What should i (not) do? Control over irrelevant tasks in obsessive-compulsive disorder patients

Obsessive compulsive disorder (OCD) is characterized by intrusive and anxiety evoking thoughts followed by repetitive behaviors (compulsions). Accumulative evidence revealed neuropsychological deficits in executive functions, especially in inhibitory mechanisms, in OCD patients. The connection between inhibitory control and the onset and maintenance of OCD is yet unclear. Task control-a mechanism responsible for promoting and maintaining goal directed actions and suppressing irrelevant actions that stimuli associatively and automatically evoke-was found to be contingent upon inhibitory control. Specifically, task control was found to be inadequate in OCD patients. We propose here that deficient task control might function as a mediator between inhibitory control deficit and the development of OCD. The difficulty to inhibit irrelevant behaviors related to intrusive thoughts inflates the perceived importance of these thoughts, which eventually are interpreted as catastrophic and thus should be suppressed by committing compulsive behavior. Paradoxically, these repetitive behaviors increase the anxiety first aroused by the obsessions and a vicious circle is perpetuated.