Top-down and bottom-up contributions to memory performance in OCD: A multilevel meta-analysis with clinical...

Area of Science:

• Cognitive neuroscience
• Clinical psychology
• Psychiatry

Background:

• The relationship between executive function and memory deficits in obsessive-compulsive disorder (OCD) is well-documented, yet specific executive control contributions remain unclear.
• Previous meta-analyses identified executive function demand as a significant factor in OCD-related memory impairments.
• A finer-grained analysis is needed to dissect the distinct roles of top-down and bottom-up executive control processes.

Approach:

• A multilevel meta-analytic approach was employed, integrating 255 effect sizes from 131 studies involving 4,101 individuals with OCD.
• Executive control was segregated into top-down (attentional control, maintenance and updating, planning) and bottom-up (perceptual integration, perceptual salience) components.
• The analysis examined the predictive power of these specific executive functions on memory performance in OCD.

Key Points:

• Maintenance and updating (top-down executive function) significantly predicted general memory performance.
• Perceptual integration (bottom-up executive function) also predicted memory performance in individuals with clinical OCD.
• Exploratory findings suggested potential differences in subclinical OCD groups, though these require cautious interpretation.

Conclusions:

• Deficits in sensory gating (perceptual integration) and working memory gating (maintenance and updating) may underlie memory impairments in OCD.
• A proposed model integrates these findings to explain the expression of cognitive deficits in obsessive-compulsive symptoms.
• This meta-analysis highlights potential novel cognitive targets for therapeutic interventions in OCD.