Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study

ObjectiveObsessive compulsive disorder (OCD) and anorexia nervosa (AN) are conditions associated with poor cognitive flexibility, a factor considered to interfere with treatment, but research into the relationship between cognitive flexibility and treatment outcome is limited. This study explores wh...

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Main Authors: Boris van Passel, Unna N. Danner, Alexandra E. Dingemans, Theo G. Broekman, Lot C. Sternheim, Eni S. Becker, Annemarie A. van Elburg, Eric F. van Furth, Gert-Jan Hendriks, Daniëlle C. Cath
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1456890/full
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author Boris van Passel
Boris van Passel
Unna N. Danner
Unna N. Danner
Alexandra E. Dingemans
Theo G. Broekman
Lot C. Sternheim
Lot C. Sternheim
Eni S. Becker
Annemarie A. van Elburg
Annemarie A. van Elburg
Eric F. van Furth
Eric F. van Furth
Gert-Jan Hendriks
Gert-Jan Hendriks
Gert-Jan Hendriks
Daniëlle C. Cath
Daniëlle C. Cath
author_facet Boris van Passel
Boris van Passel
Unna N. Danner
Unna N. Danner
Alexandra E. Dingemans
Theo G. Broekman
Lot C. Sternheim
Lot C. Sternheim
Eni S. Becker
Annemarie A. van Elburg
Annemarie A. van Elburg
Eric F. van Furth
Eric F. van Furth
Gert-Jan Hendriks
Gert-Jan Hendriks
Gert-Jan Hendriks
Daniëlle C. Cath
Daniëlle C. Cath
author_sort Boris van Passel
collection DOAJ
description ObjectiveObsessive compulsive disorder (OCD) and anorexia nervosa (AN) are conditions associated with poor cognitive flexibility, a factor considered to interfere with treatment, but research into the relationship between cognitive flexibility and treatment outcome is limited. This study explores whether baseline measures of cognitive flexibility predict outcomes in OCD and AN, evaluates whether changes in these measures contribute to treatment outcome, and evaluates the effectiveness of adjunctive cognitive remediation therapy (CRT) in improving cognitive flexibility.MethodsThis secondary analysis utilized linear mixed model analysis on data from a randomized controlled multicenter clinical trial involving adult participants with OCD (n=71) AND AN (n=61). Participants underwent 10 twice-weekly sessions of either CRT or a non-specific active control intervention (specialized attention therapy; SAT), followed by treatment as usual. Assessments using Yale-Brown Obsessive Compulsive Scale and the Eating Disorder Examination Questionnaire were conducted at baseline, post-CRT/SAT and at 6 and 12 months. Cognitive flexibility was evaluated through the Trail Making Test (TMT), the Color-Word Interference Test (CWIT) and the Detail and Flexibility Questionnaire (DFlex).ResultsLevels of cognitive flexibility at baseline did not predict or moderate treatment outcome, nor did change in cognitive flexibility (baseline post-CRT/SAT) mediate treatment outcome, with CRT providing no greater improvement in measures of cognitive flexibility than SAT.ConclusionsThis study failed to find any relationship between measures of cognitive flexibility and treatment outcome in OCD and AN, and thus questions hypothetical associations between measures of cognitive flexibility and mechanisms of change in patients with OCD and AN.
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spelling doaj-art-aaebec846c9049c8b370c223ada2c53b2025-01-13T06:10:15ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-01-011510.3389/fpsyt.2024.14568901456890Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory studyBoris van Passel0Boris van Passel1Unna N. Danner2Unna N. Danner3Alexandra E. Dingemans4Theo G. Broekman5Lot C. Sternheim6Lot C. Sternheim7Eni S. Becker8Annemarie A. van Elburg9Annemarie A. van Elburg10Eric F. van Furth11Eric F. van Furth12Gert-Jan Hendriks13Gert-Jan Hendriks14Gert-Jan Hendriks15Daniëlle C. Cath16Daniëlle C. Cath17Overwaal Centre of Expertise for Anxiety Disorders, Obsessive Compulsive Disorder (OCD) and Posttraumatic Stress-Disorder (PTSD), Institution for Integrated Mental Health Care, Pro Persona, Nijmegen, NetherlandsBehavioural Science Institute, Radboud University, Nijmegen, NetherlandsAltrecht Eating Disorders Rintveld, Zeist, NetherlandsDepartment of Clinical Psychology, Utrecht University, Utrecht, NetherlandsRivierduinen Eating Disorders Ursula, Leiden, NetherlandsBureau Bêta, Nijmegen, NetherlandsAltrecht Eating Disorders Rintveld, Zeist, NetherlandsDepartment of Clinical Psychology, Utrecht University, Utrecht, NetherlandsBehavioural Science Institute, Radboud University, Nijmegen, NetherlandsAltrecht Eating Disorders Rintveld, Zeist, NetherlandsDepartment of Clinical Psychology, Utrecht University, Utrecht, NetherlandsRivierduinen Eating Disorders Ursula, Leiden, NetherlandsDepartment of Psychiatry, Leiden University Medical Center, Leiden, NetherlandsOverwaal Centre of Expertise for Anxiety Disorders, Obsessive Compulsive Disorder (OCD) and Posttraumatic Stress-Disorder (PTSD), Institution for Integrated Mental Health Care, Pro Persona, Nijmegen, NetherlandsBehavioural Science Institute, Radboud University, Nijmegen, NetherlandsRadboud University Medical Centre, Department of Psychiatry, Radboud University, Nijmegen, NetherlandsDepartment of Specialist Training, Institution for Integrated Mental Health Care (GGz) Drenthe, Assen, Netherlands0Department of Psychiatry, University of Groningen & University Medical Center Groningen, Groningen, NetherlandsObjectiveObsessive compulsive disorder (OCD) and anorexia nervosa (AN) are conditions associated with poor cognitive flexibility, a factor considered to interfere with treatment, but research into the relationship between cognitive flexibility and treatment outcome is limited. This study explores whether baseline measures of cognitive flexibility predict outcomes in OCD and AN, evaluates whether changes in these measures contribute to treatment outcome, and evaluates the effectiveness of adjunctive cognitive remediation therapy (CRT) in improving cognitive flexibility.MethodsThis secondary analysis utilized linear mixed model analysis on data from a randomized controlled multicenter clinical trial involving adult participants with OCD (n=71) AND AN (n=61). Participants underwent 10 twice-weekly sessions of either CRT or a non-specific active control intervention (specialized attention therapy; SAT), followed by treatment as usual. Assessments using Yale-Brown Obsessive Compulsive Scale and the Eating Disorder Examination Questionnaire were conducted at baseline, post-CRT/SAT and at 6 and 12 months. Cognitive flexibility was evaluated through the Trail Making Test (TMT), the Color-Word Interference Test (CWIT) and the Detail and Flexibility Questionnaire (DFlex).ResultsLevels of cognitive flexibility at baseline did not predict or moderate treatment outcome, nor did change in cognitive flexibility (baseline post-CRT/SAT) mediate treatment outcome, with CRT providing no greater improvement in measures of cognitive flexibility than SAT.ConclusionsThis study failed to find any relationship between measures of cognitive flexibility and treatment outcome in OCD and AN, and thus questions hypothetical associations between measures of cognitive flexibility and mechanisms of change in patients with OCD and AN.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1456890/fullobsessive compulsive disorderanorexia nervosacognitive flexibilitycognitive remediation therapymoderation analysis
spellingShingle Boris van Passel
Boris van Passel
Unna N. Danner
Unna N. Danner
Alexandra E. Dingemans
Theo G. Broekman
Lot C. Sternheim
Lot C. Sternheim
Eni S. Becker
Annemarie A. van Elburg
Annemarie A. van Elburg
Eric F. van Furth
Eric F. van Furth
Gert-Jan Hendriks
Gert-Jan Hendriks
Gert-Jan Hendriks
Daniëlle C. Cath
Daniëlle C. Cath
Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study
Frontiers in Psychiatry
obsessive compulsive disorder
anorexia nervosa
cognitive flexibility
cognitive remediation therapy
moderation analysis
title Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study
title_full Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study
title_fullStr Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study
title_full_unstemmed Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study
title_short Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study
title_sort remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects an exploratory study
topic obsessive compulsive disorder
anorexia nervosa
cognitive flexibility
cognitive remediation therapy
moderation analysis
url https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1456890/full
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