Cognitive Load and Attentional Control in Puerto Ricans with Obsessive-Compulsive Disorder

Carga cognitiva y control atencional en puertorriqueños con trastorno obsesivocompulsivo

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Stephanie Santiago-Mejias
Karen G. Martinez
Frances Centeno
Carlos Sellas
Resumen

Background: The executive control of attention involves problem solving and voluntary action and has been implicated in emotion regulation. Some researchers have reported that attentional control is impaired in individuals with obsessive-compulsive disorder (OCD). However, influence of cognitive load and distraction on task performance has not been considered, which may have an impact on the control of attention. In this study, we evaluated if low and high cognitive load influences attentional control in individuals with OCD, compared to healthy controls.Methods: A total of 41 Puerto Rican adults participated in the study, 15 with OCD (M=31.60, SD=10.70) and 26 healthy controls (M=28.42, SD=10.73). A psychological evaluation was completed using structured interviews and self-reports. The Attention Network Test and a cognitive load task were performed to assess attentional control. Results: No significant differences in alerting, orienting, and attentional control scores were observed between groups on both cognitive load conditions (p>0.05). A significant difference was only observed in the attentional control of OCD (z= -1.99, p=0.047) and healthy participants (z= -2.83, p=0.005) between low and high cognitive load. Conclusions: OCD and healthy participants experienced decreased interference from distractors under high cognitive load, suggesting increased attentional control during this condition. It is possible that increasing cognitive load can reduce distraction in OCD and healthy Puerto Ricans. Considering load may facilitate cognitive training for the control of attention and increase cognitive flexibility, enhancing treatment response.

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Abe, Y., Sakai, Y., Nishida, S., Nakamae, T., Yamada, K., Fukui, K., & Narumoto, J. (2015).

Hyper-influence of the orbitofrontal cortex over the ventral striatum in obsessive compulsive disorder. European Neuropsychopharmacology, 25(11), 1898-1905. https://doi.org/10.1016/j.euroneuro.2015.08.017 DOI: https://doi.org/10.1016/j.euroneuro.2015.08.017

Abramovitch, A., & Cooperman, A. (2015). The cognitive neuropsychology of obsessive-compulsive disorder: A critical review. Journal of Obsessive-Compulsive and Related Disorders, 5, 24-36. http://doi.org/10.1016/j.jocrd.2015.01.002 DOI: https://doi.org/10.1016/j.jocrd.2015.01.002

Abramovitch, A., Mittelman, A., Tankersley, A. P., Abramowitz, J. S., & Schweiger, A. (2015). Neuropsychological investigations in obsessive–compulsive disorder: A systematic review of methodological challenges. Psychiatry Research, 228(1), 112-120. http://doi.org/10.1016/j.psychres.2015.04.025 DOI: https://doi.org/10.1016/j.psychres.2015.04.025

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. DOI: https://doi.org/10.1176/appi.books.9780890425596

Amir, N., Najmi, S., & Morrison, A. S. (2009). Attenuation of attention bias in obsessive–compulsive disorder. Behaviour Research and Therapy, 47(2), 153-157. http://doi.org/10.1016/j.brat.2008.10.020 DOI: https://doi.org/10.1016/j.brat.2008.10.020

Andrés-Perpiñá, S., Lázaro-García, L., Canalda-Salhi, G., & Boget-Llucia, T. (2002). Aspectos neuropsicológicos del trastorno obsesivo compulsivo. Revista de Neurología, 35(10), 959-963. https://doi.org/10.33588/rn.3510.2002117 DOI: https://doi.org/10.33588/rn.3510.2002117

Armstrong, T., Zald, D. H., & Olatunji, B. O. (2011). Attentional control in OCD and GAD: Specificity and associations with core cognitive symptoms. Behaviour Research and Therapy, 49(11), 756-762. http://doi.org/10/1016/j.brat.2011.08.003 DOI: https://doi.org/10.1016/j.brat.2011.08.003

Aydin, P. C., Koybasi, G. P., Sert, E., Mete, L., & Oyekcin, D. G. (2014). Executive functions and memory in autogenous and reactive subtype of obsessive-compulsive disorder patients. Comprehensive Psychiatry, 55(4), 904-911. http://doi.org/10.1016/j.compsych.2014.01.005 DOI: https://doi.org/10.1016/j.comppsych.2014.01.005

Bechara, A. (2000). Emotion, Decision Making and the Orbitofrontal Cortex. Cerebral Cortex, 10(3), 295-307. http://doi.org/10.1093/cercor/10.3.295 DOI: https://doi.org/10.1093/cercor/10.3.295

Beck, A. T., Epstein, N., Brown, G., & Steer, R. (1988). Beck Anxiety Inventory. PsycTESTS Dataset. http://doi.org/10.1037/t02025-000 DOI: https://doi.org/10.1037/t02025-000

Behzadpoor, S., Sohrabi, F., & Borjali, A. (2016). The role of attentional control and resilience in predicting the rumination in patients with obsessive-compulsive disorder. Zahedan Journal of Research in Medical Sciences, 18(3). http://doi.org/10.17795/zjrms-6249 DOI: https://doi.org/10.17795/zjrms-6249

Berggren, N., & Derakshan, N. (2013). Attentional control deficits in trait anxiety: Why you see them and why you don’t. Biological Psychology, 92, 440-446. http://doi.org/10.1016/j.biopsycho.2012.03.007 DOI: https://doi.org/10.1016/j.biopsycho.2012.03.007

Berggren, N., Richards, A., Taylor, J., & Derakshan, N. (2013). Affective attention under cognitive load: Reduced emotional biases but emergent anxiety-related costs to inhibitory control. Frontiers in Human Neuroscience,7. http://doi.org/10.3389/fnhum.2013.00188 DOI: https://doi.org/10.3389/fnhum.2013.00188

Beucke, J. C., Sepulcre, J., Talukdar, T., Linnman, C., Zschenderlein, K., Endrass, T., Kaufmann, C., Kathmann, N. (2013). Abnormally high degree connectivity of the orbitofrontal cortex in obsessive-compulsive disorder. JAMA Psychiatry, 70(6), 619. http://doi.org/10.1001/jamapsychiatry.2013.173 DOI: https://doi.org/10.1001/jamapsychiatry.2013.173

Bishop, S. J. (2008). Neural mechanisms underlying selective attention to threat. Annals of the New York Academy of Sciences, 1129(1), 141-152. http://doi.org/10.1196/annals.1417.016 DOI: https://doi.org/10.1196/annals.1417.016

Canino, G. J., Bird, H.R., Shrout, P.E., Rubio-Stipec, M., Bravo, M., Martinez, R., Sesman, M., & Guevara, L.M. (1987). The Prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry, 44(8), 727. http://doi.org/10.1001/archpsyc.1987.01800200053008 DOI: https://doi.org/10.1001/archpsyc.1987.01800200053008

Canino, G., Shrout, P.E., NeMoyer, A., Vila, D., Santiago, K.M., Garcia, P., Quiñones, A., Cruz, V., & Alegria, M. (2019). A comparison of the prevalence of psychiatric disorders in Puerto Rico with the United States and the Puerto Rican population of the United States. Social Psychiatry and Psychiatric Epidemiology, 54(3):369-378. http://doi.org/10.1007/s00127-019-01653-6 DOI: https://doi.org/10.1007/s00127-019-01653-6

Cintron, J., Carter, M., & Sbrocco, T. (2006). Ataques de nervios in relation to anxiety sensitivity among island Puerto Ricans. Culture Medicine and Psychiatry, 29(4): 415-31. http://doi.org/10.1007/s11013-006-9001-7 DOI: https://doi.org/10.1007/s11013-006-9001-7

D’Alcante, C.C., Diniz, J.B., Fossaluza, V., Batistuzzo, M.C., Lopes, A.C., Shavitt, R.G., Deckersbach, T., Malloy-Diniz, L., Miguel, E.C., & Hoexter, M.Q. (2012). Neuropsychological predictors of response to randomized treatment in obsessive-compulsive disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 39(2): 310-317. https://doi.org/10.1016/j.pnpbp.2012.07.002 DOI: https://doi.org/10.1016/j.pnpbp.2012.07.002

Derryberry, D., & Reed, M. A. (2002). Anxiety-related attentional biases and their regulation by attentional control. Journal of Abnormal Psychology,111(2), 225-236. http://doi.org/10.1037//0021-843x.111.2.225 DOI: https://doi.org/10.1037/0021-843X.111.2.225

Dittrich, W. H., & Johansen, T. (2013). Cognitive deficits of executive functions and decision-making in obsessive-compulsive disorder. Scandinavian Journal of Psychology, 54(5), 393-400. http://doi.org/10.1111/sjop.12066 DOI: https://doi.org/10.1111/sjop.12066

Eisen, J. L., Mancebo, M. A., Pinto, A., Coles, M. E., Pagano, M. E., Stout, R., & Rasmussen, S. A. (2006). Impact of obsessive-compulsive disorder on quality of life. Comprehensive Psychiatry, 47(4), 270-275. http://doi.org/10.1016/j.comppsych.2005.11.006 DOI: https://doi.org/10.1016/j.comppsych.2005.11.006

Engstrom, J., Markkula, G., Victor, T., & Merat, N. (2017). Effects of cognitive load on driving performance: The cognitive control hypothesis. Human Factors, 59(5), 734-764. http://doi.org/10.1177/0018720817690639 DOI: https://doi.org/10.1177/0018720817690639

Eysenck, M. W., & Calvo, M. G. (1992). Anxiety and Performance: The Processing Efficiency Theory. Cognition & Emotion, 6(6), 409-434. http://doi.org/10.1080/02699939208409696 DOI: https://doi.org/10.1080/02699939208409696

Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7(2), 336-353. http://doi.org/10.1037/1528-3542.7.2.336 DOI: https://doi.org/10.1037/1528-3542.7.2.336

Fan, J., McCandliss, B. D., Sommer, T., Raz, A., & Posner, M. I. (2002). Testing the efficiency and independence of attentional networks. Journal of Cognitive Neuroscience, 14(3), 340-347. http://doi.org/10.1162/089892902317361886 DOI: https://doi.org/10.1162/089892902317361886

Fan, J., Gu, X., Guise, K. G., Liu, X., Fossella, J., Wang, H., & Posner, M. I. (2009). Testing the behavioral interaction and integration of attentional networks. Brain and Cognition, 70(2): 209-220. https://doi.org/10.1016/j.bandc.2009.02.002 DOI: https://doi.org/10.1016/j.bandc.2009.02.002

Fenske, J.N., & Pettersen, K. (2015). Obsessive-Compulsive Disorder: Diagnosis and Management. American Family Physician, 92(10), 896-903. Retrieved from https://www.aafp.org/afp/2015/1115/afp20151115p896.pdf

First, MB., Spitzer, RL., Gibbon, M., & Williams, J. B.W.: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P) New York: Biometrics Research, New York State Psychiatric Institute, 2002.

Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The Obsessive-Complusive Inventory: Development and validation of a short version. Psychological Assessment,14(4), 485-495. http://doi.org/10.1037//1040-3590.14.4.485 DOI: https://doi.org/10.1037/1040-3590.14.4.485

Fox, E., Dutton, K., Yates, A., Georgiou, G. A., & Mouchlianitis, E. (2015). Attentional control and suppressing negative thought intrusions in pathological worry. Clinical Psychological Science: A Journal of the Association for Psychological Science, 3(4), 593–606. https://doi.org/10.1177/2167702615575878 DOI: https://doi.org/10.1177/2167702615575878

Friedlander, L., & Desrocher, M. (2006). Neuroimaging studies of obsessive–compulsive disorder in adults and children. Clinical Psychology Review,26(1), 32-49. http://doi.org/10.1016/j.cpr.2005.06.010 DOI: https://doi.org/10.1016/j.cpr.2005.06.010

Fungueirino, M.T., Fernandez-Prieto, M., Carvalho, S., Leite, J., Carracedo, A., & Goncalves, O.F. (2020). Executive impairments in obsessive-compulsive disorder: A systematic review with emotional and non-emotional paradigms. Psicothema, 32(1): 24-32. http://doi.org/10.7334/psicothema2019.187

Geller, D.A., McGuire, J.F., Orr, S.P., Small, B.J., Murphy, T.K., Trainor, K., Porth, R., Wilhelm, S., & Storch, E.A. (2019). Fear extinction learning as a predictor of response to cognitive behavioral therapy for pediatric obsessive compulsive disorder. Journal of Anxiety Disorders, 64: 1-8. https://doi.org/10.1016/j.janxdis.2019.02.005 DOI: https://doi.org/10.1016/j.janxdis.2019.02.005

Goncalves, O.F., Carvalho, S., Leite, J., Fernandes-Goncalves, A., Carracedo, A., Sampaio, A. (2016). Cognitive and emotional impairments in obsessive-compulsive disorder. Evidence from functional brain alterations. Porto Biomedical Journal, 1(3): 92-105. https://doi.org/10.1016/j.pbj.2016.07.005 DOI: https://doi.org/10.1016/j.pbj.2016.07.005

Goodman, W. K. (1989). The Yale-Brown Obsessive Compulsive Scale. Archives of General Psychiatry, 46(11), 1006. http://doi.org/10.1001/archpsyc.1989.01810110048007 DOI: https://doi.org/10.1001/archpsyc.1989.01810110048007

Grassi, G., Pallanti, S., Righi, L., Figee, M., Mantione, M., Denys, D., Piccagliani, D., Rossi, A., & Stratta, P. (2015). Think twice: Impulsivity and decision making in obsessive–compulsive disorder. Journal of Behavioral Addictions, 4(4), 263-272. http://doi.org/10.1556/2006.4.2015.039 DOI: https://doi.org/10.1556/2006.4.2015.039

Greisberg, S., & Mckay, D. (2003). Neuropsychology of obsessive-compulsive disorder: A review and treatment implications. Clinical Psychology Review,23(1), 95-117. http://doi.org/10.1016/s0272-7358(02)00232-5 DOI: https://doi.org/10.1016/S0272-7358(02)00232-5

Gruner, P., & Pittenger, C. (2017). Cognitive inflexibility in obsessive-compulsive disorder. Neuroscience, 345, 243–255. Retrieved from https://doi.org/10.1016/j.neuroscience.2016.07.030 DOI: https://doi.org/10.1016/j.neuroscience.2016.07.030

Guzick, A.G., Cooke, D., Gage, N., & McNamara, J. (2018). CBT-Plus: A meta-analysis of cognitive behavioral therapy augmentation strategies for obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 19: 6-14. http://doi.org/10.1016/j.jocrd.2018.07.001 DOI: https://doi.org/10.1016/j.jocrd.2018.07.001

Haber, S. N., & Heilbronner, S. R. (2013). Translational Research in OCD: Circuitry and Mechanisms. Neuropsychopharmacology, 38(1), 252-253. http://doi.org/10.1038/npp.2012.182 DOI: https://doi.org/10.1038/npp.2012.182

Hernández-Sampieri, Fernández-Collado, & Baptista-Lucio. (2010). Metodología de la investigación. (Ed. 5). México, DF: McGraw Hill.

Hinton, D., Chong, R., Pollack, M., David, B., & McNally, R. (2008). Ataque de nervios:

Relationship to anxiety sensitivity and dissociation predisposition. Depression and Anxiety,

(6): 489-495. http://doi.org/10.1002/da.20309 DOI: https://doi.org/10.1002/da.20309

Hybel, K.A., Mortensen, E.L., Lambek, R., Hojgaard, D.R.M.A., Thomsen, P.H. (2017). Executive

function predicts cognitive-behavioral therapy response in childhood obsessive-compulsive

disorder. Behaviour Research and Therapy, 99:11-18. http://doi.org/10.1016/j.brat.2017.08.009 DOI: https://doi.org/10.1016/j.brat.2017.08.009

International OCD Foundation. (2018). What is OCD? Retrieved from https://iocdf.org/about-ocd/

Jonnal, A. H., Gardner, C. O., Prescott, C. A., & Kendler, K. S. (2000). Obsessive and compulsive symptoms in a general population sample of female twins. American Journal of Medical Genetics, 96(6), 791-796. http://doi.org/10.1002/1096-8628(20001204)96:63.0.co;2-c DOI: https://doi.org/10.1002/1096-8628(20001204)96:6<791::AID-AJMG19>3.0.CO;2-C

Judah, M. R., Grant, D. M., Lechner, W. V., & Mills, A. C. (2013). Working memory load moderates late attentional bias in social anxiety. Cognition & Emotion, 27(3), 502-511. http://doi.org/10.1080/02699931.2012.719490 DOI: https://doi.org/10.1080/02699931.2012.719490

Kashyap, H., Reddy, P., Mandadi, S., & Narayanaswamy, J. (2019). Cognitive training for neurocognitive and functional impairments in obsessive-compulsive disorder: A case report.

http://doi.org/10.1016/j.jocrd.2019.100480 DOI: https://doi.org/10.1016/j.jocrd.2019.100480

Lavie, N., & Dalton, P. (2014). Load theory of attention and cognitive control. In A. C. Nobre & S. Kastner (Eds.), Oxford library of psychology. The Oxford handbook of attention (p. 56–75). Oxford University Press. DOI: https://doi.org/10.1093/oxfordhb/9780199675111.013.003

Lavie, N., Hirst, A., Fockert, J. W., & Viding, E. (2004). Load theory of selective attention and cognitive control. Journal of Experimental Psychology: General, 133(3), 339-354. http://doi.org/10.1037/0096-3445.133.3.339 DOI: https://doi.org/10.1037/0096-3445.133.3.339

Luo, X., Zhang, L., & Wang, J. (2017). The benefits of working memory capacity on attentional control under pressure. Frontiers in Psychology, 8: 1-15. https://doi.org/10.3389/fpsyg.2017.01105 DOI: https://doi.org/10.3389/fpsyg.2017.01105

MacNamara, A., & Proudfit, G. H. (2014). Cognitive load and emotional processing in generalized anxiety disorder: Electrocortical evidence for increased distractibility. Journal of Abnormal Psychology, 123(3), 557-565. http://doi.org/10.1037/a0036997 DOI: https://doi.org/10.1037/a0036997

Manjula, M., & Sudhir, P.M. (2019). New-wave behavioral therapies in obsessive-compulsive disorder: Moving toward integrated behavioral therapies. Indian Journal of Psychiatry, 61(1):S104-S113. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_531_18 DOI: https://doi.org/10.4103/psychiatry.IndianJPsychiatry_531_18

Menzies, L., Chamberlain, S. R., Laird, A. R., Thelen, S. M., Sahakian, B. J., & Bullmore, E. T. (2008). Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: The orbitofronto-striatal model revisited. Neuroscience & Biobehavioral Reviews,32(3), 525-549. http://doi.org/10.1016/j.neubiorev.2007.09.005 DOI: https://doi.org/10.1016/j.neubiorev.2007.09.005

Millet, B., Dondaine, T., Reymann, J., Bourguignon, A., Naudet, F., Jaafari, N., . . . Jeune, F. L. (2013). Obsessive compulsive disorder networks: Positron Emission Tomography and neuropsychology provide new insights. PLoS ONE, 8(1). http://doi.org/10.1371/journal.pone.0053241 DOI: https://doi.org/10.1371/journal.pone.0053241

Milliery, M., Bouvard, M., & Cottraux, J. (2000). Sustained attention in patients with obsessive-compulsive disorder: A controlled study. Psychiatry Research, 96(3): 199-209. http://doi.org/10.1016/s0165-1781(00)00210-9 DOI: https://doi.org/10.1016/S0165-1781(00)00210-9

Moradi, M., Fata, L., Abhari, AA., & Abbasi, I. (2014). Comparing attentional control and intrusive thoughts in obsessive-compulsive disorder, generalized anxiety disorder and non clinical population. Iranian Journal of Psychiatry, 9(2), 69-75. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300468/

Murphy, G., Groeger, J. A., & Greene, C. M. (2016). Twenty years of load theory—Where are we now, and where should we go next? Psychonomic Bulletin & Review, 23(5), 1316-1340. http://doi.org/10.3758/s13423-015-0982-5 DOI: https://doi.org/10.3758/s13423-015-0982-5

Najmi, S., Amir, N., Frosio, K. E., & Ayers, C. (2015). The effects of cognitive load on attention control in subclinical anxiety and generalised anxiety disorder. Cognition and Emotion, 29(7), 1210-1223. http://doi.org/10.1080/02699931.2014.975188 DOI: https://doi.org/10.1080/02699931.2014.975188

Nakao, T., Okada, K., & Kanba, S. (2014). Neurobiological model of obsessive-compulsive disorder: Evidence from recent neuropsychological and neuroimaging findings. Psychiatry and Clinical Neurosciences, 68(8). http://doi.org/10.1111/pcn.12195 DOI: https://doi.org/10.1111/pcn.12195

National Institute of Mental Health. (2019, October). Obsessive-Compulsive Disorder. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/

Nestadt, G., Grados, M., & Samuels, J. F. (2010). Genetics of Obsessive-Compulsive Disorder. Psychiatric Clinics of North America, 33(1), 141-158. http://doi.org/10.1016/j.psc.2009.11.001 DOI: https://doi.org/10.1016/j.psc.2009.11.001

Nicolini, H., Salin-Pascual, R., Cabrera, B., & Lanzagorta, N. (2017). Influence of culture in obsessive-compulsive disorder and its treatment. Current Psychiatry Reviews, 13, 285-292. http://doi.org/10.2174/2211556007666180115105935 DOI: https://doi.org/10.2174/2211556007666180115105935

Nogueira, B.L., de Jesus-Mari, J., & Razzouk, D. (2015). Culture-bound syndromes in Spanish speaking Latin America: The case of nervios, susto, and ataques de nervios. Archives of Clinical Psychiatry, 42(6): 171-8. https://doi.org/10.1590/0101-60830000000070 DOI: https://doi.org/10.1590/0101-60830000000070

Novy, D. M., Stanley, M. A., Averill, P., & Daza, P. (2001). Psychometric comparability of English- and Spanish-language measures of anxiety and related affective symptoms. Psychological Assessment, 13(3), 347-355. http://doi.org/10.1037//1040-3590.13.3.347 DOI: https://doi.org/10.1037/1040-3590.13.3.347

Ociskova, M., Prasko, J., Cerna, M., Jelenova, D., Kamaradova, D., Latalova, K., & Sedlackova, Z. (2013). Obsessive compulsive disorder and stigmatization. Activitas Nervosa Superior Rediviva, 55(1-2), 19-26. Retrieved from http://www.rediviva.sav.sk/55i1/19.pdf

Paas, F. G., Merriënboer, J. J., & Adam, J. J. (1994). Measurement of cognitive load in instructional research. Perceptual and Motor Skills, 79(1), 419-430. http://doi.org/10.2466/pms.1994.79.1.419 DOI: https://doi.org/10.2466/pms.1994.79.1.419

Paas, F., Tuovinen, J. E., Tabbers, H., & Gerven, P. W. (2003). Cognitive load measurement as a means to advance cognitive load theory. Educational Psychologist, 38(1), 63-71. http://doi.org/10.1207/s15326985ep3801_8 DOI: https://doi.org/10.1207/S15326985EP3801_8

Pacheco-Unguetti, A., Acosta, A., Lupiáñez, J., Román, N., & Derakshan, N. (2012). Response inhibition and attentional control in anxiety. Quarterly Journal of Experimental Psychology, 65(4), 646-660. http://doi.org/10.1080/17470218.2011.637114 DOI: https://doi.org/10.1080/17470218.2011.637114

Pallanti, S., Grassi, G., Sarrecchia, E. D., Cantisani, A., & Pellegrini, M. (2011). Obsessive–compulsive disorder comorbidity: Clinical assessment and therapeutic implications. Frontiers in Psychiatry, 2. http://doi.org/10.3389/fpsyt.2011.00070 DOI: https://doi.org/10.3389/fpsyt.2011.00070

Park, H., Choe, Y., Na, Y., Nam, K. (2011). The changes in performance during cognitive load inducing tasks. In: Park, J.J., Yang, L.T., Lee, C. (Eds). Communications in Computer and Information Science, 185, 348-351. https://doi.org/10.1007/978-3-642-22309-9_45 DOI: https://doi.org/10.1007/978-3-642-22309-9_45

Pauls, D. L., Abramovitch, A., Rauch, S. L., & Geller, D. A. (2014). Obsessive–compulsive disorder: An integrative genetic and neurobiological perspective. Nature Reviews Neuroscience, 15(6), 410-424. http://doi.org/10.1038/nrn3746 DOI: https://doi.org/10.1038/nrn3746

Redick, T.S., & Engle, R.W. (2006). Working memory capacity and attention network test performance. Applied Cognitive Psychology, 20(5): 713-721. https://doi.org/10.1002/acp.1224 DOI: https://doi.org/10.1002/acp.1224

Rossouw, P. (2012). The neurobiological roots of obsessive-compulsive disorder – Implications for treatment. Neuropsychotherapy, 2-6. Retrieved from https://www.researchgate.net/publication/257815843_The_Neurobiological_Roots_of_Obsessive-Compulsive_Disorder_-_Implications_for_Treatment

Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53-63. http://doi.org/10.1038/mp.2008.94 DOI: https://doi.org/10.1038/mp.2008.94

SanMiguel, I., Corral, M.J., & Escera, C. (2008). When loading working memory reduces distraction: Behavioral and electrophysiological evidence from an auditory-visual distraction paradigm. Journal of Cognitive Neurosciences, 20(7): 1131-1145. http://doi.org/10.1162/jocn.2008.20078 DOI: https://doi.org/10.1162/jocn.2008.20078

Santiago-Mejias, S., Lopez-Valentin, C.M., Gonzalez-Barrios, P., & Martinez, K. (2019). Evaluating the impact of ataques de nervios on cognitive functioning in Puerto Ricans with anxiety disorders: A pilot study. Puerto Rican Journal of Psychology, 30(2): 210-221. Retrieved from http://www.ojs.repsasppr.net/index.php/reps/article/view/542

Stefanopoulou, E., Hirsch, C.R., Hayes, S., Adlam, A., & Coker, S. (2014). Are attentional control resources reduced by worry in generalized anxiety disorder? Journal of Abnormal Psychology, 123(2), 330-335. http://dx.doi.org/10.1037/a0036343 DOI: https://doi.org/10.1037/a0036343

vanDillen, L.F., Heslenfeld, D.J., & Koole, S.L. (2009). Tuning down the emotional brain: An fMRI study of the effects of cognitive load on the processing of affective images. NeuroImage. 45(4). 1212-9. http://doi.org/10.1016/j.neuroimage.2009.01.016 DOI: https://doi.org/10.1016/j.neuroimage.2009.01.016

Vega-Dienstmaier, JM., Sal Y Rosas, HJ., Mazzotti Suárez, G., Vidal, H., Guimas, B., Adrianzén, C., & Vivar, R. (2002). [Validation of a version in Spanish of the Yale-Brown Obsessive-Compulsive Scale]. Actas Españolas de Psiquiatría, 30(1), 30-35.

Vytal, K. E., Cornwell, B. R., Letkiewicz, A. M., Arkin, N. E., & Grillon, C. (2013). The complex interaction between anxiety and cognition: Insight from spatial and verbal working memory. Frontiers in Human Neuroscience, 7. http://doi.org/10.3389/fnhum.2013.00093 DOI: https://doi.org/10.3389/fnhum.2013.00093

Weissman, M. M. (1998). Cross-National Epidemiology of Obsessive-Compulsive Disorder. CNS Spectrums, 3(S1), 6-9. http://doi.org/10.1017/s1092852900007136 DOI: https://doi.org/10.1017/S1092852900007136

Wetterneck, C. T., Little, T. E., Rinehart, K. L., Cervantes, M. E., Hyde, E., & Williams, M. (2012). Latinos with obsessive-compulsive disorder: Mental healthcare utilization and inclusion in clinical trials. Journal of Obsessive-Compulsive and Related Disorders, 1(2), 85-97. http://doi.org/10.1016/j.jocrd.2011.12.001 DOI: https://doi.org/10.1016/j.jocrd.2011.12.001

Williams, M. & Steever, A. (2015). Cultural manifestations of obsessive-compulsive disorder. In Lack, C.W. (Ed.), Obsessive-Compulsive Disorder: Etiology, Phenomenology, and Treatment. (pp. 63-84). Onus Books.

Williams, M., Powers, M., Yun, Y., & Foa, E. (2010). Minority participation in randomized controlled trials for obsessive–compulsive disorder. Journal of Anxiety Disorders, 24(2), 171-177. http://doi.org/10.1016/j.janxdis.2009.11.004 DOI: https://doi.org/10.1016/j.janxdis.2009.11.004

Wilson, R. (2016). Stopping the noise in your head: The new way to overcome anxiety and worry. Healthy Communications Inc.

Wood, J., & Ahmari, S. E. (2015). A framework for understanding the emerging role of corticolimbic-ventral striatal networks in OCD-associated repetitive behaviors. Frontiers in Systems Neuroscience, 9. http://doi.org/10.3389/fnsys.2015.00171 DOI: https://doi.org/10.3389/fnsys.2015.00171

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