An Intervention Study On Cognitive Flexibility Of College Students With High Obsessive-compulsive Symptoms By Cognitive Behavioral Group Counseling

Objective: In recent years,obsessive-compulsive symptoms have been more serious than other psychological problems among Chinese college students.Cognitive flexibility impairment is one of the most serious cognitive impairments in obsessive-compulsive disorder(OCD).Cognitive flexibility plays an important role in individual development and adaptation to the environment.It is a question worth exploring whether college students with compulsive problems have cognitive flexibility impairments and whether they can improve their compulsive problems by improving their cognitive flexibility.Firstly,this study took college students as the research objects,and explored the relationship between obsessive-compulsive symptoms and cognitive flexibility of them by means of distribution of scales.Secondly,the cognitive behavioral group counseling technique was used to intervene the cognitive flexibility of college students with high obsessive-compulsive symptoms,and the effect of this method on the improvement of college students' obsessive-compulsive symptoms was explored.Methods:Study 1:687 college students were surveyed by using the Obsessive-Compulsive Inventory-Revised(OCI-R)and Cognitive Flexibility Inventory(CFI).We analyzed the correlation between obsessive-compulsive symptoms and cognitive flexibility based on the results.Study 2:58 college students with high Obsessive-compulsive symptoms were randomly allocated to the experimental group(29cases)and the control group(29 cases).The experimental group received 8 consecutive cognitive behavioral group counseling intervention,while the control group did not.Before and after the experiment,all the subjects were measured from scale,behavior paradigm and event related potentials(ERPs).OCI-R was used to measure obsessive-compulsive symptoms.The changes in cognitive flexibility were measured by using the CFI,stroop color word test,trail making test(TMT),and the task switching paradigm(in combination with ERPs).Changes in emotions were measured by the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Results:Study 1: Compared with the students with low obsessive-compulsive symptoms,the scores of cognitive flexibility of the students with high obsessive-compulsive symptoms were relatively low.There was a negative correlation between the total score of CFI and two dimensions(alternatives subscale and control subscale)and the total score of OCI-R(all P<0.05).Study 2:(1)In OCI-R,the total score of the experimental group after intervention were significantly lower than those before the intervention[(37.24 ± 6.33)vs(25.69 ± 7.97)](P<0.05),while there was no significant change in the control group before and after intervention[(34.00±6.60)vs(31.83±7.11)](P=0.155);(2)In CFI,the total scores[(65.97 ± 5.99)vs(69.00 ± 6.54)]and control subscale scores[(22.34 ± 2.93)vs(25.41 ± 2.95)]of the experimental group after intervention were significantly higher than those before the intervention(all P<0.05),and there was no significant change in the alternatives subscale before and after intervention[(42.72±4.73)vs(43.59±4.80)](P=0.366).There was no significant change in the control group before and after intervention[(66.52±9.67)vs(66.48±9.38)][(43.38±6.75)vs(43.28±6.55)][(23.14±3.73)vs(23.21±3.69)](all P >0.05);(3)In the stroop color word test,the reaction time of the experimental group after intervention was significantly lower than those before the intervention[(8.36 ± 3.87)vs(4.82 ± 1.86)](P<0.01),while there was no significant change in the control group before and after intervention[(8.61 ± 4.43)vs(8.04 ± 4.84)](P=0.39);In TMT,the reaction time of the experimental group after intervention was significantly lower than those before the intervention[(34.21 ± 16.9)vs(25.31 ± 11.55)](P<0.01),while there was no significant change in the control group before and after intervention[(35.04 ± 10.95)vs(31.41 ±12.53)](P=0.167);(4)In SAS,the scores of both the experimental group[(44.45 ±7.67)vs(38.41 ± 7.35)](P<0.01)and the control group[(43.83 ± 9.04)vs(39.10 ±7.63)](P<0.05)after intervention were significantly lower than those before the intervention;In SDS,the scores of both the experimental group [(50.90±8.35)vs(43.45±8.81)](P<0.01)and the control group [(46.79±20.34)vs(43.34±9.05)](P<0.05)after intervention were significantly lower than those before the intervention;(5)In the task switching paradigm,in the repetitive sequence,the response time of both the experimental group[(717.16 ± 215.10)vs(596.31 ± 162.93)](P<0.05)and the control group[(739.2 ± 171.08)vs(633.48 ± 146.54)](P<0.01)after intervention significantly lower than those before the intervention;in the switch sequence,the response time of the experimental group after intervention was significantly lower than those before the intervention[(781.69 ± 227.10)vs(633.34 ± 162.93)](P<0.01),while there was no significant change in the control group[(859.61 ± 247.44)vs(788.88 ± 206.85)](P=0.132);(6)In ERPs,the mean amplitudes of electrode CZ,FCZ and FZ in N2(all P<0.01)and P3(all P<0.05)in the experimental group after intervention were significantly lower than those before the intervention.The mean amplitudes of N2(electrodes CZ,FCZ and FZ)in the control group after intervention were significantly lower than those before intervention(all P<0.01)and there was no significant change in the mean amplitude of P3(all P>0.05).Conclusion:Compared with the students with less obsessive-compulsive symptoms,the cognitive flexibility of the students with more obsessive-compulsive symptoms is relatively low.There is a negative correlation between cognitive flexibility and Obsessive-compulsive symptoms.Aimed at improving cognitive flexibility,cognitive behavioral group counseling for college students with high obsessive-compulsive symptoms,can improve their obsessive-compulsive symptoms.