 2005, Journal of the International Neuropsychological Society.

[55]  Fritz Hohagen,et al.  Neuropsychological performance in obsessive-compulsive disorder: a critical review , 2004, Biological Psychology.

[56]  Young Youn Kim,et al.  Neuropsychological profiles of patients with obsessive-compulsive disorder: early onset versus late onset , 2006, Journal of the International Neuropsychological Society.

[57]  W. Heller,et al.  Distinguishing neural substrates of heterogeneity among anxiety disorders. , 2005, International review of neurobiology.

[58]  J. Rybakowski,et al.  The frontal lobe neuropsychological tests in patients with schizophrenia and/or obsessive-compulsive disorder. , 2003, The Journal of neuropsychiatry and clinical neurosciences.

[59]  Gustavo Deco,et al.  An attractor hypothesis of obsessive–compulsive disorder , 2008, The European journal of neuroscience.

[60]  R. Lam,et al.  Brain glutamate levels measured by magnetic resonance spectroscopy in patients with bipolar disorder: a meta‐analysis , 2012, Bipolar disorders.

[61]  M. J. Emerson,et al.  The Unity and Diversity of Executive Functions and Their Contributions to Complex “Frontal Lobe” Tasks: A Latent Variable Analysis , 2000, Cognitive Psychology.

[62]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[63]  Henk J Groenewegen,et al.  Frontal-striatal dysfunction during planning in obsessive-compulsive disorder. , 2005, Archives of general psychiatry.

[64]  Steven Laureys,et al.  Exploring the unity and diversity of the neural substrates of executive functioning , 2005, Human brain mapping.

[65]  I. Marks,et al.  Wisconsin Card Sorting Task (WCST) errors and cerebral blood flow in obsessive-compulsive disorder (OCD). , 1997, The British journal of medical psychology.

[66]  P. Falkai,et al.  Evidence for specific cognitive deficits in visual information processing in patients with OCD compared to patients with unipolar depression , 2010, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[67]  P. Maruff,et al.  Neuropsychological deficits in obsessive-compulsive disorder: a comparison with unipolar depression, panic disorder, and normal controls. , 1998, Archives of general psychiatry.

[68]  John Suckling,et al.  White matter abnormalities in patients with obsessive-compulsive disorder and their first-degree relatives. , 2008, The American journal of psychiatry.

[69]  M. Herrmann,et al.  Reduced response-inhibition in obsessive–compulsive disorder measured with topographic evoked potential mapping , 2003, Psychiatry Research.

[70]  J. Abramowitz Cognitive-behavioral therapy for OCD , 2008 .

[71]  T. Robbins,et al.  Executive function in Tourette's syndrome and obsessive–compulsive disorder , 2004, Psychological Medicine.

[72]  J. Alvarez,et al.  Executive Function and the Frontal Lobes: A Meta-Analytic Review , 2006, Neuropsychology Review.

[73]  A M Owen,et al.  Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive–compulsive disorder , 1996, Psychological Medicine.

[74]  T. Insel,et al.  Wesleyan University From the SelectedWorks of Charles A . Sanislow , Ph . D . 2010 Research Domain Criteria ( RDoC ) : Toward a New Classification Framework for Research on Mental Disorders , 2018 .

[75]  M. Boldrini,et al.  Selective cognitive deficits in obsessive‐compulsive disorder compared to panic disorder with agoraphobia , 2005, Acta psychiatrica Scandinavica.

[76]  F. Castellanos,et al.  An fMRI examination of developmental differences in the neural correlates of uncertainty and decision-making. , 2006, Journal of child psychology and psychiatry, and allied disciplines.

[77]  Tao Li,et al.  Neuropsychological study of patients with obsessive-compulsive disorder and their parents in China: searching for potential endophenotypes , 2012, Neuroscience Bulletin.

[78]  S. Scarone,et al.  The selective breakdown of frontal functions in patients with obsessive–compulsive disorder and in patients with schizophrenia: A double dissociation experimental finding , 1997, Neuropsychologia.

[79]  O. Oner,et al.  Impaired executive functions in paediatric obsessive-compulsive disorder patients , 2011, Acta Neuropsychiatrica.

[80]  J. Kwon,et al.  Switching strategy underlies phonemic verbal fluency impairment in obsessive–compulsive disorder , 2012 .

[81]  S Duval,et al.  Trim and Fill: A Simple Funnel‐Plot–Based Method of Testing and Adjusting for Publication Bias in Meta‐Analysis , 2000, Biometrics.

[82]  S. Scarone,et al.  Wisconsin Card Sorting Test performance in obsessive-compulsive disorder: no evidence for involvement of dorsolateral prefrontal cortex , 1995, Psychiatry Research.

[83]  R. Kahn,et al.  Region and state specific glutamate downregulation in major depressive disorder: A meta-analysis of 1H-MRS findings , 2012, Neuroscience & Biobehavioral Reviews.

[84]  H. Gürvit,et al.  Neuropsychological function in obsessive-compulsive disorder. , 2012, Comprehensive psychiatry.

[85]  Robert Krikorian,et al.  Inhibitory control in Obsessive-Compulsive Disorder , 2004, Brain and Cognition.

[86]  Maria Larsson,et al.  Neuropsychological functions in anxiety disorders in population-based samples: evidence of episodic memory dysfunction. , 2005, Journal of psychiatric research.

[87]  M. D’Esposito Working memory. , 2008, Handbook of clinical neurology.

[88]  E. Bullmore,et al.  Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: The orbitofronto-striatal model revisited , 2008, Neuroscience & Biobehavioral Reviews.

[89]  L. Hedges Unbiased estimation of effect size , 1980 .

[90]  P. Maruff,et al.  Differences in Neuropsychological Performance Between Subtypes of Obsessive–Compulsive Disorder , 2009, The Australian and New Zealand journal of psychiatry.

[91]  Eric A Youngstrom,et al.  Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. , 2004, Neuropsychology.

[92]  H. Hermesh,et al.  Neuropsychological impairments and their association with obsessive-compulsive symptom severity in obsessive-compulsive disorder. , 2011, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[93]  Martin Aigner,et al.  Memory Deficits in Patients with DSM-IV Obsessive-Compulsive Disorder , 2001, Psychopathology.

[94]  F. Hohagen,et al.  Cognitive Frontal Lobe Dysfunction in Obsessive-Compulsive Disorder , 1998, Biological Psychiatry.

[95]  K. N’diaye,et al.  Cognitive Dysfunction in Obsessive-Compulsive Disorder , 2016, Current Psychiatry Reports.

[96]  M. Keshavan,et al.  Neuropsychological performance and regional cerebral blood flow in obsessive–compulsive disorder , 2003, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[97]  Rodney J Croft,et al.  Executive functions in obsessive-compulsive disorder: state or trait deficits? , 2006, The Australian and New Zealand journal of psychiatry.

[98]  Alishia D. Williams,et al.  Responding to intrusions in obsessive-compulsive disorder: the roles of neuropsychological functioning and beliefs about thoughts. , 2013, Journal of behavior therapy and experimental psychiatry.

[99]  Kent A. Kiehl,et al.  Dysfunctional Action Monitoring Hyperactivates Frontal–striatal Circuits in Obsessive–compulsive Disorder: an Event-related Fmri Study , 2004 .

[100]  J. Kwon,et al.  Persistent cognitive dysfunction in patients with obsessive‐compulsive disorder: A naturalistic study , 2005, Psychiatry and clinical neurosciences.

[101]  M. Jenike,et al.  Visuospatial Abilities, Memory, and Executive Functioning in Trichotillomania and Obsessive-Compulsive Disorder , 2005, Journal of clinical and experimental neuropsychology.

[102]  T. Hendler,et al.  Alternation learning in obsessive-compulsive disorder , 1996, Biological Psychiatry.

[103]  Nick F. Ramsey,et al.  Spatial working memory deficits in obsessive compulsive disorder are associated with excessive engagement of the medial frontal cortex , 2003, NeuroImage.

[104]  J. Fisk,et al.  Age-Related Impairment in Executive Functioning: Updating, Inhibition, Shifting, and Access , 2004, Journal of clinical and experimental neuropsychology.

[105]  J. Gross,et al.  The cognitive control of emotion , 2005, Trends in Cognitive Sciences.

[106]  J. Kwon,et al.  Impact of coexistent schizotypal personality traits on frontal lobe function in obsessive–compulsive disorder , 2008, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[107]  J. Kwon,et al.  Do pathological gambling and obsessive-compulsive disorder overlap? a neurocognitive perspective , 2012, CNS Spectrums.

[108]  A. Scheurich,et al.  Effects of Obsessive-Compulsive Symptoms on Neuropsychological Test Performance: Complicating an Already Complicated Story , 2012, The Clinical neuropsychologist.

[109]  Dan J Stein,et al.  Specificity of neuropsychological impairment in obsessive-compulsive disorder: a comparison with social phobic and normal control subjects. , 1996, The Journal of neuropsychiatry and clinical neurosciences.

[110]  T. Boll,et al.  Neuropsychological testing in obsessive-compulsive disorder: a clinical review. , 1994, The Journal of neuropsychiatry and clinical neurosciences.

[111]  W. Gehring,et al.  Error-related hyperactivity of the anterior cingulate cortex in obsessive-compulsive disorder , 2005, Biological Psychiatry.

[112]  A. Saykin,et al.  Event-Related Functional Magnetic Resonance Imaging of Response Inhibition in Obsessive-Compulsive Disorder , 2007, Biological Psychiatry.

[113]  Katya Rubia,et al.  Disorder‐specific dysfunction in right inferior prefrontal cortex during two inhibition tasks in boys with attention‐deficit hyperactivity disorder compared to boys with obsessive–compulsive disorder , 2009, Human brain mapping.

[114]  Elizabeth M. Pratt,et al.  Behavioral and cognitive impulsivity in obsessive–compulsive disorder and eating disorders , 2012, Psychiatry Research.

[115]  Karen H. Adams,et al.  Cognitive deficits in obsessive–compulsive disorder on tests of frontal lobe functions , 2005, Nordic journal of psychiatry.

[116]  J. Kwon,et al.  Neuropsychological profile in patients with obsessive-compulsive disorder over a period of 4-month treatment. , 2002, Journal of psychiatric research.

[117]  Maurice W. Dysken,et al.  Neuropyschological performance in obsessive-compulsive disorder , 1992, Biological Psychiatry.

[118]  W. Dittrich,et al.  Cognitive deficits of executive functions and decision-making in obsessive-compulsive disorder. , 2013, Scandinavian journal of psychology.

[119]  J. Suhr,et al.  Executive function deficits associated with symptoms of schizotypy and obsessive–compulsive disorder , 2002, Psychiatry Research.

[120]  I. Robertson A Comparison of Depression Rating Scales , 1983, British Journal of Psychiatry.

[121]  E. Hollander,et al.  Neuropsychology of obsessive compulsive disorder: Preliminary findings. , 1994 .

[122]  T. Robbins,et al.  The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers , 2005, Neuroscience & Biobehavioral Reviews.

[123]  S. Moritz,et al.  Executive functioning in obsessive-compulsive disorder, unipolar depression, and schizophrenia. , 2002, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[124]  O. M. Kocak,et al.  Evaluation of cognitive slowing in OCD by means of creating incongruence between lexicon and prosody , 2010, Psychiatry Research.

[125]  H. Westenberg,et al.  Attention and cognition in patients with obsessive–compulsive disorder , 2007, Psychiatry and clinical neurosciences.

[126]  T. Brown,et al.  Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. , 2001, Journal of abnormal psychology.

[127]  Visuospatial priming and stroop performance in patients with obsessive compulsive disorder. , 1999, Neuropsychology.

[128]  S. Moritz,et al.  Perseveration and not strategic deficits underlie delayed alternation impairment in obsessive–compulsive disorder (OCD) , 2009, Psychiatry Research.

[129]  R. Zahn,et al.  Object alternation test—is it sensitive enough to detect cognitive dysfunction in obsessive–compulsive disorder? , 2004, European Psychiatry.

[130]  Stephen W. Raudenbush,et al.  Analyzing effect sizes: Random-effects models. , 2009 .

[131]  T. Yoshiura,et al.  Working memory dysfunction in obsessive-compulsive disorder: a neuropsychological and functional MRI study. , 2009, Journal of psychiatric research.

[132]  A. Lees,et al.  The neurology of obsessional slowness. , 1991, Brain : a journal of neurology.

[133]  K. Boone,et al.  Neuropsychological characteristics of nondepressed adults with obsessive-compulsive disorder. , 1991 .

[134]  Cynthia L. Turk,et al.  Applying an Emotion Regulation Framework to Integrative Approaches to Generalized Anxiety Disorder , 2006 .

[135]  J. Castro-Fornieles,et al.  Neuropsychological Performance in Children and Adolescents with Obsessive-Compulsive Disorder and Influence of Clinical Variables , 2007, Biological Psychiatry.

[136]  W. Goodman,et al.  The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. , 1989, Archives of general psychiatry.

[137]  B. Reuter,et al.  Evidence for a deficit in volitional action generation in patients with obsessive-compulsive disorder. , 2011, Psychophysiology.

[138]  T. Yoshiura,et al.  Duration effect of obsessive–compulsive disorder on cognitive function: a functional MRI study , 2009, Depression and anxiety.

[139]  D. Pauls,et al.  The genetics of obsessive compulsive disorder: A review of the evidence , 2008, American journal of medical genetics. Part C, Seminars in medical genetics.

[140]  Paul Maruff,et al.  Cognitive Deficits in Obsessive–Compulsive Disorder on Tests of Frontal–Striatal Function , 1998, Biological Psychiatry.

[141]  K. O'Connor,et al.  Speed and accuracy on tests of executive function in obsessive–compulsive disorder , 2004, Brain and Cognition.

[142]  E. Miller,et al.  An integrative theory of prefrontal cortex function. , 2001, Annual review of neuroscience.

[143]  Raphael T. Gerraty,et al.  A meta-analytic investigation of neurocognitive deficits in bipolar illness: profile and effects of clinical state. , 2009, Neuropsychology.

[144]  N. Rao,et al.  Are neuropsychological deficits trait markers in OCD? , 2008, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[145]  B. Aouizerate,et al.  Forgetting What You Have Checked: A Link Between Working Memory Impairment and Checking Behaviors in Obsessive-Compulsive Disorder , 2013, European psychiatry.

[146]  A. Baddeley,et al.  The multi-component model of working memory: Explorations in experimental cognitive psychology , 2006, Neuroscience.

[147]  P. Sachdev,et al.  Memory and executive functioning in obsessive-compulsive disorder: a selective review. , 2007, Journal of affective disorders.

[148]  Young Youn Kim,et al.  Electrophysiological correlates of behavioral response inhibition in patients with obsessive–compulsive disorder , 2007, Depression and anxiety.

[149]  J. Lachenmeyer,et al.  Anxiety and selective attention in obsessive-compulsive disorder. , 2003, Behaviour research and therapy.

[150]  A Baddeley,et al.  The fractionation of working memory. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[151]  W. Rosen,et al.  Are there reliable neuropsychological deficits in obsessive-compulsive disorder? , 2006, Journal of psychiatric research.

[152]  D. Murphy,et al.  Working memory as assessed by subject-ordered tasks in patients with obsessive-compulsive disorder. , 1995, Journal of clinical and experimental neuropsychology.

[153]  Henk J Groenewegen,et al.  Disorder-specific neuroanatomical correlates of attentional bias in obsessive-compulsive disorder, panic disorder, and hypochondriasis. , 2005, Archives of general psychiatry.

[154]  Ezio Sanavio,et al.  Is Performance on the Go/Nogo Task Related to Not Just Right Experiences in Patients with Obsessive Compulsive Disorder? , 2013, Cognitive Therapy and Research.

[155]  D. Joel,et al.  Current animal models of obsessive compulsive disorder: an update , 2012, Neuroscience.

[156]  M. Dysken,et al.  Neuropsychological performance in obsessive-compulsive disorder. , 1992, Biological psychiatry.

[157]  C. Gonsalvez,et al.  Response inhibition deficits in obsessive–compulsive disorder , 2002, Psychiatry Research.

[158]  S. Faraone,et al.  Neurocognition in first-episode schizophrenia: a meta-analytic review. , 2009, Neuropsychology.

[159]  P R Houck,et al.  Decreased working memory and processing speed mediate cognitive impairment in geriatric depression , 2000, Psychological Medicine.

[160]  Michael J. Brammer,et al.  A parametric approach to voxel-based meta-analysis , 2009, NeuroImage.

[161]  R. Henson,et al.  Frontal lobes and human memory: insights from functional neuroimaging. , 2001, Brain : a journal of neurology.

[162]  J. Abramowitz,et al.  The neuropsychology of adult obsessive-compulsive disorder: a meta-analysis. , 2013, Clinical psychology review.

[163]  Jack L. Vevea,et al.  Are Compulsive Checkers Impaired in Memory? A Meta‐Analytic Review , 2002 .

[164]  J. Duncan,et al.  Common regions of the human frontal lobe recruited by diverse cognitive demands , 2000, Trends in Neurosciences.

[165]  C. Junqué,et al.  Impairment of incidental memory for frequency in patients with obsessive–compulsive disorder , 2001, Psychiatry Research.

[166]  A. Miyake,et al.  The Nature and Organization of Individual Differences in Executive Functions , 2012, Current directions in psychological science.

[167]  Tae Young Lee,et al.  Cognitive functioning in obsessive-compulsive disorder: a meta-analysis , 2013, Psychological Medicine.

[168]  C. Harris,et al.  Neuropsychological function in obsessive-compulsive disorder: effects of comorbid conditions on task performance , 2003, European Psychiatry.

[169]  Susan J. Thomas,et al.  How specific are inhibitory deficits to obsessive-compulsive disorder? A neurophysiological comparison with panic disorder , 2014, Clinical Neurophysiology.

[170]  Alex Martin,et al.  Lack of evidence for huntington's disease-like cognitive dysfunction in obsessive-compulsive disorder , 1993, Biological Psychiatry.

[171]  J. Kwon,et al.  Neural correlates of cognitive inflexibility during task-switching in obsessive-compulsive disorder. , 2007, Brain : a journal of neurology.

[172]  M. Hogge,et al.  Exploration of the neural substrates of executive functioning by functional neuroimaging , 2006, Neuroscience.

[173]  M. Cavallini,et al.  Executive Dysfunctions in Obsessive-Compulsive Patients and Unaffected Relatives: Searching for a New Intermediate Phenotype , 2010, Biological Psychiatry.

[174]  A M McIntosh,et al.  Working memory in schizophrenia: a meta-analysis , 2008, Psychological Medicine.

[175]  R. Catalán,et al.  Executive function and nonverbal memory in obsessive-compulsive disorder , 2005, Psychiatry Research.

[176]  K. Rubia,et al.  Impaired response inhibition in obsessive compulsive disorder , 2007, European Psychiatry.

[177]  Seth A. Herd,et al.  From an Executive Network to Executive Control: A Computational Model of the n-back Task , 2011, Journal of Cognitive Neuroscience.

[178]  Thennarasu Kandavel,et al.  Neuropsychological functioning in obsessive-compulsive disorder: are executive functions the key deficit? , 2013, Comprehensive psychiatry.

[179]  Dennis Velakoulis,et al.  Functional and biochemical alterations of the medial frontal cortex in obsessive-compulsive disorder. , 2007, Archives of general psychiatry.

[180]  Randall W Engle,et al.  Working memory, short-term memory, and general fluid intelligence: a latent-variable approach. , 1999, Journal of experimental psychology. General.

[181]  J. Grafman,et al.  Are the frontal lobes implicated in “planning” functions? Interpreting data from the Tower of Hanoi , 1995, Neuropsychologia.

[182]  V. Giampietro,et al.  A functional magnetic resonance imaging study of inhibitory control in obsessive-compulsive disorder , 2009, Psychiatry Research: Neuroimaging.

[183]  S. Moritz,et al.  No evidence for object alternation impairment in obsessive-compulsive disorder (OCD) , 2009, Brain and Cognition.

[184]  M. Banich Executive Function , 2009 .