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Investigating the role of anticipatory reward and habit strength in obsessive-compulsive disorder

Published online by Cambridge University Press:  09 January 2017

Gabriela M. Ferreira ,
Murat Yücel ,
Andrew Dawson ,
Valentina Lorenzetti  and
Leonardo F. Fontenelle
Gabriela M. Ferreira
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Murat Yücel
Affiliation:
Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
Andrew Dawson
Affiliation:
Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
Valentina Lorenzetti
Affiliation:
Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
Leonardo F. Fontenelle*
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia D’Or Institute for Research and Education, Rio de Janeiro, Brazil
*
*Address for correspondence: Leonardo F. Fontenelle, MD, PhD, Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro-RJ 22410-003, Brazil. (Email: lfontenelle@gmail.com)
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Abstract

Aims

To determine the rates and associated illness characteristics of obsessive-compulsive disorder (OCD) patients who describe their symptoms as either rewarding or habitual.

Methods

Seventy-three treatment-seeking OCD patients had their dominant compulsive behavior assessed with a structured interview (the Temporal Impulsive-Compulsive Scale–Revised) to track the progression of rewarding (ie, gain in positive affect), aversive (ie, decrease in negative affect), and neutral (or non-affective) states and a self-report scale (the Self-Report Habit Index) to evaluate their habitual features. Additional measures included structured diagnostic interviews for axis I and II disorders, measures of OCD symptoms severity, and a battery of instruments to comprehensively assess relevant aspects of sensitivity to reward and fear.

Results

Almost half (49%) of our OCD patients (particularly washers) endorsed that they anticipated obtaining a reward (ie, positive affect) from the enactment of their dominant compulsive behavior. Washers stood out in that their positive affects during and after compulsive behaviors were highly (and positively) correlated with duration of illness. In contrast, habit strength did not differ between washers, checkers, and arrangers, although it also correlated with duration of illness among checkers. Furthermore, the severity of OCD and comorbidity with impulse control disorders predicted up to 35% of the variance in the habit strength of OCD behaviors.

Conclusion

Compulsive washing may be more clearly characterized by problems in reward processing. In contrast, duration of checking, severity of OCD, and comorbidity with impulse control disorders shape compulsive behaviors by imparting them with habitual tendencies.

Keywords

Habitsobsessive-compulsive disorderpsychopathologyreward
Type
Original Research
Information
CNS Spectrums , Volume 22 , Issue 3 , June 2017 , pp. 295 - 304
Copyright
© Cambridge University Press 2017 

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