Executive Functions Evaluation through Evoked Potentials among Children with Obsessive-Compulsive Disorder

pychological and pedagogical survey Abstract Introduction: Obsessive-compulsive disorder [OCD] is characterized by repetitive, disturbing obsessions and/or compulsions. Obsessions are thoughts, images or feelings which are unwanted, persistent and recurrent. Compulsions are repetitive and ritual motor acts which are performed to decrease the anxiety level caused by repetitive obsessions. The onset of the OCD is typically during adolescence or early adulthood. Its prevalence among children is from 1% to 3% and it appears to be more present among boys than girls. Nowadays, the most effective way to treat OCD is to combine psychopharmacological with cognitive-behavioral treatment strategies. In the past decades researchers were more involved in investigating the role of the executive functions [EF] in psychiatric disorders. Aim of the study: to investigate EF among children with OCD by using Event Related Potentials (ERPs) on the Go/NoGo tasks. Subjects and methods: The sample is comprised of 20 children from both genders, between seven and 14 years of age [M=10,33±1,83], all diagnosed with OCD. Psychological evaluation was performed with Child Behavior Check List, Kohs cubes for assessment of the intellectual capacities, Beck Depression Inventory, The Schedule for Affective Disorders and Schizophrenia for School-Age Children, Stroop Color Word Test and Wisconsin Card Sorting Test. Neuropsychological evaluation was performed with the Visual Continuous Performance Test [VCPT] from which the Event Related Potentials [ERP] components were extracted. Results: There is a clear presence of obsessions and/or compulsions, absence of symptoms of depression, presence of perseverative errors and mild difficulties in mental flexibility. The ERP results cannot be understood as a disturbance of the EF in a direct sense, rather than as a disturbed normal functioning caused by the high anxiety level. Conclusion: There is no significant clinical manifestation of cognitive dysfunction among children with OCD in the early stage of the disorder, but it could be expected the same one to be appearing in the later stages of the disorder. Key words: obsessive-compulsive disorder, executive functions, children (ProQuest: . denotes non-USASCII text omitted.) Introduction Until recently, obsessive-compulsive disorder [OCD] was considered a rare condition, especially in childhood. Obsessions are thoughts, images or feelings which are unwanted, persistent and recurrent. Compulsions are motor acts which are stereotyped, ritual and repetitive. Certain compulsion is a consequence of a certain obsession with a goal to neutralize the anxiety which is in the background. Like adults, children are also not free from experiencing worries, fears and doubts about their everyday life. But when these stressful situations become very powerful and cannot be stopped or overcome, and start to disturbe the everyday functioning, academic achievements and peer relations, a disorder is present. The most frequent obsessions among children are fear of dirt and germs, excessive need for order and symmetry, fixations on urination and defecation, persistent thoughts fulfilled with aggressive or sexual context that are "bad and unmoral", feeling that something bad will happen to a close member of their family or themselves, etc. On the other hand, most frequent compulsions among children are frequent hand washing, ordering or counting objects, rechecking finished actions, word repetition, coughing, rituals before bed time, etc. When the child will resist carrying out the compulsions, anxiety usually increases. Adult patients generally recognize that the obsessions and compulsions are excessive and irrational but in children this is not the case. The majority of the patients with OCD experience both obsessions and compulsions. Around 25% of adult patients experience only obsession and 5% only compulsions (1). …