Enhanced Avoidance Habits in Obsessive-Compulsive Disorder

Abstract

BackgroundObsessive-compulsive disorder (OCD) is a psychiatric condition that typically manifests in compulsive urges to perform irrational or excessive avoidance behaviors. A recent account has suggested that compulsivity in OCD might arise from excessive stimulus-response habit formation, rendering behavior insensitive to goal value. We tested if OCD patients have a bias toward habits using a novel shock avoidance task. To explore how habits, as a putative model of compulsivity, might relate to obsessions and anxiety, we recorded measures of contingency knowledge, explicit fear, and physiological arousal.MethodsTwenty-five OCD patients and 25 control subjects completed a shock avoidance task designed to induce habits through overtraining, which were identified using goal-devaluation. The relationship between habitual behavior, erroneous cognitions, and physiological arousal was assessed using behavior, questionnaires, subjective report, and skin conductance responses.ResultsA devaluation sensitivity test revealed that both groups could inhibit unnecessary behavioral responses before overtraining. Following overtraining, OCD patients showed greater avoidance habits than control subjects. Groups did not differ in conditioned arousal (skin conductance responses) at any stage. Additionally, groups did not differ in contingency knowledge or explicit ratings of shock expectancy following the habit test. Habit responses were associated with a subjective urge to respond.ConclusionsThese data indicate that OCD patients have a tendency to develop excessive avoidance habits, providing support for a habit account of OCD. Future research is needed to fully characterize the causal role of physiological arousal and explicit fear in habit formation in OCD.

Model-Based Control in Dimensional Psychiatry

“…Using an aversive shock habit task, OCD subjects showed greater habitual responding following overtraining to a virtual devaluation of a shock outcome (43). These results contrast with a study using a loss version of the twostep task where OCD subjects demonstrated the opposite, with more pronounced model-based behaviors to avoid loss outcomes (42).…”

The role of learning-related dopamine signals in addiction vulnerability

“…Along the same lines, amphetamine pre-treatment speeds up the rate at which the outcome insensitivity develops (Nelson and Killcross, 2006), and this depends particularly on D 1 rather than D 2 receptors (Nelson and Killcross, 2013). In humans, there is evidence for enhanced habitization in obsessive-compulsive disorder (Everitt and Robbins, 2005;Robbins et al, 2012;Gillan et al, 2011Gillan et al, , 2013 and forthcoming evidence in cocaine addiction (N. Daw and V. Voon, personal communication), but not yet in alcohol addiction (Sebold et al, subm).…”

“…It is important, though, to bear in mind that although habits share features with compulsions (Gillan et al, 2011(Gillan et al, , 2013, they are not one and the same (Dayan 2009;Robbins et al 2012 and many others). It has been suggested that after extended training, habits become deeply engrained by shifting further dorsally in the corticostriatal loops (Belin and Everitt, 2008;Willuhn et al, 2012).…”

Don't Think, Just Feel the Music: Individuals with Strong Pavlovian-to-Instrumental Transfer Effects Rely Less on Model-based Reinforcement Learning

“…After an outcome devaluation (e.g., through satiation), the MB system can change preferences quickly, but the MF system cannot. Individual variation in the balance between MB and MF decisions, with a shift toward MF and away from MB learning, is associated with addictive and impulsive traits in animals (Huys et al, 2014;Everitt & Robbins, 2005), and a bias has been reported in conditions such as addiction and obsessive-compulsive disorder where behavioral preferences persist against explicit desires (Voon et al, , 2015Gillan et al, 2011Gillan et al, , 2014Sebold et al, 2014;Sjoerds et al, 2013).…”