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Childhood behavioral inhibition and overcontrol: Relationships with cognitive functioning, error monitoring, anxiety and obsessive-compulsive symptoms.

ABSTRACT: Anxiety and obsessive-compulsive disorders are common childhood psychiatric disorders. Behavioral inhibition (BI) is a widely studied risk factor for anxiety. Less is known about overcontrol, a related behavioral phenotype characterized by concern for errors, perfectionism, and inflexibility and also associated with anxiety and obsessive-compulsive disorder. Both BI and overcontrol show associations with aberrant cognitive control and neural error responding (via the error-related negativity; ERN) yet it is unknown whether each imparts differential risk. Understanding whether overcontrol demonstrates independent associations from BI with cognitive functioning, neural error monitoring, and childhood anxiety and obsessive-compulsive presentations could aid in identifying a novel mechanistic treatment target. We assessed BI, overcontrol, cognitive functioning and psychopathology in a cross-sectional sample of 5-6 year old children (N = 126). Children completed an electroencephalogram (EEG) to assess the ERN. Overcontrol was associated with worse cognitive shifting, worse inhibitory control and higher anxiety and obsessive-compulsive symptoms, beyond BI. BI was associated with worse cognitive shifting, better inhibitory control and higher anxiety symptoms, beyond overcontrol. When assessed simultaneously, only overcontrol demonstrated a significant relationship with a blunted ERN. Moreover, overcontrol mediated (cross-sectionally) the well-established relationship between ERN and anxiety and obsessive-compulsive symptoms. BI and overcontrol impart differential risk for child cognitive functioning and anxiety while overcontrol demonstrates additional risk for aberrant neural error monitoring, anxiety and obsessive-compulsive presentations. Overcontrol may also be a mechanistic pathway between the ERN and transdiagnostic anxiety and obsessive-compulsive symptoms. Overcontrol may be a target warranted for early-childhood intervention in anxiety and OCD.

SUBMITTER: Gilbert K

PROVIDER: S-EPMC9906714 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Childhood behavioral inhibition and overcontrol: Relationships with cognitive functioning, error monitoring, anxiety and obsessive-compulsive symptoms.

Gilbert Kirsten K Sudit Ella E Fox Nathan A NA Barch Deanna M DM Luby Joan L JL

Research on child and adolescent psychopathology 20220719 12

Anxiety and obsessive-compulsive disorders are common childhood psychiatric disorders. Behavioral inhibition (BI) is a widely studied risk factor for anxiety. Less is known about overcontrol, a related behavioral phenotype characterized by concern for errors, perfectionism, and inflexibility and also associated with anxiety and obsessive-compulsive disorder. Both BI and overcontrol show associations with aberrant cognitive control and neural error responding (via the error-related negativity; ER ...[more]

PMID: 35852701

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Project description:Introduction: Studies have shown that patients with obsessive compulsive disorder (OCD) often perform more poorly than healthy control (HC) participants on cognitive tasks involving executive functions. Most studies, however, have been performed in Western countries and societies, making it uncertain whether impaired executive functions can also be observed among non-Western patients with OCD. To address this gap in the literature, we evaluated several executive functions in Chinese patients with OCD and HCs. Methods: Participants included consisted of 46 Chinese patients with OCD (25 men, 21 women), ranging in age from 19 to 56 years, and 45 matched HCs without any self-reported lifetime psychiatric disorder. They all lived in Shanghai or the surrounding area. Five tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used to evaluate several executive functions (response inhibition, spatial working memory, planning, and cognitive flexibility) along with testing basic learning and visual recognition memory. Statistical tests using a Bonferroni-corrected significance level of p = 0.003 were performed to assess overall patient-control group differences in cognitive performance. Additionally, we explored performance differences between patients classified as having either relatively mild symptoms or severe symptoms based on the individual total scores on the Yale-Brown Obsessive-Compulsive Scale. Results: There were no significant performance differences between patients with OCD and HC in any of the cognitive tests. Similarly, cognitive performance of patients with relatively mild OCD symptoms did not differ significantly from that of patients with severe symptoms. Conclusions: These results do not seem to support the view that impaired executive functioning represents a basic cognitive and pathophysiological feature of Chinese patients with OCD. However, due to study limitations, additional research is required before this conclusion can be well accepted.

Project description:Objective: To evaluate the lifetime prevalence of infectious, inflammatory, and autoimmune disorders in a multisite study of probands with childhood-onset obsessive compulsive disorder (OCD) and their first-degree relatives. Methods: Medical questionnaires were completed by 1401 probands and 1045 first-degree relatives in the OCD Collaborative Genetics Association Study. Lifetime prevalence of immune-related diseases was compared with the highest available population estimate and reported as a point estimate with 95% adjusted Wald interval. Worst-episode OCD severity and symptom dimensions were assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS) and Symptom Checklist (YBOCS-CL). Results: Probands reported higher-than-expected prevalence of scarlet fever (4.0 [3.1-5.2]% vs. 1.0%-2.0%, z = 1.491, p < 0.001, n = 1389), encephalitis or meningitis (1.4 [0.9-2.1]% vs. 0.1%-0.4%, z = 5.913, p < 0.001, n = 1393), rheumatoid arthritis (1.1 [0.6-2.0]% vs. 0.2%-0.4%, z = 3.416, p < 0.001, n = 949) and rheumatic fever (0.6 [0.3-1.2]% vs. 0.1%-0.2%, z = 3.338, p < 0.001, n = 1390), but not systemic lupus erythematosus, diabetes, asthma, multiple sclerosis, psoriasis, or inflammatory bowel disease. First-degree relatives reported similarly elevated rates of scarlet fever, rheumatic fever, and encephalitis or meningitis independent of OCD status. There was no association between worst-episode severity and immune-related comorbidities, although probands reporting frequent ear or throat infections had increased severity of cleaning-/contamination-related symptoms (mean factor score 2.5 ± 0.9 vs. 2.3 ± 1.0, t = 3.183, p = 0.002, n = 822). Conclusion: These data suggest high rates of streptococcal-related and other immune-mediated diseases in patients with childhood-onset OCD and are consistent with epidemiological studies in adults noting familial clustering. Limitations include potential reporting bias and absence of a control group, underscoring the need for further prospective studies characterizing medical and psychiatric disease clusters and their interactions in children. Such studies may ultimately improve our understanding of OCD pathogenesis and aid in the development of adjunctive immune-modulating therapeutic strategies.

Dataset Information

Childhood behavioral inhibition and overcontrol: Relationships with cognitive functioning, error monitoring, anxiety and obsessive-compulsive symptoms.

Publications

Childhood behavioral inhibition and overcontrol: Relationships with cognitive functioning, error monitoring, anxiety and obsessive-compulsive symptoms.

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