Differences in neuropsychological performance between incompleteness- and harm avoidance-related core dimensions in obsessive-compulsive disorder

Background The division of symptom themes into those related to incompleteness (INC) and those related to harm avoidance (HA) has been identified as an alternative to conventional subtyping. The aim of this study was to elucidate any potential differences between these two symptom themes based on neuropsychological task performance. Method: Participants (N = 123) with a primary DSM-5 diagnosis of OCD were recruited and classified into INC or HA groups based on detailed direct report of their current most troubling symptoms. All participants completed a set of neuropsychological tasks covering verbal memory and various executive function subdomains. Results: Those in the INC group performed better on a task assessing verbal memory (p < .05) while those in the HA group showed better performance on the Tower of London task (p < .05). The INC group also rated themselves as significantly more impaired across domains of subjective cognition. Discussion: The differences observed in neuropsychological task performance are in line with the hypothesis that HA-related symptoms of OCD may be more closely related to generalized anxiety—with poorer performance observed on verbal memory—while INC-related symptoms appear to be associated with executive function and problem-solving deficits.