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Cool and Hot Aspects of Executive Function in Childhood Obsessive-Compulsive Disorder

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Abstract

Aspects of executive functioning (EF) have been put forward as endophenotypes in obsessive- compulsive disorder (OCD) and meta-analyses support EF underperformance in adult samples. Childhood-onset OCD has been suggested to constitute a separate neurodevelopmental subtype of the disorder but studies on neuropsychological functioning in childhood OCD are limited. The aim of the present study was to investigate performance-based EF in pediatric OCD using observed and latent variable analyses. A case-control design was applied including 50 unmedicated children and adolescents with OCD aged 7–17 years of which 70% were female, 50 pairwise age and gender matched non-psychiatric controls (NP) and 38 children and adolescents with mixed anxiety disorders (MA). Participants underwent structured diagnostic interviews and assessment with a battery encompassing cool EF tasks of working memory, set shifting, inhibition, and planning, and hot EF tasks of decision making and dot probe paradigm affective interference. First, groups were compared on observed variables with multilevel mixed-effects linear regression and analysis of variance. Then the latent structure of cool EF was tested with confirmatory factor analysis (CFA) and groups were compared on the CFA scores. No significant differences between groups appeared on individual cool EF tasks. On the hot EF tasks the OCD group displayed significant interference effects on the dot probe paradigm OCD-specific stimuli relative to NP, but not compared to MA and no group differences emerged for decision making. In the CFA a one-factor solution showed best fit, but the groups did not differ significantly on the resulting latent variable. The present study does not support cool or hot EF impairments in childhood OCD.

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Acknowledgments

This study was funded by The Danish Council for independent Research, Medical Sciences, The Research Fund for Psychiatric Research, Central Denmark Region, The Fru C. Hermansen’s Memorial Foundation, The Tryg Foundation, The, A.P. Møller Foundation for the Advancement of Medical Science and The G.J.’s Foundation. The authors thank all participating families. Further the authors wish to thank Morten Overgaard for his statistical assistance on the CFA.

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  1. Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Skovagervej 2, indgang 81, DK-8240, Risskov, Denmark

    Katja Anna Hybel & Per Hove Thomsen

  2. Department of Public Health and Center for Healthy Aging, University of Copenhagen, Øster Farimagsgade 5, DK-1014, København K, Denmark

    Erik Lykke Mortensen

  3. Department of Psychology and Behavioral Sciences, Aarhus University, Bartholins Allé 9, DK-8000, Aarhus C, Denmark

    Rikke Lambek & Mikael Thastum

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  1. Katja Anna Hybel
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Correspondence to Katja Anna Hybel.

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Per Hove Thomsen has received speaker’s fee at ADHD seminars from Shire and Medice, he also receives royalties from different publishers for textbooks on OCD, ADHD, and general textbooks on child and adolescent psychiatry. The other authors declare that they have no conflicting interest.

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Danish regional ethics committee and informed consent was obtained from all individual participants included in the study. All youth were offered a minor gift voucher for study participation.

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Hybel, K.A., Mortensen, E.L., Lambek, R. et al. Cool and Hot Aspects of Executive Function in Childhood Obsessive-Compulsive Disorder. J Abnorm Child Psychol 45, 1195–1205 (2017). https://doi.org/10.1007/s10802-016-0229-6

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