Incentives Boost Model-Based Control Across a Range of Severity on Several Psychiatric Constructs

Patzelt, Edward H.; Kool, Wouter; Millner, Alexander J.; Gershman, Samuel J.

doi:10.1016/j.biopsych.2018.06.018

Cited by 87 publications

(133 citation statements)

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“…We selected this disorder because the clinical presentation of GAD does not involve compulsive behavior and individual differences in trait anxiety have not been linked to goal-directed planning deficits. 14,17 However, GAD shares a pattern of excessive worry and intrusive thoughts with OCD as well as nonspecific clinical features, such as general distress and impairment. 1 The use of patients with GAD allowed us to assess the potential contribution of these features to goal-directed deficits in OCD, separating compulsivity from obsessionality and general distress.…”

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confidence: 99%

“…In terms of cognitive flexibility (WCST), the compulsive factor was associated with fewer categories completed (β [SE], −0.57 [0.09]; P < .001) and more nonperseverative errors (β [SE], 5.86 [1.01]; P < .001) and trials to complete the first category (β [SE], 6.32 [1.36]; P < .001). Perseverative errors were not significantly associated with compulsivity (β [SE], 0.87 [0.59]; P = 14)…”

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confidence: 99%

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Comparison of the Association Between Goal-Directed Planning and Self-reported Compulsivity vs Obsessive-Compulsive Disorder Diagnosis

et al. 2020

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IMPORTANCE Dimensional definitions of transdiagnostic mental health problems have been suggested as an alternative to categorical diagnoses, having the advantage of capturing heterogeneity within diagnostic categories and similarity across them and bridging more naturally psychological and neural substrates. OBJECTIVE To examine whether a self-reported compulsivity dimension has a stronger association with goal-directed and related higher-order cognitive deficits compared with a diagnosis of obsessive-compulsive disorder (OCD). DESIGN, SETTING, AND PARTICIPANTSIn this cross-sectional study, patients with OCD and/or generalized anxiety disorder (GAD) from across the United States completed a telephone-based diagnostic interview by a trained rater, internet-based cognitive testing, and self-reported clinical assessments from October 8, 2015, to October 1, 2017. Follow-up data were collected to test for replicability. MAIN OUTCOMES AND MEASURESPerformance was measured on a test of goal-directed planning and cognitive flexibility (Wisconsin Card Sorting Test [WCST]) and a test of abstract reasoning. Clinical variables included DSM-5 diagnosis of OCD and GAD and 3 psychiatric symptom dimensions (general distress, compulsivity, and obsessionality) derived from a factor analysis. RESULTS Of 285 individuals in the analysis (mean [SD] age, 32 [12] years; age range, 18-77 years; 219 [76.8%] female), 111 had OCD; 82, GAD; and 92, OCD and GAD. A diagnosis of OCD was not associated with goal-directed performance compared with GAD at baseline (β [SE], −0.02 [0.02]; P = .18). In contrast, a compulsivity dimension was negatively associated with goal-directed performance (β [SE], −0.05 [0.02]; P = .003). Results for abstract reasoning task and WCST mirrored this pattern; the compulsivity dimension was associated with abstract reasoning (β [SE], 2.99 [0.63]; P < .001) and several indicators of WCST performance (eg, categories completed: β [SE], −0.57 [0.09]; P < .001), whereas OCD diagnosis was not (abstract reasoning: β [SE], 0.39 [0.66]; P = .56; categories completed: β [SE], −0.09 [0.10]; P = .38). Other symptom dimensions relevant to OCD, obsessionality, and general distress had no reliable association with goal-directed performance, WCST, or abstract reasoning. Obsessionality had a positive association with requiring more trials to reach the first category on the WCST at baseline (β [SE], 2.92 [1.39]; P = .04), and general distress was associated with impaired goal-directed performance at baseline (β [SE],−0.04 [0.02]; P = .01). However, unlike the key results of this study, neither survived correction for multiple comparisons or was replicated at follow-up testing.CONCLUSIONS AND RELEVANCE Deficits in goal-directed planning in OCD may be more strongly associated with a compulsivity dimension than with OCD diagnosis. This result may have implications for research assessing the association between brain mechanisms and clinical manifestations and for understanding the structure of mental illness.

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confidence: 99%

Comparison of the Association Between Goal-Directed Planning and Self-reported Compulsivity vs Obsessive-Compulsive Disorder Diagnosis

et al. 2020

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“…This manipulation demonstrated that model-based control could be boosted within the individual. Moreover, recent work using the same task showed model-based deficits could be improved across a range of transdiagnostic symptoms and traits of psychopathology (Patzelt et al, 2019a). This suggests that incentives might also boost model-based control in aging adults and lead to more flexible decision-making strategies.…”

Section: Model-based Control Across the Lifespanmentioning

confidence: 94%

“…This is why recent research has focused on methods to boost model-based control within the individual. Efforts to increase model-based control using incentives have been successful (Kool, Gershman, & Cushman, 4 2017), and this is also true for people with elevated symptoms and traits of psychopathology (Patzelt, Kool, Millner, & Gershman, 2019a). These findings demonstrate the possibility of boosting model-based control in older adults.…”

Section: Introductionmentioning

confidence: 92%

Boosting model-based control in older adults

Patzelt¹,

Kool²,

Gershman³

2019

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The tension between habits and plans is reflected in everyday decision-making. Habits are computationally cheap, but fail to flexibly adapt to changes in the environment. Planning is a flexible decision-making strategy, but requires greater resources. Arbitration between habits and plans has been formalized using reinforcement learning algorithms that distinguish between model-free control (habits) and model-based control (plans). Evidence about these two decision-making approaches suggests model-based control follows a developmental trajectory, emerging during adolescence, strengthening during young adulthood, and declining in older adulthood. The normative decline in planning (model-based control) presents the opportunity to develop interventions to increase flexible decision-making. Therefore, we asked if incentives could be used to increase model-based control in older adults. We expected older adults would fail to increase model-based control in response to incentives. This prediction was based upon prior research suggesting older adulthood is associated with deficits in representing and updating the expected value of rewards. Contrary to our expectations, in Experiment 1 we found that incentives could be used to boost model-based control in older adults sampled from an online population. We hypothesized this may be due to previous experience with the task (or with similar tasks). In Experiment 2, a naïve sample of older adults did not boost model-based control in response to incentives. These results suggest that incentives may be a useful intervention to increase model-based planning in older adulthood, but this may require extensive experience with the incentive structure.

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“…Using this method, we previously showed that a transdiagnostic compulsive dimension maps onto deficits in goal-directed control better than OCD symptoms (Gillan et al, 2016); a finding that has since been replicated (Patzelt et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Null results from a dimensional study of error-related negativity (ERN) and self-reported psychiatric symptoms

Seow

Benoit

Dempsey

et al. 2019

Preprint

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Alterations in error processing are implicated in a range of DSM-defined psychiatric disorders. For instance, obsessive-compulsive disorder (OCD) and generalised anxiety disorder show enhanced electrophysiological responses to errors -i.e. errorrelated negativity (ERN) -while others like schizophrenia have an attenuated ERN.However, as diagnostic categories in psychiatry are heterogeneous and also highly intercorrelated, the precise mapping of ERN enhancements and impairments is unclear. To address this, we recorded electroencephalograms (EEG) from 196 participants who performed the Flanker task and collected scores on 9 questionnaires assessing psychiatric symptoms to test if a dimensional framework could reveal specific transdiagnostic clinical manifestations of error processing dysfunctions. Contrary to our hypothesis, we found no association between ERN amplitude and symptom severity of OCD, trait anxiety, depression, social anxiety, impulsivity, eating disorders, alcohol addiction, schizotypy or apathy. A transdiagnostic approach did nothing to improve signal; there was no association between three transdiagnostic dimensions (anxious-depression, compulsive behaviour and intrusive thought and social withdrawal) and ERN magnitude. In these same individuals, we replicated a previously published transdiagnostic association between goal-directed learning and compulsive behaviour and intrusive thought.Associations between the ERN and psychopathology might be smaller than previously assumed and/or dependent on a greater level of symptom severity than other transdiagnostic cognitive biomarkers.

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Incentives Boost Model-Based Control Across a Range of Severity on Several Psychiatric Constructs

Abstract: Our results demonstrate that model-based control can reliably be improved independent of construct severity for most measures. This suggests that incentives may be a useful intervention for boosting model-based control across a range of symptom and trait severity.

Cited by 87 publications

References 47 publications

Comparison of the Association Between Goal-Directed Planning and Self-reported Compulsivity vs Obsessive-Compulsive Disorder Diagnosis

Comparison of the Association Between Goal-Directed Planning and Self-reported Compulsivity vs Obsessive-Compulsive Disorder Diagnosis

Boosting model-based control in older adults

Null results from a dimensional study of error-related negativity (ERN) and self-reported psychiatric symptoms

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