Planning and problem solving across multiple psychiatric disorders in young adults

Planning and problem solving, subdomains of executive functioning, are important for daily functioning and clinical outcomes. Although executive functioning encompasses several domains, whether planning-specific deficits are a transdiagnostic feature across psychiatric disorders remains unclear.

Planning and problem solving in 658 young adults aged 18-29 was assessed in a cross-sectional study using the One Touch Stocking of Cambridge (OTS) task, with the number of problems solved correctly on first choice and mean latency to correct response as outcomes. Participants had a diverse range of psychiatric diagnoses, which were determined by structured clinical interviews. Planning and problem solving performance was compared between psychiatric groups and healthy controls using standardized z-scores and Cohen's d effect sizes.

Participants with psychiatric diagnoses generally demonstrated impaired planning and problem solving compared to controls. Large effect deficits in problem-solving accuracy were found in obsessive-compulsive disorder (z = -1.32) and trichotillomania (z = -0.87). Moderate effect deficits were observed in agoraphobia, gambling disorder, panic disorder, antisocial personality disorder, compulsive buying disorder, substance abuse, and borderline personality disorder. Trichotillomania also showed the highest planning latency (z = 0.59). Results for diagnostic groups with small sample sizes should be interpreted with caution.

These data indicate that planning and problem solving may be impaired in several psychiatric disorders. Future work may wish to examine the contribution of comorbidities and psychoactive substances to the profiles identified.