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A Neurocognitive Comparison of Pediatric Obsessive-Compulsive Disorder and Trichotillomania (Hair Pulling Disorder)
Emily P Wilton1, Christopher A Flessner2, Elle Brennan2
1Department of Psychological Sciences, Kent State University, Kent, OH, USA. ewilton@kent.edu.
Insights
Children with obsessive-compulsive disorder (OCD) and hair pulling disorder (HPD) show distinct neurocognitive profiles. While both groups excel in planning compared to healthy controls, children with OCD struggle with sustained attention.
Area of Science:
- Neuroscience
- Child Psychology
- Psychiatry
Background:
- Obsessive-compulsive disorder (OCD) and trichotillomania (hair pulling disorder, HPD) are classified as obsessive-compulsive and related disorders.
- Shared etiological and phenomenological characteristics suggest overlap, but direct pediatric comparisons are limited.
Purpose of the Study:
- To compare neurocognitive functioning between pediatric samples diagnosed with OCD and HPD.
- To identify divergent and convergent cognitive characteristics in these related disorders.
Main Methods:
- A neurocognitive assessment battery was administered to children with HPD (n=21), OCD (n=40), and healthy controls (HCs, n=29).
- Tasks assessed inhibitory control, sustained attention, planning, working memory, visual memory, and cognitive flexibility.
- Parent and self-report measures were also collected.
Main Results:
- Significant group differences emerged in planning and sustained attention.
- Children with OCD and HPD outperformed HCs on planning tasks.
- Children with OCD showed poorer sustained attention compared to both HPD and HC groups.
Conclusions:
- Pediatric OCD and HPD exhibit distinct neurocognitive profiles, particularly in sustained attention.
- Findings support transdiagnostic research and inform targeted interventions for these disorders.
Abstract:
Obsessive-compulsive disorder (OCD) and trichotillomania (hair pulling disorder, HPD) are both considered obsessive-compulsive and related disorders due to some indications of shared etiological and phenomenological characteristics. However, a lack of direct comparisons between these disorders, especially in pediatric samples, limits our understanding of divergent versus convergent characteristics. This study compared neurocognitive functioning between children diagnosed with OCD and HPD. In total, 21 children diagnosed with HPD, 40 diagnosed with OCD, and 29 healthy controls (HCs), along with their parents, completed self-/parent-report measures and a neurocognitive assessment battery, which included tasks of inhibitory control, sustained attention, planning, working memory, visual memory, and cognitive flexibility. A series of analyses of variance (or covariance) indicated significant differences between groups on tasks examining planning and sustained attention. Specifically, children in both the OCD and HPD groups outperformed HCs on a task of planning. Further, children with OCD underperformed as compared to both the HPD and HC groups on a task of sustained attention. No between group differences were found with respect to tasks of reversal learning, working memory, spatial working memory, visual memory, or inhibitory control. The implications these findings may have for future, transdiagnostic work, as well as limitations and future directions are discussed.
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