Sensory Processing and Performance-Based Executive Functioning in Adolescent Obsessive Compulsive Disorder: An Integrated Assessment.

Abstract

Prior research in pediatric OCD has addressed sensory processing characteristics and executive functions (EF), typically within separate lines of investigation. This study examined the interrelationships among OCD symptom severity, sensory processing characteristics, and performance-based EF in adolescents with OCD and assessed whether sensory processing and symptom severity are associated with executive outcomes. One hundred adolescents aged 12-18 years meeting DSM-5 criteria exclusively for OCD were assessed. Symptom severity was measured with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), sensory processing with the Adolescent/Adult Sensory Profile (AASP), and EF with the Wisconsin Card Sorting Test (WCST), Stroop Color-Word Test (SCWT), Children's Color Trails Test (CCTT), and Verbal Fluency Tests (VFT). Associations were examined using bivariate correlations and multivariate linear regression models. CY-BOCS Total scores were moderately correlated with AASP Sensory Sensitivity and Sensory Avoiding, and weakly with Low Registration. Greater OCD symptom severity was associated with poorer WCST performance and longer CCTT-2 completion time, whereas no significant associations emerged with Stroop completion times or VFTs. In regression models, higher CY-BOCS Total scores were independently associated with poorer WCST indices and longer CCTT-2 completion time, whereas AASP subscales were not independently associated with executive outcomes. These findings suggest that sensory processing characteristics are associated with OCD symptom severity and that OCD symptom severity is independently linked to cognitive flexibility-related EF performance in adolescents with OCD. Further longitudinal and case-control studies including healthy and clinical comparison groups are needed to determine the direction, specificity, and clinical significance of these associations.