Category: Obsessive Compulsive and Related Disorders


Proactive and Reactive Cognitive Control as a Mechanism of Intrusive Thought in OCD

Saturday, November 18
8:30 AM - 10:00 AM
Location: Sapphire Ballroom A, Level 4, Sapphire Level

Keywords: OCD (Obsessive Compulsive Disorder) | Cognitive Processes
Presentation Type: Symposium

Background: Obsessive-compulsive disorder (OCD) is characterized in part by uncontrollable, unwanted thoughts known as obsessions. We apply recent theoretical and methodological developments from the cognitive neuroscience literature to test a novel potential mechanism of obsessions: abnormal proactive or reactive cognitive control over emotional material. Proactive control involves sustained effort and early attentional gating to prevent distractions from entering awareness. It is more effective than reactive control but also more cognitively demanding. Reactive control is initiated only after a distraction is noticed. It is less demanding but also less effective. An overreliance on reactive control strategies may increase vulnerability to attentional capture by intrusive thoughts.

Method: Participants with OCD (current n = 20) and healthy controls (n = 24) completed the well-established AX-Continuous Performance Task (AX-CPT) and a novel emotional variant (e-CPT) designed to assess proactive and reactive control in the context of emotional distraction.

Results: AX-CPT performance was comparable for OCD and healthy controls.  On the e-CPT, there was an interaction between group and trial type such that, relative to healthy controls, participants with OCD showed intact reactive control but impaired (slower) proactive control (F = 5.80, p = .021) following emotional distraction. The effect was not observed following neutral distraction (F = 1.69, p = .202). Within the OCD sample, greater reliance on reactive versus proactive control following emotional distraction predicted higher overall OCD severity (r = .57, p = .010) and lower perceived control over obsessions (r = -.49, p = .032).

Conclusions: OCD was associated with intact “cold” cognitive control but altered cognitive control over emotional material. A tendency to rely on reactive control predicted lower control over obsessions and correspondingly greater severity. Overreliance on ineffectual reactive control strategies may be a mechanism by which obsessions gain entry to awareness. Interventions to increase reliance on proactive control have been effective in healthy samples and may have benefits for OCD.

Lauren S. Hallion

University of Pittsburgh


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Proactive and Reactive Cognitive Control as a Mechanism of Intrusive Thought in OCD

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