Cognitive retraining for organizational impairment in obsessive–compulsive disorder

Buhlmann, Ulrike; Deckersbach, Thilo; Engelhard, Iris; Cook, Laura M.; Rauch, Scott L.; Kathmann, Norbert; Wilhelm, Sabine; Savage, Cary R.

doi:10.1016/j.psychres.2005.10.012

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Volume 144, Issue 2 , Pages 109-116, 15 November 2006

Cognitive retraining for organizational impairment in obsessive–compulsive disorder

Ulrike Buhlmann
- Department of Psychiatry/OCD Clinic, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA
- Corresponding author. Tel.: +1 617 726 5374; fax: +1 617 643 3080.
Thilo Deckersbach
- Department of Psychiatry/OCD Clinic, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA
Iris Engelhard
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
Laura M. Cook
- Department of Psychiatry/OCD Clinic, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA
Scott L. Rauch
- Department of Psychiatry/OCD Clinic, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA
Norbert Kathmann
- Department of Clinical Psychology, Humboldt University of Berlin, Berlin, Germany
Sabine Wilhelm
- Department of Psychiatry/OCD Clinic, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA
Cary R. Savage
- Hoglund Brain Imaging Center and Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, KS, USA

Received 14 March 2005; received in revised form 26 August 2005; accepted 27 October 2005.

Abstract

Individuals with obsessive–compulsive disorder (OCD) have difficulties in organizing information during encoding associated with subsequent memory impairments. This study was designed to investigate whether impairments in organization in individuals with OCD can be alleviated with cognitive training. Thirty-five OCD subjects and 36 controls copied and recalled the Rey–Osterrieth Complex Figure Test (RCFT) [Osterrieth, P.A., 1944. Le test de copie d'une figure complexe: Contribution a l'étude de la perception et de la memoire (The test of copying a complex figure: A contribution to the study of perception and memory). Archive de Psychologie 30, 286-350.] before being randomly assigned to a training or non-training condition. The training condition was designed to improve the ability to organize complex visuospatial information in a meaningful way. The intervention phase was followed by another copy and recall trial of the RCFT. Both OCD and control subjects who underwent training improved more in organization and memory than subjects who did not receive organizational training, providing evidence that the training procedure was effective. OCD subjects improved more in organizational during encoding than control subjects, irrespective of whether or not they had received training. This suggests that organization impairment in OCD affects primarily the ability to spontaneously utilize strategies when faced with complex, ambiguous information but that the ability to implement such strategies when provided with additional trials is preserved. These findings support a distinction in OCD between failure to utilize a strategy and incapacity to implement a strategy.

Keywords: Obsessive–compulsive disorder, Neuropsychology, Nonverbal memory, Organization, Recall, Rey–Osterrieth Complex Figure, Taylor Complex Figure