Beschreibung:
<jats:sec><jats:title>Background</jats:title><jats:p>A major facet of obsessive–compulsive disorder (<jats:styled-content style="fixed-case">OCD</jats:styled-content>) is cognitive inflexibility. However, sometimes, cognitive flexibility can be needed to reuse recently abandoned mental sets. Therefore, cognitive flexibility can in certain cases be useful to reinstate some form of rigid, repetitive behavior characterizing <jats:styled-content style="fixed-case">OCD</jats:styled-content>. We test the counterintuitive hypothesis that under such circumstances, cognitive flexibility is better in <jats:styled-content style="fixed-case">OCD</jats:styled-content> patients than controls.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We examined <jats:italic>N</jats:italic> = 20 adolescent <jats:styled-content style="fixed-case">OCD</jats:styled-content> patients and <jats:italic>N</jats:italic> = 22 controls in a backward inhibition (<jats:styled-content style="fixed-case">BI</jats:styled-content>) paradigm. This was combined with event‐related potential (<jats:styled-content style="fixed-case">ERP</jats:styled-content>) recordings and source localization. The <jats:styled-content style="fixed-case">BI</jats:styled-content> effect describes the cost of overcoming the inhibition of a recently abandoned mental set that is relevant again. Therefore, a strong <jats:styled-content style="fixed-case">BI</jats:styled-content> effect is disadvantageous for cognitive flexibility.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Compared to controls, <jats:styled-content style="fixed-case">OCD</jats:styled-content> patients revealed a smaller backward inhibition effect. The <jats:styled-content style="fixed-case">EEG</jats:styled-content> data revealed larger P1 amplitudes in backward inhibition trials in the <jats:styled-content style="fixed-case">OCD</jats:styled-content> group, which was due to activation differences in the inferior frontal gyrus (<jats:styled-content style="fixed-case">BA</jats:styled-content>47). The severity of clinical symptoms predicted these neurophysiological modulations. The power of the observed effects was about 95%.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The study shows that cognitive flexibility can be better in <jats:styled-content style="fixed-case">OCD</jats:styled-content> than controls. This may be the case in situations where superior abilities in the reactivation of repeating mental sets and difficulties to process new ones coincide. This may be accomplished by intensified inhibitory control mechanisms. The results challenge the view on <jats:styled-content style="fixed-case">OCD</jats:styled-content>, since <jats:styled-content style="fixed-case">OCD</jats:styled-content> is not generally associated with cognitive inflexibility.</jats:p></jats:sec>