Cognitive factors of mental activity abnormalities in obsessive-compulsive disorder

Abstract

The article presents an analytical review of approaches to the study of cognitive factors of mental activity abnormalities in obsessive-compulsive disorder (OCD), which reflects the dynamics of scientific ideas development. Significant transclinical cognitive identities of abnormalities in OCD and anxiety-related disorders, particularly in social anxiety disorder (SAD), are shown. In the article we discuss controversial issues and conflicting points of view regarding the cognitive aspects of OCD. Our attention is focused on how the symptoms, pathological mechanisms and the syndromic status of this disorder were understood through the ages. Modern theoretical concepts and relevant studies are highlighted as well. The first cognitive theories of OCD indicated a significant similarity between the mechanisms of this disorder and anxiety disorders. In contrast, theoretical concepts were created that focused on identifying pathological mechanisms in the form of a system of dysfunctional beliefs, which made it possible to differentiate OCD from other disorders. The high comorbidity of OCD and anxiety disorders, especially SAD, may be caused by the fact that anxiety is often encountered with various mental disorders, it is a transclinical symptom, therefore, scientists face the necessity of determining the place of anxiety in the syndrome formation process, as well as neurocognitive mechanisms of formation and maintenance disorders. Perhaps the pathological mechanism of OCD consists not in the content of mental activity, but in the form of proceeding. A separate stage in the development of understanding the OCD mechanisms is the analysis of perfectionism as an anxiety disorders cognitive predictor. However, at this stage of psychological science development, the question of perfectionism effect on the OCD occurrence and maintenance remains open due to the fact that the structure of perfectionism itself also needs further clarification. A number of studies are devoted to the analysis of causal relationships between the "responsibility" parameter and OCD symptoms, but first it is necessary to conduct differential diagnosis of OCD and OC personality disorder. Increased responsibility is a central theme in OCD, and with respect to OCD, this parameter is a derivative violation. One of the most important lines of studying the cognitive mechanisms of OCD is the analysis of mental activity features. Rumination and obsession have common procedural properties. At the present stage of development of our knowledge about the mechanisms of OCD, an analysis of factors that ensure heterogeneity of OCD symptoms is underway, and rumination is possibly one of the factors. The heterogeneity of OCD symptoms may be explained due to the presence of concomitant disorders. A number of works are focused on the study of OCD and SAD comorbidity, having a common pattern of attention biases, as well as the features of guilt and shame experience in social contexts. Modern psychology is aimed at studying complex self-developing systems, which is associated with the process of its integration with neurosciences. A meta-analysis of neurocognitive studies has shown significant inconsistencies in the results regarding the neural correlates of the disorder. There is a lack of comparative cognitive activity studies of children or adults with OCD and other anxiety disorders, in particular, with SAD. It has been shown that a probable transdiagnostic neural mechanism of the formation and maintenance of an anxiety pattern in OCD and SAD is an event related potential component called ERN (error related negativity), which expresses vigilance to error, self-focused attention. Despite the great backlog in science on this issue, there are contradictions in the results. It is possibly connected with fragmentation in comprehension of a large number of empirical facts, the lack of single logic for understanding a complex phenomenon, and eclecticism in methodological interpretation. In the scientific context, a small amount of work is presented in which an analysis of OCD in connection with the transdiagnostic neural mechanisms of SAD is indicated, including the syndrome-factor method in clinical psychology based on a systematic view of the mental activity.