Think twice: Impulsivity and decision making in obsessive–compulsive disorder

Abstract

Background and AimsRecent studies have challenged the anxiety-avoidance model of obsessive–compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls.MethodsWe assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task.ResultsOCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task.ConclusionsOCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.

Validity of Quinpirole Sensitization Rat Model of OCD: Linking Evidence from Animal and Clinical Studies

“…This is important because a link between changes in reward systems, impulsivity and psychiatric disorders including OCD has been convincingly documented (Eslami-Shahrbabaki et al, 2015; Grassi et al, 2015). An important implication of the quinpirole sensitization in relation to neurobiology is a proposal that OCD as a clinical condition can represent a disorder of a “security motivation” system (Szechtman and Woody, 2004).…”

Adaptation and validation of the Melbourne Decision Making Questionnaire to Brazilian Portuguese

“…It is a necessary ability for adequate functioning, and is often impaired in patients with psychiatric disorders such as schizophrenia, 1 obsessive-compulsive disorder, 2,3 bipolar disorder (BD) 4 and depression, 5 and neurological disorders such as multiple sclerosis 6 and traumatic brain injury. 7 Recent studies have also identified it as a significant predictor of clinical outcomes such as treatment dropout and relapse in substance disorders 8,9 and future substance use in patients with BD.…”

Effects of NMDA receptor antagonists on probability discounting depend on the order of probability presentation

“…In this case, choosing the probabilistic reinforcer is advantageous. Regardless, risky decision making is associated with attention deficit/hyperactivity disorder (ADHD; see Dekkers et al, 2016 for a meta-analysis), borderline personality disorder (Schuermann et al, 2011; Svaldi et al, 2012), human immunodeficiency virus (HIV; Fujiwara et al, 2015; Hardy et al, 2006), obsessive-compulsive disorder (OCD; Grassi et al, 2015), psychopathy (Takahashi et al, 2014), sleep deprivation (Killgore et al, 2006), substance abuse (Brevers et al, 2014; Schutter et al, 2011), and pathological gambling (PG; Brand et al, 2005; Madden et al, 2009). Directly related to probability discounting, individuals diagnosed with psychopathy and PG often show shallower discounting of a large, uncertain reinforcer relative to matched controls (Madden et al, 2009; Takahashi et al, 2014).…”