Impulsivity in obsessive-compulsive disorder: A systematic review and meta-analysis

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Impulsivity, defined as acting without forethought, is debated in obsessive-compulsive disorder (OCD).
• OCD is traditionally viewed as opposite to impulsivity, emphasizing risk avoidance.
• This study addresses the role of trait-level impulsivity in OCD.

Purpose of the Study:

• To systematically review and meta-analyze studies comparing impulsivity in OCD patients and non-clinical controls.
• To investigate self-report measures of impulsivity in individuals with OCD.

Main Methods:

• A systematic review and meta-analysis of 27 studies involving 1547 participants with OCD.
• Meta-analyses were performed on total and subscale scores of impulsivity measures, primarily the Barratt Impulsivity Scale (BIS).

Main Results:

• Large effect size for attention impulsivity (g=0.83) in OCD patients compared to controls.
• Medium effect size for nonplanning impulsivity (g=0.41) and very small effect size for motor impulsivity (g=0.17).
• Most studies found significantly higher attention impulsivity in OCD, but few reported elevated motor impulsivity.

Conclusions:

• OCD is not associated with elevated trait-level impulsivity.
• High total BIS scores in OCD may be driven by attentional impulsivity.
• Individuals with OCD may inflate self-reported impulsivity; differentiating trait and state impulsivity is crucial.