Cognitive flexibility differentiates young adults exhibiting obsessive-compulsive behaviors from controls

• Young adults with OCBs exhibit significantly worse cognitive flexibility.
• Greater cognitive inflexibility does not predict worsened OCB severity.
• Cognitive flexibility may be one important factor for understanding OCB severity.

The National Institute of Mental Health has proposed a shift toward classifying clusters of disorders on the basis of underlying biomarkers and neurological correlates. The present study sought to determine whether cognitive flexibility represents one such construct underlying obsessive-compulsive behaviors (OCBs), a cluster of behaviors characteristic of OCD and other body-focused repetitive behaviors (BFRBs), including trichotillomania, pathological skin picking, nail biting, and tic disorders. One-hundred and twenty-four undergraduate students completed the Depression Anxiety and Stress Scales, Padua Inventory—Washington State University Revision, Massachusetts General Hospital—Hairpulling Scale, Skin Picking Scale, and an Intradimensional/Extradimensional Shift (IDED) Test. Analyses were performed using a subsample of participants who met criteria for inclusion in the OCB group and a control group (N=56). Results indicated that young adults in the OCB group demonstrated significantly poorer performance on the IDED compared to controls. However, hierarchical regression analyses revealed that increased deficits in cognitive flexibility failed to predict worsened OCB severity—as assessed via a composite score. These results suggest that while cognitive flexibility differentiates those exhibiting OCBs from controls, it does not appear to be related to OCB severity. Future research is needed to replicate these results in larger clinical samples.