Anxiety and selective attention in obsessive–compulsive disorder

https://doi.org/10.1016/S0005-7967(03)00037-8Get rights and content

Abstract

Recently, there has been increasing evidence for information-processing deficits in individuals with obsessive–compulsive disorder (OCD). While impairments in selective attention have been identified to be central to the symptomatology of OCD, the role that situational anxiety plays in attentional processes has not been fully explored. Previous research findings were limited to tasks containing anxiety-relevant materials, only permitting for the evaluation of the impact of anxiety on simultaneous cognitive processing. Furthermore, it has not yet been determined whether the impact of anxiety is limited to selective attention or is indicative of a more general cognitive impairment. This study was designed to examine the role that situational anxiety plays in selective attention impairments. OCD participants and controls were presented with an anxiety producing statement and a neutral statement, followed by the Stroop Task. Results indicated that situational anxiety plays a significant role in the performance of tasks that require selective attention in OCD. A significant deterioration was detected in performance on selective attention tasks for the OCD participants after confronting anxiety-provoking scenarios, as compared to neutral scenarios. Anxiety did not impair performance on simple reading tasks. Possible explanations are discussed.

Section snippets

Subjects

Seventeen individuals were recruited from the Anxiety and Stress Treatment Program at North Shore University Hospital. All of the participants met the DSM-IV (American Psychiatric Association, 1994) criteria for OCD, based on the Structured Clinical Interview for DSM-IV (SCID) (First, Spitzer, Gibbon, & Williams, 1995). They were also administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (Goodman, Price, Rasmussen, Mazure, Fleischmann, Hill et al., 1989). Individuals with severe

Reported levels of anxiety

As expected, controlling for baseline anxiety and for age, after reading the anxiety-provoking scenario, the OCD participants reported significantly higher subjective anxiety than did the controls (F(1, 33)=12.24, p<0.001). No group differences in reported anxiety were found at baseline or after the neutral scenario was presented (Table 1). The results supported the hypothesis that compared to controls, individuals with OCD report higher levels of anxiety when an anxiety-provoking cue is

Discussion

In order to evaluate the role that anxiety plays in selective attention, the performance of participants with OCD and controls was compared on cognitive tasks in a low level anxiety condition. Results showed that the OCD group performed slower than the control group on both the simple reading and the selective attention task, suggesting that OCD patients are likely to perform various cognitive tasks slower than individuals without OCD. This finding is consistent with Cox’s (1997) conclusion

Acknowledgements

We would like to thank Linda Reddy, Margaret Gibbs, Liat Ayalon, Ron Field, and Louis Hsu for their comments on earlier versions of the manuscript.

References (32)

  • P.R Tata et al.

    Attentional bias in obsessional compulsive disorder

    Behaviour Research and Therapy

    (1996)
  • Diagnostic and statistical manual of mental disorders

    (1994)
  • C.S Cox

    Neuropsychological abnormalities in obsessive–compulsive disorder and their assessments

    International Review of Psychiatry

    (1997)
  • I.C Clayton et al.

    Selective attention in obsessive–compulsive disorder

    Journal of Abnormal Psychology

    (1999)
  • D.R Davies et al.

    Selective and sustained-attention tasks: Individual and group differences

  • S.J Enright et al.

    Obsessional states: Anxiety disorders or schizotypes? An information processing and personality assessment

    Psychological Medicine

    (1990)
  • Cited by (46)

    • Neuro-hemodynamic endophenotypes of emotional interference in OCD: fMRI study using emotion counting stroop task

      2019, Asian Journal of Psychiatry
      Citation Excerpt :

      The neural basis of emotional interference has been studied in anxiety disorders such as panic disorder (Dresler et al., 2012) and specific phobia (Britton et al., 2009). In the context of OCD, emotional interference appears to be critical because patients with OCD have limited capacity to selectively pay attention to relevant information and concurrently disregarding unnecessary competing information (Cohen et al., 2003). There appears to be an attentional bias toward emotionally salient stimuli in OCD (Kuelz et al., 2004), particularly towards threat related stimuli (Cohen et al., 2003), supporting the “threat-relatedness hypothesis” (Beck and Clark, 1997).

    • The effects of obsessive-compulsive symptoms and disorder-relevant stimuli on the dynamics of selective attention

      2017, Journal of Obsessive-Compulsive and Related Disorders
      Citation Excerpt :

      The absence of a relationship between trait OCD and selective attention is also in contrast with cognitive models proposing that attentional bias to threat is one of the mechanisms contributing to the development and maintenance of OCD (e.g., Bar-Haim et al., 2007; Muller & Roberts, 2005). The finding that there was no effect of an OCD symptom induction on subsequent selective attention is in contrast with Cohen et al. (2003), who found a decrease in performance after OCD symptom induction. Furthermore, this finding suggests models such as the ACT (Eysenck et al., 2007) proposing a mutually reinforcing relation between attentional bias toward threat and anxiety may not apply to OCD.

    View all citing articles on Scopus
    View full text