Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-17T01:17:37.477Z Has data issue: false hasContentIssue false
  • English
  • Français

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: [email protected])
Get access Rights & Permissions [Opens in a new window]

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 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Fontenelle, LF, Mendlowicz, MV, Versiani, M. Impulse control disorders in patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci. 2005; 59(1): 30–37.CrossRefGoogle ScholarPubMed
2. Kashyap, H, Fontenelle, LF, Miguel, EC, et al. “Impulsive compulsivity” in obsessive-compulsive disorder: a phenotypic marker of patients with poor clinical outcome. J Psychiatr Res. 2012; 46(9): 1146–1152.Google Scholar
3. Rado, S. So-called obsessive-compulsive neurosis. In: Arieti S, ed. American Handbook of Psychiatry. New York: Basic Books; 1974: 195–208.Google Scholar
4. Marks, IM. Fears, Phobias, and Rituals: Panic, Anxiety, and Their Disorders. New York: Oxford University Press; 1987.Google Scholar
5. Gillan, CM, Papmeyer, M, Morein-Zamir, S, et al. Disruption in the balance between goal-directed behavior and habit learning in obsessive-compulsive disorder. Am J Psychiatry. 2011; 168(7): 718–726.CrossRefGoogle ScholarPubMed
6. Gillan, CM, Morein-Zamir, S, Urcelay, GP, et al. Enhanced avoidance habits in obsessive-compulsive disorder. Biol Psychiatry. 2014; 75(8): 631–638.Google Scholar
7. Gillan, CM, Robbins, TW. Goal-directed learning and obsessive-compulsive disorder. Philos Trans R Soc Lond B Biol Sci. 2014; 369(1655). DOI: 10.1098/rstb.2013.0475.CrossRefGoogle ScholarPubMed
8. Berridge, KC, Kringelbach, ML. Pleasure systems in the brain. Neuron. 2015; 86(3): 646–664.CrossRefGoogle ScholarPubMed
9. Figee, M, Vink, M, de Geus, F, et al. Dysfunctional reward circuitry in obsessive-compulsive disorder. Biol Psychiatry. 2011; 69(9): 867–874.CrossRefGoogle ScholarPubMed
10. Denys, D, Mantione, M, Figee, M, et al. Deep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder. Arch Gen Psychiatry. 2010; 67(10): 1061–1068.CrossRefGoogle ScholarPubMed
11. Fontenelle, LF, Oostermeijer, S, Ferreira, GM, Lorenzetti, V, Luigjes, J, Yücel, M. Anticipated reward in obsessive-compulsive disorder: are compulsions rewarding? J Clin Psychiatry. 2015; 76(9): e1134–1135.CrossRefGoogle ScholarPubMed
12. Amiaz, R, Fostick, L, Gershon, A, Zohar, J. Naltrexone augmentation in OCD: a double-blind placebo-controlled cross-over study. Eur Neuropsychopharmacol. 2008; 18(6): 455–461.Google Scholar
13. Fontenelle, LF, Oostermeijer, S, Harrison, BJ, Pantelis, C, Yücel, M. Obsessive-compulsive disorder, impulse control disorders and drug addiction: common features and potential treatments. Drugs. 2011; 71(7): 827–840.CrossRefGoogle ScholarPubMed
14. Matsunaga, H, Kiriike, N, Matsui, T, Oya, K, Okino, K, Stein, DJ. Impulsive disorders in Japanese adult patients with obsessive-compulsive disorder. Compr Psychiatry. 2005; 46(1): 43–49.CrossRefGoogle ScholarPubMed
15. Del-Ben, CM, Vilela, JAA, Crippa, JAdS, Hallak, JEC, Labate, CM, Zuardi, AW. Confiabilidade da “Entrevista Clínica Estruturada para o DSM-IV - Versão Clínica” traduzida para o português. Rev Bras Psiquiatr. 2001; 23(3): 156–159.CrossRefGoogle Scholar
16. Pfohl, B, Blum, N, Zimmerman, M. Structured Interview for DSM-IV Personality: SIDP-IV. Washinton, DC: American Psychiatric Press; 1997.Google Scholar
17. Verplanken, B, Orbell, S. Reflections on past behavior: a self-report index of habit strength1. Journal of Applied Social Psychology. 2003; 33(6): 1313–1330.Google Scholar
18. Grafman, J. Plans, actions, and mental sets: managerial knowledge units in the frontal lobes. In: Perecman E, ed. Integrating Theory and Practice in Neuropsychology. Hillsdale, NJ: Erlbaum; 1989: 93–138.Google Scholar
19. Souza, FP, Foa, EB, Meyer, E, Niederauer, KG, Cordioli, AV. Psychometric properties of the Brazilian Portuguese version of the Obsessive-Compulsive Inventory–Revised (OCI-R). Rev Bras Psiquiatr. 2011; 33(2): 137–143.Google Scholar
20. Araújo, LA. Escalas de avaliação de transtorno obsessivo-compulsivo em adultos. In: Gorenstein C, Andrade LHSG, Zuardi AW, eds. Escalas de avaliação clínica em psiquiatria e psicofarmacologia. São Paulo: Lemos Editorial; 2000: 165–166.Google Scholar
21. Gard, DE, Gard, MG, Kring, AM, John, OP. Anticipatory and consummatory components of the experience of pleasure: a scale development study. Journal of Research in Personality. 2006; 40(6): 1086–1102.CrossRefGoogle Scholar
22. Carver, CS, White, TL. Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. Journal of Personality and Social Psychology. 1994; 67(2): 319–333.CrossRefGoogle Scholar
23. Cyders, MA, Smith, GT, Spillane, NS, Fischer, S, Annus, AM, Peterson, C. Integration of impulsivity and positive mood to predict risky behavior: development and validation of a measure of positive urgency. Psychol Assess. 2007; 19(1): 107–118.CrossRefGoogle ScholarPubMed
24. Carleton, RN, Norton, MA, Asmundson, GJ. Fearing the unknown: a short version of the Intolerance of Uncertainty Scale. J Anxiety Disord. 2007; 21(1): 105–117.CrossRefGoogle Scholar
25. Bortoncello, CF, Braga, DT, Gomes, JB, Souza, FP, Cordioli, AV. Psychometric properties of the Brazilian version of the Obsessive Beliefs Questionnaire (OBQ-44). J Anxiety Disord. 2012; 26(3): 430–434.Google Scholar
26. Rachman, S. The Fear of Contamination: Assessment and Treatment. Oxford, UK: Oxford University Press; 2006.CrossRefGoogle Scholar
27. Fontenelle, LF, Cocchi, L, Harrison, BJ, et al. Towards a post-traumatic subtype of obsessive-compulsive disorder. J Anxiety Disord. 2012; 26(2): 377–383.CrossRefGoogle ScholarPubMed
28. Melca, IA, Yücel, M, Mendlowicz, MV, de Oliveira-Souza, R, Fontenelle, LF. The correlates of obsessive-compulsive, schizotypal, and borderline personality disorders in obsessive-compulsive disorder. J Anxiety Disord. 2015; 33: 15–24.Google Scholar
29. Whitbeck, LB, Armenta, BE, Welch-Lazoritz, ML. Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities. Soc Psychiatry Psychiatr Epidemiol. 2015; 50(8): 1285–1291.CrossRefGoogle ScholarPubMed
30. Melo-Felippe, FB, de Salles Andrade, JB, Giori, IG, Vieira-Fonseca, T, Fontenelle, LF, Kohlrausch, FB. Catechol-O-methyltransferase gene polymorphisms in specific obsessive-compulsive disorder patients’ subgroups. J Mol Neurosci. 2016; 58(1): 129–136.CrossRefGoogle ScholarPubMed
31. Sjoerds, Z, de Wit, S, van den Brink, W, et al. Behavioral and neuroimaging evidence for overreliance on habit learning in alcohol-dependent patients. Transl Psychiatry. 2013; 3: e337.CrossRefGoogle ScholarPubMed
32. Gillan, CM, Otto, AR, Phelps, EA, Daw, ND. Model-based learning protects against forming habits. Cogn Affect Behav Neurosci. 2015; 15(3): 523–536.CrossRefGoogle ScholarPubMed
33. de Haan, S, Rietveld, E, Denys, D. On the nature of obsessions and compulsions. Mod Trends Pharmacopsychiatri. 2013; 29: 1–15.CrossRefGoogle ScholarPubMed
34. Voon, V, Derbyshire, K, Ruck, C, et al. Disorders of compulsivity: a common bias towards learning habits. Mol Psychiatry. 2015; 20(3): 345–352.Google Scholar
35. Bender, R, Lange, S. Adjusting for multiple testing—when and how? J Clin Epidemiol. 2001; 54(4): 343–349.CrossRefGoogle ScholarPubMed
36. Arzeno Ferrao, Y, Almeida, VP, Bedin, NR, Rosa, R, D’Arrigo Busnello, E. Impulsivity and compulsivity in patients with trichotillomania or skin picking compared with patients with obsessive-compulsive disorder. Compr Psychiatry. 2006; 47(4): 282–288.CrossRefGoogle ScholarPubMed
37. Piquet-Pessoa, M, Fontenelle, LF. Opioid antagonists in “broadly” defined behavioral addictions: a narrative review. Expert Opin Pharmacother. 2016; 17(6): 835–844.Google Scholar
38. Carroll, KM, Onken, LS. Behavioral therapies for drug abuse. Am J Psychiatry. 2005; 162(8): 1452–1460.CrossRefGoogle ScholarPubMed
39. Woods, DW, Miltenberger, RG. Habit reversal: a review of applications and variations. J Behav Ther Exp Psychiatry. 1995; 26(2): 123–131.CrossRefGoogle ScholarPubMed
Supplementary material: File

Ferreira supplementary material

Ferreira supplementary material 1

Download Ferreira supplementary material(File)
File 15.4 KB