Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun:87:102019.
doi: 10.1016/j.jbtep.2025.102019. Epub 2025 Jan 20.

Neurocognitive performance in obsessive-compulsive disorder before and after treatment with cognitive behavioral therapy

Michael G Wheaton  1 , Eyal Kalanthroff  2 , Micha Mandel  3 , Rachel Marsh  4 , H Blair Simpson  4
Affiliations

Neurocognitive performance in obsessive-compulsive disorder before and after treatment with cognitive behavioral therapy

Michael G Wheaton et al. J Behav Ther Exp Psychiatry. 2025 Jun.

Abstract

Background: Cross-sectional studies have reported neurocognitive performance deficits in obsessive-compulsive disorder (OCD), particularly on tasks assessing response inhibition and proactive control over stimulus-driven behaviors (task control). However, it is not clear whether these deficits represent trait-like markers of OCD or are state-dependent.

Methods: This study examined performance on two neurocognitive tasks in OCD patients (N = 26) before and after cognitive behavioral therapy (CBT) and matched healthy controls (HCs, N = 19). Tasks included the stop-signal task (assessing response inhibition) and the Object Interference (OI) task (assessing a specific form of task control). OCD patients completed these tasks and clinical ratings before and after 17 sessions of CBT delivered by expert therapists over two months. HCs completed tasks before and after 2-months. This design used CBT as a tool to reduce OCD symptoms to determine whether neurocognitive performance similarly improves.

Results: Results showed that OCD patients and HCs did not significantly differ in their stop-signal performance at either time point. In contrast, OCD patients exhibited impaired performance on the OI task at baseline and their OI performance improved after treatment, resolving the deficit relative to HC.

Limitations: The sample size was small, particularly for the healthy control group. We also tested only two neurocognitive tasks. Future study with larger sample sizes and more tasks is warranted.

Conclusions: These results suggest that task control deficits in OCD may be sensitive to symptom state. The possibility that improving task control represents a neurocognitive mechanism of successful CBT represents an important direction for future research.

Trial registration: ClinicalTrials.gov NCT02221518 NCT01686087.

Keywords: EX/RP; Exposure and ritual prevention; OCD; Obsessive-compulsive disorder; Response inhibition.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest In the last three years, HBS has received royalties from Cambridge University Press and UpToDate, Inc, and a stipend from JAMA for her role as Associate Editor at JAMA Psychiatry. All other authors report no financial disclosures or competing interests. The first authors is an associate editor and member of the editorial board of this journal. Given his role as an Editorial Board Member, he had no involvement in the peer-review of this article and had no access to information regarding its peer-review. The parent studies from which data were analyzed was supported by NIH grants (R01MH045436 and R01MH104648). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References

Publication types

Associated data