Efficacy of an Integrated Cognitive Control Training Program (ICCT) in Patients with Obsessive Compulsive Disorder: An Open-Label Trial

BackgroundNeuropsychological deficits are common in obsessive-compulsive disorder (OCD) and may influence functional and treatment outcomes. Only a few studies have effectively targeted these deficits, with most failing to show broad transfer of training. This study aimed to evaluate the efficacy of an integrated cognitive control training (ICCT) program on neuropsychological functioning in OCD patients and assess related changes in clinical and socio-occupational functions. MethodA single-group open-label design with pre-, mid-, post-treatment, and follow-up assessments was employed with 38 participants diagnosed with OCD, who were on stable doses of serotonin reuptake inhibitors (SRIs). The ICCT program, integrating task- and game-based cognitive stimulation with metacognitive strategy training and generalization exercises, included 24 hours of training over eight weeks across therapist-guided and homework sessions. The intervention was systematically adapted and validated, and its efficacy was examined across neuropsychological, clinical, and socio-occupational domains. ResultsThe intervention demonstrated moderate to large improvements in neuropsychological functioning (R{superscript 2}M range = .15 to .27) and self-reported cognitive difficulties (R{superscript 2}M = .58) and further demonstrated transfer to untrained domains such as OCD symptom reduction (R{superscript 2}M = .54), anxiety (R{superscript 2}M = .61), depression (R{superscript 2}M = .60), metacognitive regulation (R{superscript 2}M = .30), and socio-occupational functioning (R{superscript 2}M = .26). However, response inhibition saw only small improvements (R{superscript 2}M = .11). ConclusionThe ICCT program achieved both near and far transfer of cognitive training, improving neuropsychological, clinical, and socio-occupational outcomes. This contrasts with prior interventions with limited transfer of training. The small effect on response inhibition may reflect the trait nature of the deficit, assessment limitations, or gaps in the intervention. Future studies should use randomized control designs to validate and compare ICCT with other interventions.