The Characteristics Of Guilt And Its Influence On Cognitive Flexibility Of College Students With High Obsessive-compulsive Tendency

Objective:Obsessive-compulsive disorder（OCD）is a common clinical neuropsychiatric disease.Patients often repeatedly fall into intrusive thinking,focus on internal thoughts,and find it difficult to use external information to adjust their state.These characteristics make OCD patients often have excessive guilt.Pathological guilt plays a key role in the occurrence and maintenance of OCD,however,few studies on guilt emotions in OCD,especially interpersonal-related guilt.Therefore,this study uses highly ecologically valid interpersonal interactive games combined with electrophysiology to explore the mechanism of the development of guilt in college students with high obsessive-compulsive tendency.In addition,the rigid and stereotyped behavior of OCD patients is often considered to be a manifestation of cognitive flexibility impairment.Cognitive flexibility is an important basis for individual problem-solving,environmental adaptation,and innovation ability,and is indispensable for individuals to maintain normal social functions.Emotion is an important factor affecting cognitive flexibility.Starting from the guilt emotion at the core of obsessive-compulsive disorder,the research may be able to open up a new way to improve the cognitive flexibility of OCD patients.Methods:Recruited subjects from college students.Study 1:According to the obsessive-compulsive inventory-revised（OCI-R）score,27 subjects in the high-compulsive tendency group and 28 in the low-compulsive tendency group were enrolled.The clinical symptom scale and the guilt-related scale were administered to all subjects,and brain electrical activity was recorded when the subjects completed the advice-decision game.Study 2 invited subjects to participate voluntarily based on Study 1,observed the performance of the task-switching paradigm under the guilt induced by the interpersonal interaction game,and recorded EEG activity during the process.Results:Study 1:Except for the guilt-compensation tendency was marginally significant（P=0.053）,the total score of guilt and shame and other subscales all showed statistically significant differences（P<0.05）.Correlation analysis showed that,except for the correlation between OCI-R and guilt-compensatory orientation,there was no statistical significance,and it was positively correlated with the total score of guilt and shame and other subscales,and the state-trait guilt scale for college students.The behavioral results show that the advice-decision game can better induce the target emotion.There was a marginally significant difference（P=0.085）in the guilt score in the guilt condition.There was a statistically significant difference in the shame scores under the shame condition（P<0.05）,and the shame score of the high obsessive-compulsive tendency group（6.04±0.51）was significantly higher than that of the low obsessive-compulsive tendency group（4.45±0.48）.Electrophysiological results showed that:under the guilt condition,the average amplitudes of P2 and P3 in the high obsessive-compulsive tendency group were significantly lower than those in the low obsessive-compulsive tendency group(F_（1,53）=4.16,P<0.05,F_（1,53）=4.13,P<0.05).Under the shame condition,the group effect was not statistically significant.The average amplitudes of P2,N2,and P3components were not significantly correlated with the scores of the guilt and shame proneness scale and the state-trait guilt scale for college students.Among them,the average amplitude of the P2 component at the F2 and FC2 electrode sites,and the average amplitude of the P3 component at the C1,C2,and FC2 electrode sites were negatively correlated with the total score of OCI-R（P<0.05）.Study 2:The results of the clinical scales showed that the scores of the OCI-R,self-rating anxiety scale,and self-rating depression scale were significantly different between the groups（P<0.001）,and the scores of the high obsessive-compulsive tendency group were higher than those of the low obsessive-compulsive tendency group.There was a statistically significant difference between the two groups in the total score of cognitive flexibility（P<0.05）,there was no statistically significant difference in the optional dimension（P>0.05）,and there was a statistically significant difference in the controllable dimension（P<0.01）.The results of guilt induction showed that under the induction of guilt,there was a statistically significant difference in the intensity of guilt reported by the two groups.The main performance is that the guilt score of the high obsessive-compulsive tendency group（6.54±0.44）is higher than that of the low obsessive-compulsive tendency group（3.92±0.43）.Behavioral results showed that:compared without guilt induction,the two groups reduced the response time of the task-switching paradigm under the guilt induction.The electrophysiological results showed that under the cue stage of the task-switching paradigm,the average amplitude of N2（FCZ electrode）was smaller in the high obsessive-compulsive tendency group under the induction of guilt than without guilt induction.There was no significant difference in the effect of guilt induction on the electrophysiological indicators of the two groups of subjects under the target stage.Conclusion:Clinical scale,behavioral,and electrophysiological evidence show that the high obsessive-compulsive tendency group has higher guilt and shame tendency than the low obsessive-compulsive tendency group,and there is a significant positive correlation between obsessive-compulsive symptoms and guilt.Guilt generated in the interpersonal environment may affect the cognitive flexibility of high obsessive-compulsive tendency group.