Trade-off between speed and accuracy : associations between obsessive-compulsive symptoms and meticulousness in PANS
(2026) In Journal of Clinical and Experimental Neuropsychology 48(3). p.292-303- Abstract
Introduction: Despite increasing recognition of pediatric acute-onset neuropsychiatric syndrome (PANS), its neuropsychological underpinnings remain limited, particularly in relation to obsessive-compulsive disorder (OCD) symptoms. PANS manifests abruptly with severe OCD and/or eating restrictions alongside concurrent neuropsychiatric symptoms, causing distress and functional impairment. This study aimed to examine the relationship between neurocognitive performance and OCD symptom severity in children and adolescents with PANS. Method: Twelve children and adolescents with PANS were assessed on a total of 39 occasions using a novel touchscreen-based button-choice reaction time task. The task was designed to capture subtle aspects of... (More)
Introduction: Despite increasing recognition of pediatric acute-onset neuropsychiatric syndrome (PANS), its neuropsychological underpinnings remain limited, particularly in relation to obsessive-compulsive disorder (OCD) symptoms. PANS manifests abruptly with severe OCD and/or eating restrictions alongside concurrent neuropsychiatric symptoms, causing distress and functional impairment. This study aimed to examine the relationship between neurocognitive performance and OCD symptom severity in children and adolescents with PANS. Method: Twelve children and adolescents with PANS were assessed on a total of 39 occasions using a novel touchscreen-based button-choice reaction time task. The task was designed to capture subtle aspects of attentional focus, motor precision, and response speed. Analyses examined associations between OCD symptom severity, assessed for each testing session, and performance measures. Results: Greater OCD symptom severity was associated with heightened attentiveness (noticing the lit-up button) and more centered touch positioning, but not with faster reaction times. A significant interaction was observed, whereby increased attentiveness and precision in touch placement were linked to longer reaction times, suggesting a trade-off between speed and perfectionistic response strategies. Conclusions: Overall, while OCD symptom severity was not directly associated with reaction time, it significantly shaped response monitoring and touch positioning. These findings indicate a neurocognitive profile in PANS characterized by heightened self-monitoring and meticulousness, potentially reflecting mechanisms underlying OCD symptomatology. Our findings highlight the complex interplay between neurocognitive performance and OCD symptom severity in PANS, as revealed through digital assessment, contributing to a deeper understanding of the condition.
(Less)
- author
- Holmäng, Helena
; Fagerudd, Rosanna
; Hajjari, Parisa
; Huldt Oldmark, Malin
; Jakobsson, Klara
; Serrano Toro, Alexandra
; Vinsa, Ingrid
; Fernell, Elisabeth
; Hadjikhani, Nouchine
; Gillberg, Christopher
; Åsberg Johnels, Jakob
; Johnson, Mats
and Thorsson, Max
LU
(Less) - organization
- publishing date
- 2026
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Neurodevelopmental disorders, obsessive-compulsive disorder, pediatric acute-onset neuropsychiatric syndrome, perfectionism, reaction time, tablet-based testing
- in
- Journal of Clinical and Experimental Neuropsychology
- volume
- 48
- issue
- 3
- pages
- 292 - 303
- publisher
- Routledge
- external identifiers
-
- scopus:105028196597
- pmid:41560412
- ISSN
- 1380-3395
- DOI
- 10.1080/13803395.2026.2617355
- language
- English
- LU publication?
- yes
- id
- 8b98004c-e86f-445e-8192-f007acb44fd6
- date added to LUP
- 2026-02-25 12:20:37
- date last changed
- 2026-07-03 10:39:54
@article{8b98004c-e86f-445e-8192-f007acb44fd6,
abstract = {{<p>Introduction: Despite increasing recognition of pediatric acute-onset neuropsychiatric syndrome (PANS), its neuropsychological underpinnings remain limited, particularly in relation to obsessive-compulsive disorder (OCD) symptoms. PANS manifests abruptly with severe OCD and/or eating restrictions alongside concurrent neuropsychiatric symptoms, causing distress and functional impairment. This study aimed to examine the relationship between neurocognitive performance and OCD symptom severity in children and adolescents with PANS. Method: Twelve children and adolescents with PANS were assessed on a total of 39 occasions using a novel touchscreen-based button-choice reaction time task. The task was designed to capture subtle aspects of attentional focus, motor precision, and response speed. Analyses examined associations between OCD symptom severity, assessed for each testing session, and performance measures. Results: Greater OCD symptom severity was associated with heightened attentiveness (noticing the lit-up button) and more centered touch positioning, but not with faster reaction times. A significant interaction was observed, whereby increased attentiveness and precision in touch placement were linked to longer reaction times, suggesting a trade-off between speed and perfectionistic response strategies. Conclusions: Overall, while OCD symptom severity was not directly associated with reaction time, it significantly shaped response monitoring and touch positioning. These findings indicate a neurocognitive profile in PANS characterized by heightened self-monitoring and meticulousness, potentially reflecting mechanisms underlying OCD symptomatology. Our findings highlight the complex interplay between neurocognitive performance and OCD symptom severity in PANS, as revealed through digital assessment, contributing to a deeper understanding of the condition.</p>}},
author = {{Holmäng, Helena and Fagerudd, Rosanna and Hajjari, Parisa and Huldt Oldmark, Malin and Jakobsson, Klara and Serrano Toro, Alexandra and Vinsa, Ingrid and Fernell, Elisabeth and Hadjikhani, Nouchine and Gillberg, Christopher and Åsberg Johnels, Jakob and Johnson, Mats and Thorsson, Max}},
issn = {{1380-3395}},
keywords = {{Neurodevelopmental disorders; obsessive-compulsive disorder; pediatric acute-onset neuropsychiatric syndrome; perfectionism; reaction time; tablet-based testing}},
language = {{eng}},
number = {{3}},
pages = {{292--303}},
publisher = {{Routledge}},
series = {{Journal of Clinical and Experimental Neuropsychology}},
title = {{Trade-off between speed and accuracy : associations between obsessive-compulsive symptoms and meticulousness in PANS}},
url = {{http://dx.doi.org/10.1080/13803395.2026.2617355}},
doi = {{10.1080/13803395.2026.2617355}},
volume = {{48}},
year = {{2026}},
}