Gyula Demeter

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teljesítményt és a gátlási funkciók hatékonyságát elısegítı feladatoknak létjogosultsága van a betegek kognitív viselkedésterápiájában. ix
Introduction In our daily life we repeatedly face situations when we check the locks of the door, or if turned off the stove or think about an upcoming stressful event. The problem is when these obsessive thoughts or compulsive rituals occur so regularly and so intensely that it interferes with the normal functioning of the individual. From the perspective of a cognitive researcher there are a lot of open questions which need answers, just to mention a few: “What cognitive mechanism are involved in the persistence of obsessions and compulsions?”; “What executive functions are impaired in OCD and how do they relate to the main symptoms?”; “What is the role of inhibition in symptomathology?”; “Can different subgroups be described also by different neuropsychological patterns?”; “Is there a memory impairment in OCD?”; “What type of memory is impaired?”; “Is there a prospective memory impairment?”; “How can we interpret the memory impairment patterns?”; “Is there a retrieval induced forgetting effect and if not, why?”; “Which are the critical cortical structures and networks involved in OCD and how do they relate to the cognitive findings and symptoms?”; “What are the endophenotypic markers of OCD?”; “How can all these cognitive findings contribute to a better therapeutical outcome?”. The aim of this thesis is to give some insight to a few questions related to the cognitive function impairments in OCD. The structure of the thesis is the following: In Chapter 1 we present the main symptoms and clinical aspects of OCD. Chapter 2 begins with a short review of the executive function concept, theories, and its assessment methodology. This chapter ends with a detailed presentation of main findings in OCD executive function research which are presented under three main domains: updating/monitoring, shifting and inhibition. Chapter 3 is dedicated to the concept of prospective memory, presenting the main theories in the field and focusing on the main findings in OCD. This chapter ends with a short outline of our theoretical point of view about the possible involvement of PM functions in OCD symptomathology and we summarize the role of inhibition in memory retrieval presenting the relevant connections with OCD. In Chapter 4 we present three relevant neuropsychological models of the disorder and in Chapter 5 we outline the most important questions and hypothesis of our research studies presenting the main goals and thesis points. Two published research articles, one accepted manuscript and two unpublished studies are included under the Chapter 6. Following the Studies is the Discussion and Conclusion Chapter where we try to integrate our findings with 1
Page 1 and 2: Budapest University of Technology a
Page 3 and 4: 6.3. Study 3: Over-monitoring secon
Page 5 and 6: Glossary of abbreviations ACC Anter
Page 7 and 8: WCST-LS Wisconsin Card Sorting Task
Page 9: Kivonat Az obszesszív-kompulzív z
Page 13 and 14: Chapter 1. Overview of Obsessive co
Page 15 and 16: ilaterally at the ventromedial pref
Page 17 and 18: Chapter 2. The study of executive f
Page 19 and 20: 2.2. Theories and measurement of ex
Page 21 and 22: outcomes etc.) which in many labora
Page 23 and 24: As far as we know no executive task
Page 25 and 26: The tasks that are most commonly us
Page 27 and 28: 2002) and on the Intra-Dimensional/
Page 29 and 30: Inhibition In the Miyake et al. (20
Page 31 and 32: Table 1. Summary of OCD patients re
Page 33 and 34: Authors Samples Medication Performa
Page 35 and 36: Chapter 3. The study of memory func
Page 37 and 38: 3.2. Prospective memory Prospective
Page 39 and 40: 3.2.1. Theories of prospective memo
Page 41 and 42: According to Guynn (2008) retrieval
Page 43 and 44: intention or the initiation and exe
Page 45 and 46: 3.2.3. Studying PM in OCD While at
Page 47 and 48: 3.2.4. A possible PM model of OCD O
Page 49 and 50: 3.3. The role of inhibition in sele
Page 51 and 52: Further two recent results will be
Page 53 and 54: it, (3) the neuropsychological impa
Page 55 and 56: 4.3. Current neurobiological model
Page 57 and 58: The role of amygdale in the express
Page 59 and 60: 5.1. Main goals 1. To assess the le
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Chapter 6. Studies 6.1. Study 1: Im
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impairment in this task 15 and othe
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Procedure All OCD patients received
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series of equal length, and we cons
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called error inhibition index (SEII
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Reaction Time Colour Naming Conditi
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which might be impaired in OCD. 9 I
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REFERENCES 1. American Psychiatric
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20. van der Wee NJ., Ramsey NF, Jan
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39. Goodman WK, Price LH, Rasmussen
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6.2. Study 2: Impaired prospective
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Table 1 Sample demographics and bas
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Written instructions were read to t
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Table 2 Hit rate in the two experim
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Comparison of patient and healthy a
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can be concluded that OCD patients
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6.5. Study 5: No retrieval induced
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Experimental design and materials T
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Procedure “In the study phase, pa
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RIF effect in the control group, t(
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Chapter 7. Discussion, conclusions
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and retrospective memory processes
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Bjork, & Bjork, 1994), which was of
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of the dACC contributes to the pers
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of patients’ cognitive abilities
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Anderson, M. C., & Spellman, B. A.
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Bajo, M. T., Gómez-Ariza, C. J., F
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Burgess, P. W. (1997). Theory and m
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Cambridge Cognition Limited (2006).
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Cuttler, C., & Graf, P. (2007). Sub
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Duncan, J. (1986). Disorganziation
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Gilbert, S.J. & Shallice, T. (2002)
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Harsányi, A., Csigó, K., Demeter,
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Kearns, N. P., Cruickshank, C. A.,
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Levy, B. J., & Anderson, M. C. (200
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McDaniel, M. A., Guynn, M. J., Eins
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neuropsychological and psychoanalyt
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(Eds.), Prospective memory: Cogniti
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Rogers, R. D., & Monsell, S. (1995)
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Smith, G. V., Della Salla, S., Logi
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Thordarson, D. S., Radomsky, A. S.,
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Wincze, J. (2001). The role of unde
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Gyula Demeter

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