A randomized clinical trial of a gamified app for the treatment of perfectionism.

OBJECTIVES: Perfectionism is a common transdiagnostic problem that may lead to substantial distress and functional impairments. Cognitive behavioural therapy (CBT) is an effective treatment for perfectionism. However, the existing significant barriers to access and utilization of mental health services, including among college students, demand the development of low-intensity accessible interventions. The aim of the present study was to evaluate the effectiveness of a low-intensity CBT-based self-help gamified app developed specifically for perfectionism in a sample of college students. METHODS: Participants completed assessments of perfectionism, related symptoms, emotional burden and functional impairments at pretreatment, posttreatment and at one-month follow-up. RESULTS: Compared with the waitlist condition (n = 35), the app condition (n = 35) demonstrated a significant and greater reduction in perfectionism, obsessive-compulsive symptoms, functional impairments and subjective ratings of emotional burden. CONCLUSIONS: Results suggest that a brief, daily app-based game-like intervention targeting maladaptive perfectionistic beliefs may be a viable, low-cost alternative to traditional CBT treatments for vulnerable populations on college campuses.

A neuropsychological study of misophonia.

BACKGROUND AND OBJECTIVES: Misophonia is a recently identified condition characterized by negative emotional responsivity to certain types of sounds. Although progress has been made in understanding of neuronal, psychophysiological, and psychopathological mechanisms, important gaps in research remain, particularly insight into cognitive function. Accordingly, we conducted the first neuropsychological examination of misophonia, including clinical, diagnostic, and functional correlates. METHODS: A misophonia group (n = 32) and a control group (n = 64) were screened for comorbidities using a formal semi-structured interview and completed a comprehensive neuropsychological battery and self-report measures of depression, anxiety, stress, impulsivity, and functional impairment. RESULTS: The misophonia group significantly underperformed the control group on only 2 neuropsychological outcomes involving verbal memory retrieval. Subscales of the Misophonia Questionaaire (MQ) were inversely correlated only with measures of attention. The misophonia group reported significantly higher anxiety symptoms, behavioral impulsivity, and functional impairments, and had numerically higher rates of ADHD and OCD. LIMITATIONS: To facilitate comparability, in lieu of a formal diagnostic algorithm for misophonia, we used a commonly used empirical definition for group allocation that has been utilized in numerous previous studies. CONCLUSIONS: Misophonia was associated with a reduction in performance on a minority of cognitive tasks and a modest increase in some psychological symptoms and comorbid conditions. Correlational data suggest that difficulties with attention regulation and impulsivity may play a role in misophonia, albeit attention functions were intact. Results should be interpreted with caution given the variability in diagnostic definitions, and more research is needed to understand cognitive functioning under 'cold' conditions in misophonia.

An ultra-brief screening scale for pediatric obsessive-compulsive disorder: The OCI-CV-5.

BACKGROUND: Obsessive-compulsive disorder (OCD) is an often disabling and chronic condition that is normally assessed using diagnostic interviews or lengthy self-report questionnaires. This makes routine screening in general health settings impractical, and as a result OCD is often under-(or mis-)recognized. The present study reports on the development of an ultra-brief version of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) which may be administered routinely as a screener for pediatric OCD. METHOD: A total of 489 youth diagnosed with OCD, 259 non-clinical controls, and 299 youth with other disorders completed the OCI-CV and other indices of psychopathology. Using item analyses, we extracted five items and examined the measure's factor structure, sensitivity and specificity, and convergent and discriminant validity. RESULTS: We extracted five items that assess different dimensions of OCD (washing, checking, ordering, obsessing, neutralizing/counting), termed the OCI-CV-5. Results revealed that the measure possesses good to excellent psychometric properties, and a cutoff off (≥2) yielded optimal sensitivity and specificity. LIMITATIONS: Participants were predominantly White. In addition, more research is needed to examine the OCI-CV-5's test-retest reliability and sensitivity to treatment. CONCLUSIONS: The OCI-CV-5 shows promise as an ultra-brief self-report screener for identifying OCD in youth when in-depth assessment is unfeasible.

The OCI-CV-R: A Revision of the Obsessive-Compulsive Inventory - Child Version.

BACKGROUND: The Obsessive-Compulsive Inventory-Children's Version (OCI-CV) was developed to assess obsessive-compulsive symptoms in youth. Recent changes in the Diagnostic and Statistical Manual (DSM-5) exclude hoarding from inclusion in the diagnosis of obsessive-compulsive disorder (OCD). Accordingly, the present study examined the reliability, validity, factorial structure, and diagnostic sensitivity of a revised version of the scale - the OCI-CV-R- that excludes items assessing hoarding. METHODS: Participant were 1047 youth, including 489 meeting DSM criteria for primary OCD, 298 clinical controls, and 260 nonclinical controls, who completed the OCI-CV and measures of obsessive-compulsive symptom severity, depression, and anxiety at various treatment and research centers. RESULTS: Findings support a five-factor structure (doubting/checking, obsessing, washing, ordering, and neutralizing), with a higher order factor. Factorial invariance was found for older (12-17 years) and younger (7-11 years) children. Internal consistency of the OCI-CV-R was acceptable, and discriminant and convergent validity were adequate and akin to that of its progenitor. Diagnostic sensitivity and specificity were found for a total score of 8 and higher. CONCLUSION: It is recommended that the OCI-CV-R replace the former version, and that this measure serve as part of a comprehensive clinical assessment of youth with OCD. Recommendations for further research with ethnically and racially diverse samples, as well as the need to establish benchmark scores are discussed.

Neuropsychological Research in Obsessive-Compulsive Disorder: Current Status and Future Directions.

Neuropsychological functions in obsessive-compulsive disorder (OCD) have been extensively investigated. Despite some common findings across studies indicating deficient test performance across cognitive domains with small to medium effect sizes, results remain inconsistent and heterogeneous. However, multiple past attempts to identify moderators that may account for such variability have been unrewarding. Typical moderators including symptom severity, age at onset, medication status, and comorbid conditions failed to provide sufficient explanatory power. It has then been posited that these inconsistencies may be attributed to the inherent heterogeneous nature of the disorder (i.e., symptom dimensions), or to the natural fluctuation in symptom severity. However, recent meta-analyses suggest that these factors may not account for the persistent unexplained variability. Other potential factors-some of which are unique to neuropsychological testing-received scarce research attention, including definition of cognitive impairments, specificity and selection of test and outcome measures, and their limited ecological validity. Other moderators, particularly motivational aspects, and metacognitive factors (e.g., self-efficacy) were not previously addressed despite their potential association to OCD, and their documented impact on cognitive function. The aim of the present mini-review is to provide an updated succinct overview of the current status of the neuropsychological literature in OCD and expanding upon oft-neglected potential moderators and their putative impact on neuropsychological findings in OCD. Our goal is to highlight important avenues for further research and provide a road map for investigators in order to advance our understanding of cognitive functions in OCD that has been stagnant in the past decade.

Intact capacity for implicit learning in obsessive-compulsive disorder.

BACKGROUND AND OBJECTIVES: Individuals with OCD tend to rely on explicit processing when performing implicit learning tasks. However, it is unclear whether this tendency reflects impaired capacity for implicit processing or a preference toward explicit processing. We sought to use a psychometrically valid task to examine the hypothesis that individuals with OCD have intact capacity for implicit learning. METHODS: Twenty-four participants with OCD and 24 non-psychiatric controls completed a modified artificial grammar learning task where acquisition and retrieval of the underlying grammatical rules are considered strictly implicit. In an exploratory condition designed to examine the effect of nudging participants toward controlled processing, 12 participants in each group were told that the stimuli presented at acquisition were composed according to grammatical rules and were encouraged to identify these rules. RESULTS: As predicted, participants with OCD acquired and expressed knowledge of the grammatical rule, demonstrating intact capacity for implicit learning, with no differences found between the OCD and controls on the extent of implicit learning. The exploratory intentional learning instructions had no effect, as participants in this condition were unable to adhere to the instructions, supporting the robust implicit nature of the artificial grammar learning task. LIMITATIONS: The relatively small sample size did not allow comparisons between OCD symptom subtypes. CONCLUSIONS: Our results provide evidence for intact implicit learning in OCD, and challenge previous studies suggesting a general deficiency in implicit learning in OCD.

The C Factor: Cognitive dysfunction as a transdiagnostic dimension in psychopathology.

Research into cognitive functions across psychological disorders suggests that cognitive deficiencies may be present across multiple disorders, potentially pointing to a transdiagnostic phenomenon. More recently, a single dimension model of psychopathology, the p factor, has been proposed, in which cognitive deficits are thought to be an intrinsic construct, assumed to be transdiagnostic. However, no systematic investigation to date tested this hypothesis. The aim of the present study was to systematically review meta-analyses to assess the hypothesis that the C factor (cognitive dysfunction) is transdiagnostic in psychopathology and review potential moderators that may account for such a phenomenon. We conducted a systematic review of meta-analyses examining cognitive function across all disorders for which data were available. Included meta-analyses (n = 82), comprising 97 clinical samples, yielded 1,055 effect sizes. Twelve major disorders/categories (e.g., bipolar disorder, substance use disorders) were included, comprising 29 distinct clinical entities (e.g., euthymic bipolar disorder; alcohol use disorder). Results show that all disorders reviewed are associated with underperformance across cognitive domains, supporting the hypothesis that the C factor (or cognitive dysfunction) is a transdiagnostic factor related to p. To examine moderators that may explain or contribute to c, we first consider important interpretative limitations of neuropsychological data in psychopathology. More crucially, we review oft-neglected motivational and emotional transdiagnostic constructs of p, as prominent contributing constructs to the C factor. These constructs are offered as a roadmap for future research examining these constructs related to p, that contribute, and may account for cognitive dysfunctions in psychopathology.

The OCI-12: A syndromally valid modification of the obsessive-compulsive inventory-revised.

The 18-item Obsessive-Compulsive Inventory-Revised (OCI-R) is a widely used self-report measure of Obsessive-Compulsive Disorder (OCD) symptoms, yet its factor structure does not converge with contemporary dimensional models of OCD symptoms. In addition to assessing the four core OCD dimensions, the OCI-R includes hoarding and neutralizing factors. However, since its publication, hoarding has been designated as a separate disorder, and there are concerns about the neutralizing factor's reliability and validity. The aim of this study was to evaluate a syndromally valid modification of the OCI-R. Adult samples of individuals diagnosed with OCD (n = 1087), anxiety related disorders (n = 1306), and unselected community volunteers (n = 423) completed the OCI-R and measures of anxiety and mood. Analyses excluded the 3 OCI-R hoarding items and suggested the removal of the 3 neutralizing items. Internal consistency, sensitivity and specificity to OCD clinical status, test-retest reliability, sensitivity to treatment, and convergent and discriminant validity were evaluated for the resultant 12-item scale (termed the OCI-12). The OCI-12 evidenced good to excellent psychometric properties. Clinical norms, severity benchmarks, and a clinical cutoff score were computed. In conclusion, the OCI-12 represents a syndromally valid update of the OCI-R with comparable psychometric properties and superior sensitivity and specificity.

Neurocognitive endophenotypes in pediatric OCD probands, their unaffected parents and siblings.

BACKGROUND: Limited extant research on neurocognitive endophenotypes in obsessive-compulsive disorder (OCD) show inconsistent results. Limitations of this body of literature include small sample sizes, strict exclusion criteria, lack of objective standard normalized test scores, and significant lack of studies utilizing pediatric probands. This study aimed to address these limitations. METHODS: A large carefully screened cohort of pediatric OCD (n = 102), their unaffected siblings (n = 78), and parents (n = 164), completed a neuropsychological battery. To compare participants at different ages and developmental stages, standard scores were computed using test norms. Cluster-robust regression with sample size-adjusted sandwich estimates of variance, and interclass correlations were computed. False Discovery Rate procedures were employed to correct for multiplicity. RESULTS: Probands, siblings and parents demonstrated deficient task performance (Z < -0.5) on the 'number of trials to complete first category' on the Wisconsin Card Sorting Test, and on the Stroop color naming trials. Compared to test norms, the three groups exhibited medium to large effect sizes on these outcome measures. No other meaningful familial trends were found. CONCLUSIONS: OCD probands, their unaffected siblings and parents exhibited deficiencies in specific subdomains of cognitive flexibility and inhibitory control, namely, initial concept formation and proactive control, which may be valid candidate neurocognitive endophenotypes of OCD. No other meaningful familial effect has been found on other functions, including other executive function indices such as perseverations and interference control. These results highlight the need to carefully examine individual outcomes from executive function tests instead of the tendency to focus largely on major outcome measures.

The OCI-4: An ultra-brief screening scale for obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is a prevalent and burdensome condition that is typically assessed using in-depth interviews or lengthy self-report measures. Accordingly, routine screening in busy non-mental health settings is impractical, and OCD is often under- (or mis-) recognized. We evaluated an ultra-brief version of a widely used self-report measure, the Obsessive-Compulsive Inventory-Revised (OCI-R), which may be employed as a routine screener for OCD. A total of 1087 adults diagnosed with OCD, 1306 unselected adults from the community, and 423 adults with anxiety related disorders completed the OCI-R along with measures of anxiety and mood. Analyses were conducted to reduce the number of items and examine evidence for sensitivity and specificity to OCD clinical status, test-retest reliability, sensitivity to treatment, and convergent and discriminant validity. Four items that optimally assess different dimensions of OCD (washing, checking, ordering, obsessing) were identified. Psychometric evaluation revealed good to excellent test-retest reliability, validity, prediction of clinical OCD status, and sensitivity to treatment. A 4-item version of the OCI-R, called the OCI-4, shows promise as an ultra-brief screening tool for identifying likely OCD in settings where in-depth assessment is impractical. Patients with a positive screen may be referred for further evaluation and appropriate treatment.

Diagnostic biomarkers for obsessive-compulsive disorder: A reasonable quest or ignis fatuus?

Obsessive-compulsive disorder (OCD) has been associated with a wide range of biological and neurocognitive findings, which could assist in the search for biomarkers. We conducted an umbrella review of systematic reviews and meta-analyses to assess and grade the strength of the evidence of the association between OCD and several potential diagnostic biomarkers while controlling for several potential biases. Twenty-four systematic reviews and meta-analyses were included, comprising 352 individual studies, more than 10,000 individuals with OCD, and covering 73 potential biomarkers. OCD was significantly associated with several neurocognitive biomarkers, with varying degrees of evidence, ranging from weak to convincing. A number of biochemical, neurophysiological, and neuroimaging biomarkers also showed statistically significant, albeit weak, associations with OCD. Analyses in unmedicated samples (123 studies) weakened the strength of the evidence for most biomarkers or rendered them non-significant. None of the biomarkers seem to have sufficient sensitivity and specificity to become a diagnostic biomarker. A more promising avenue for future biomarker research in OCD might be the prediction of clinical outcomes rather than diagnosis.

A Neuropsychological Investigation of Perfectionism.

Perfectionism entails a burdensome preoccupation with one's self-evaluation in the context of performance outcomes. Although perfectionism has been subject to extensive research, scant literature on its effect on cognitive functioning is available, let alone in nonclinical populations. The aim of the present study is to utilize a comprehensive neuropsychological battery to assess cognitive functions among college students with high and low levels of perfectionism. Participants were 98 college students who were screened for clinical status, completed a neuropsychological battery, and assessed for perfectionism and related symptomatology. Results revealed that the high negative perfectionism group had significantly higher levels of depression and stress compared to the low negative perfectionism group. However, no group differences were found across neuropsychological outcomes. Gradient differences on clinical outcome measures were found when three groups characterized by high adaptive, high maladaptive, and mixed perfectionism were compared. However, no differences were found on neuropsychological tests. These findings suggest that higher levels of negative perfectionism are associated with significant psychopathological burden, but with intact neuropsychological test performance. These results are important, particularly in the context of the need to identify and treat students struggling with high levels of perfectionism and related psychopathological burden, which can be overlooked given that they present with intact cognitive and academic performance.

Cognitive functions in young adults with generalized anxiety disorder.

BACKGROUND: Anxiety and worry are central symptoms of Generalized Anxiety Disorder (GAD) that have been theorized to negatively impact cognitive functions. However, most of the research has focused on threat-related or emotionally-charged stimuli, and a surprisingly small number of investigations examined 'cold' cognitive functions using classic neuropsychological tests. Such investigations are particularly important given that some theoretical models suggest compensatory mechanisms associated with anxiety that in certain circumstances may result in intact performance. The aim of the present study is to assess the neuropsychological profile associated with GAD, using a comprehensive neuropsychological battery. METHODS: A sample of 23 college students meeting criteria for DSM-5 GAD and 20 control participants completed a psychometrically valid comprehensive computerized neuropsychological battery and clinical questionnaires. RESULTS: The GAD sample presented with significantly elevated symptomatic rates of anxiety, worry, depression and stress. However, no significant differences were found on any neuropsychological outcome measures or domain indexes. Effect sizes were small, some of which favored the GAD sample. CONCLUSION: Despite substantial psychopathological burden, GAD exhibited intact cognitive functioning. These results support the Cognitive Control Theory of Anxiety, suggesting that elevated primary anxiety may not impact 'cold' cognitive functions in the absence of threat or substantial cognitive load. Given that this is one of the only studies employing a comprehensive neuropsychological battery in GAD, more research is needed in this population to replicate these results and to examine the impact of anxiety on cognitive functions at varying degrees of cognitive load in this population.

Body mass index in obsessive-compulsive disorder.

BACKGROUND: Psychiatric disorders are associated with overweight/obesity. Obsessive-compulsive disorder (OCD) may be an exception, as anecdotal evidence suggests lower BMI in OCD. Additionally, depression is associated with elevated BMI, but effects of comorbid secondary depression are unknown. The aim of the present study was to assess BMI and risk for overweight/obesity in OCD and to assess the effect of comorbid depression on BMI. METHODS: BMI, demographics, and clinical status were assessed in large samples of individuals with OCD, anxiety disorders, depressive disorders, comorbid anxiety/depressive disorders, and non-clinical controls (NCC). RESULTS: Although no initial differences were found between the samples on BMI, the non-depressed OCD subsample had significantly lower BMI and risk for overweight/obesity compared to all other clinical samples. NCC were nearly twice as likely to be overweight compared to non-depressed OCD. LIMITATIONS: Eating disorders were excluded in the OCD sample, but BMI < 17 was used as an exclusion criterion in the clinical control groups in lieu of screening for Anorexia. Group differences on demographics were controlled for. Recruitment methodology differed between samples. CONCLUSIONS: OCD is associated with significantly lower rates of obesity and overweight, but this relationship was not found when comorbid depression was present. This suggests that the purer the phenotype of OCD, the more substantial protective factor against overweight/obesity emerges compared to other clinical samples and NCC. An OCD-specific reward/anhedonia model, previously offered to elucidate lower smoking rates in OCD, may account for lower BMI in OCD. These results warrant careful clinical attention to the negative impact of comorbid depression on OCD that spans from increasing risk for obesity and cigarette smoking, to hindering treatment response.

The impact of symptom severity on cognitive function in obsessive-compulsive disorder: A meta-analysis.

Research on cognitive functions in obsessive-compulsive disorder (OCD) is notoriously heterogeneous with no moderators identified that account for this variability. OCD severity is the primary potential moderator of interest given the longstanding trait versus state debate. Nevertheless, severity has been previously assessed exclusively as a moderator and was not directly and systematically investigated. To address this gap in the literature, the aim of this study was to conduct a systematic meta-analytic review of correlations between cognitive function and symptom severity in OCD samples. Thirty-eight studies were included, allowing for analysis of 132 effects and meta-regression analyses for potential moderators. Small effects were found for the association between cognitive function and symptom severity on major neuropsychological domains, and some subdomains exhibited medium effects for this association. However, several significant methodological and conceptual problems were identified, including the use of the Yale-Brown Obsessive-Compulsive Scale that assesses severity in the past week and not at time of testing, a tendency to not report non-significant correlations, and problematic ecological validity of neuropsychological tests in OCD. In conclusion, we found a small-to-moderate degree of association between OCD symptom severity and cognitive function, but results should be interpreted cautiously given the limitations identified. We offer recommendations that will facilitate future research into this association and move the field beyond the largely stagnant debate about the state versus trait nature of cognitive functioning in OCD, and across disorders.

Explicit instructions facilitate performance of OCD participants but impair performance of non-OCD participants on a serial reaction time task.

Previous studies have shown that individuals diagnosed with OCD tend to rely on explicit processing while performing implicit learning tasks. We sought to investigate whether individuals with OCD are capable of implicit learning, but would demonstrate improved performance when explicit processing strategies are enhanced. Twenty-four participants with OCD and 24 non-psychiatric control (NPC) participants performed an implicit learning task in which they responded to a single target stimulus that successively appears at one of four locations according to an underlying sequence. We manipulated the learning strategy by informing half of the participants that the target stimulus location was determined by an underlying sequence, which they should identify (intentional learning). The other half of the participants was not informed of the existence of the underlying sequence, and was expected to learn the sequence implicitly (standard learning). We predicted that OCD participants will exhibit inferior performance compared to NPC participants in the standard learning condition, and that intentional learning instructions would impair the performance of NPC participants, but enhance the performance of OCD participants. The results supported these predictions and suggest that individuals with OCD prefer controlled to automatic processing. We discuss the implications of this conclusion to our understanding of OCD.

A computerized neuropsychological evaluation of cognitive functions in a subclinical obsessive-compulsive sample.

BACKGROUND AND OBJECTIVES: Ample research in obsessive-compulsive disorder (OCD) reveals a moderate degree of underperformance on various neuropsychological tasks. Less is known about neuropsychological function in subclinical obsessive-compulsive (OC) samples. Most analogue OCD studies did not use a comprehensive neuropsychological battery and none utilized a fully computerized battery. To fill this gap in the literature, the present study aimed at assessing cognitive functions in a subclinical OC sample using a validated computerized neuropsychological battery. METHODS: Initially, a sample of 165 students completed the Obsessive-Compulsive Inventory-Revised (OCI-R). Using a psychometrically valid methodology, a high OC (HOC, n = 29) and low OC (LOC, n = 29) groups were selected based on scores in the upper and lower quartiles on the OCI-R. The two groups completed the NeuroTrax computerized neuropsychological battery and clinical questionnaires. RESULTS: Although the HOC group underperformed on most outcome measures, controlling for state-anxiety and depression symptoms, no significant differences were found on major domains (i.e., memory, attention, executive functions, processing speed, visuospatial functions, verbal functions, and motor skills), and subdomains. Normalized scores, produced using population norms, indicated that both groups performed within the normative range. LIMITATIONS: Not all neuropsychological subdomains were assessed. CONCLUSIONS: Results are consistent with the general picture in analogue OC samples, and may be more reliable than paper-pencil testing, given that a full computerized neuropsychological battery minimizes examiner-examinee interactions, and increases timing accuracy. In sum, analogue OC samples, characterized by equivalent symptom severity but high functioning compared to OCD samples, do not present with cognitive deficits.

Neurocognitive function in paediatric obsessive-compulsive disorder.

OBJECTIVES: The small body of neuropsychological research in paediatric obsessive-compulsive disorder (OCD) yields inconsistent results. A recent meta-analysis found small effect sizes, concluding that paediatric OCD may not be associated with cognitive impairments, stressing the need for more research. We investigated neuropsychological performance in a large sample of youths with OCD, while assessing potential moderators. METHODS: Participants with OCD (n = 102) and matched controls (n = 161) were thoroughly screened and blindly evaluated for comorbidities, and completed a neuropsychological battery assessing processing speed, visuospatial abilities (VSA), working memory (WM), non-verbal memory (NVM), and executive functions (EF). RESULTS: Compared to controls, youths with OCD exhibited underperformance on tasks assessing processing speed. On tests of VSA and WM, underperformance was found only on timed tasks. There were no differences on NVM and EF tasks. Notably, the OCD group's standardised scores were in the normative range. Test performance was not associated with demographic or clinical variables. CONCLUSIONS: Youths with OCD exhibited intact performance on memory and EF tests, but slower processing speed, and underperformance only on timed VSA and WM tasks. While the OCD group performed in the normative range, these findings reveal relative weaknesses that may be overlooked. Such an oversight may be of particular importance in clinical and school settings.

Meta-Analysis of Intelligence Quotient (IQ) in Obsessive-Compulsive Disorder.

Obsessive compulsive disorder (OCD) is associated with a moderate degree of underperformance on cognitive tests, including deficient processing speed. However, despite little research focusing on Intelligence Quotient (IQ) in OCD, it has long been speculated that the disorder is associated with elevated intellectual capacity. The present meta-analytic study was, therefore, conducted to quantitatively summarize the literature on IQ in OCD systematically. We identified 98 studies containing IQ data among individuals with OCD and non-psychiatric comparison groups, and computed 108 effect sizes for Verbal IQ (VIQ, n = 55), Performance IQ (PIQ, n = 13), and Full Scale IQ (FSIQ, n = 40). Across studies, small effect sizes were found for FSIQ and VIQ, and a moderate effect size for PIQ, exemplifying reduced IQ in OCD. However, mean IQ scores across OCD samples were in the normative range. Moderator analyses revealed no significant moderating effect across clinical and demographic indices. We conclude that, although lower than controls, OCD is associated with normative FSIQ and VIQ, and relatively lowered PIQ. These results are discussed in light of neuropsychological research in OCD, and particularly the putative impact of reduced processing speed in this population. Recommendations for utilization of IQ tests in OCD, and directions for future studies are offered.

A yoga program for cognitive enhancement.

BACKGROUND: Recent studies suggest that yoga practice may improve cognitive functioning. Although preliminary data indicate that yoga improves working memory (WM), high-resolution information about the type of WM subconstructs, namely maintenance and manipulation, is not available. Furthermore, the association between cognitive enhancement and improved mindfulness as a result of yoga practice requires empirical examination. The aim of the present study is to assess the impact of a brief yoga program on WM maintenance, WM manipulation and attentive mindfulness. METHODS: Measures of WM (Digit Span Forward, Backward, and Sequencing, and Letter-Number Sequencing) were administered prior to and following 6 sessions of yoga (N = 43). Additionally, the Mindfulness Attention Awareness Scale was administered to examine the potential impact of yoga practice on mindfulness, as well as the relationships among changes in WM and mindfulness. RESULTS: Analyses revealed significant improvement from pre- to post- training assessment on both maintenance WM (Digit Span Forward) and manipulation WM (Digit Span Backward and Letter-Number Sequencing). No change was found on Digit Span Sequencing. Improvement was also found on mindfulness scores. However, no correlation was observed between mindfulness and WM measures. CONCLUSIONS: A 6-session yoga program was associated with improvement on manipulation and maintenance WM measures as well as enhanced mindfulness scores. Additional research is needed to understand the extent of yoga-related cognitive enhancement and mechanisms by which yoga may enhance cognition, ideally by utilizing randomized controlled trials and more comprehensive neuropsychological batteries.