The ability to flexibly adapt thoughts and behaviours represents a fundamental attribute for behavioural success. Impairments in aspects of cognitive flexibility are found as transdiagnostic latent phenotypes of obsessive-compulsive symptomatology and are present within a range of mental disorders and within the population at large. In this narrative review, we focus on the attentional set-shifting aspect of cognitive inflexibility, which has been largely investigated in the context of obsessive-compulsive spectrum disorders and is thought to underpin perseverative symptomatology. We appraise the published literature relating to the putative neurobiological mechanisms, methods of assessment, interventional approaches, and health and wellbeing impacts. We discuss critical knowledge gaps, promising new research avenues, and potential interventional approaches from a clinical and public health perspective. We conclude that cognitive inflexibility has relevance for clinicians in terms of understanding clinical outcomes and tailoring personalised forms of treatments, and for public health professionals in terms of understanding rigid attitudes and adjustment in the current post-pandemic environment.
