(PS2-67) Can You Repeat That? I Was Ruminating. internal-external Attention Switching in Obsessive Compulsive Disorder

Individuals with OCD are often internally focused, with their attention attuned to obsessions and mental compulsions. However, efficient functioning requires disengaging one’s attention from internal focus toward external stimuli. The present study used an attention-switching task to investigate the associations between OCD symptom dimensions and internal-external attention switching. 47 participants who met DSM-V criteria for OCD completed the attention-switching task. Obsessive-compulsive symptoms dimensions were assessed through the self-report Dimensional Obsessional-Compulsive Scale (DOCS). Overall OCD severity was assessed with the clinician-administered Yale-Brown Obsessive Compulsive Scale (Y-BOCS).

The attention-switching task involves performing a target detection (TD) task following an internally focused negative or positive event imagination condition, a rest condition, or a color-word conflict Stroop condition. Dependent measures from the task were mean reaction time (RT) on correct TD trials (corrRTmean), standard deviation of RT on correct TD trials (corrRTstd), percent commission errors on TD trials (accuracy), and percent omission errors on TD trials (no response). Measures were calculated separately based on whether TD blocks followed negative imagination (TD-IMneg), positive imagination (TD-IMpos), TD-Stroop, or TD-Rest.

Paired sample t-tests examined differences between conditions in the OCD group as a whole. Correlations assessed bivariate relationships between task measures (corrRTmean, corrRTstd, accuracy, omission) and DOCS subscales of Contamination (DOCS-C), Responsibility for Harm (DOCS-R), Unacceptable Thoughts (DOCS-UT), and Symmetry/Not-Just-Right-Experiences (DOCS-S). Additionally, correlations assessed bivariate relationships between task measures and total YBOCS scores, obsession and compulsion subscores, and individual items of time spent, distress, interference, resistance, and control.

DOCS-UT scores were negatively correlated with the percentage of omission responses during TD following IMpos (r=-0.291, p< 0.05). DOCS-UT and DOCS-R scores were negatively correlated with standard deviation (variance) of RT during TD following Stroop (r=-0.318, p< 0.05, r=-0.408, p< 0.05). YBOCS obsession resistance, compulsion resistance, and obsession control (higher scores indicate more impairment) were also negatively correlated with commission error percentage during TD following IMneg (r = -.344, p < .05, r = -.302, p < .05, r = -.425, p < .05).

Our study revealed that patients who have more OCD-related impairment with less resistance to obsessions (i.e., more giving into obsessions) showed better ability to switch attention from negative event imagination to TD. These unexpected findings linking greater OCD severity to improved attention switching in a variety of conditions suggest that certain forms of cognition may actually be enhanced in OCD, perhaps in relation to the hyperactive fronto-striatal circuit so often linked to the disorder. Future work will address this question further by examining the relationship between fronto-striatal function and behavior in the task.