Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-27T22:48:54.507Z Has data issue: false hasContentIssue false
  • English
  • Français

Patients with obsessive–compulsive disorder are impaired in associative learning based on external feedback

Published online by Cambridge University Press:  26 February 2009

M. M. Nielen ,
J. A. den Boer  and
H. G. O. M. Smid
M. M. Nielen
Affiliation:
Institute for Clinical and Experimental Neurosciences, Department of Psychiatry, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
J. A. den Boer
Affiliation:
Department of Biological Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
H. G. O. M. Smid*
Affiliation:
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
*
*Address for correspondence: H. G. O. M. Smid, Ph.D., Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Patients with obsessive–compulsive disorder (OCD) have to repeat their actions before feeling satisfied that the action reached its intended goal. Learning theory predicts that this may be due to a failure in the processing of external feedback.

Method

We examined the performance of 29 OCD patients and 28 healthy volunteers on an associative learning task, in which initial learning is based solely on external feedback signals. Feedback valence was manipulated with monetary gains and losses.

Results

As predicted, OCD patients were impaired during initial, external feedback-driven learning but not during later learning stages. The emotional salience of the feedback modulated learning during the initial stage in patients and controls alike. During later learning stages, however, patients approached near-normal performance with rewarding feedback but continued to produce deficient learning with punishing feedback.

Conclusion

OCD patients have a fundamental impairment in updating behavior based on the external outcome of their actions, possibly mediated by faulty error signals in response selection processes.

Keywords

External feedbacklearningobsessive–compulsive disorder
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 9 , September 2009 , pp. 1519 - 1526
Copyright
Copyright © 2009 Cambridge University Press

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

Aouizerate, B, Guehl, D, Cuny, E, Rougier, A, Bioulac, B, Tignol, J, Burbaud, P (2004). Pathophysiology of obsessive–compulsive disorder: a necessary link between phenomenology, neuropsychology, imagery and physiology. Progress in Neurobiology 72, 195–221.Google Scholar
APA (1994). Diagnostic and statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Bohne, A, Savage, CR, Deckersbach, T, Keuthen, NJ, Jenike, MA, Tuschen-Caffier, B, Wilhelm, S (2005). Visuospatial abilities, memory, and executive functioning in trichotillomania and obsessive–compulsive disorder. Journal of Clinical and Experimental Neuropsychology 27, 385–399.CrossRefGoogle ScholarPubMed
Braver, TS, Cohen, JD (2000). On the control of control: the role of dopamine in regulating prefrontal function. In Attention and Performance (ed. Monsell, S. and Driver, J.), vol. 18, pp. 713–737. MIT Press: Cambridge, MA.Google Scholar
Chamberlain, SR, Blackwell, AD, Fineberg, NA, Robbins, TW, Sahakian, BJ (2005). The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neuroscience and Biobehavioural Reviews 29, 399–419.Google Scholar
Endrass, T, Klawohn, J, Schuster, F, Kathmann, N (2008). Overactive performance monitoring in obsessive–compulsive disorder: ERP evidence from correct and erroneous reactions. Neuropsychologia 46, 1877–1887.Google Scholar
Fitzgerald, KD, Welsh, RC, Gehring, WJ, Abelson, JL, Himle, JA, Liberzon, I, Taylor, SF (2005). Error-related hyperactivity of the anterior cingulate cortex in obsessive–compulsive disorder. Biological Psychiatry 57, 287–294.Google Scholar
Gehring, WJ, Himle, J, Nisenson, LG (2000). Action-monitoring dysfunction in obsessive–compulsive disorder. Psychological Science 11, 1–6.CrossRefGoogle ScholarPubMed
Goodman, WK, Price, LH, Rasmussen, SH, Mazure, C, Fleischmann, RL, Hill, CL, Heninger, GR, Charney, DS (1989). The Yale–Brown Obsessive–Compulsive Scale. 1. Development, use, and reliability. Archives of General Psychiatry 46, 1006–1011.CrossRefGoogle Scholar
Hamilton, M (1960). Diagnosis and rating scale for depression. British Journal of Psychiatry 3, 76–78.Google Scholar
Holroyd, CB, Coles, MG (2002). The neural basis of human error processing: reinforcement learning, dopamine, and the error-related negativity. Psychological Review 10, 679–709.Google Scholar
Iaboni, F, Douglas, VI, Baker, AG (1995). Effects of reward and response costs on inhibition in ADHD children. Journal of Abnormal Psychology 104, 232–240.Google Scholar
Leplow, B, Murphy, R, Nutzinger, DO (2002). Specificity of conditional associative-learning deficits in obsessive–compulsive disorder (OCD) and non-OCD anxiety disorders. Journal of Clinical and Experimental Neuropsychology 24, 792–805.CrossRefGoogle ScholarPubMed
Mataix-Cols, D, Rosario-Campos, MC, Leckman, JF (2005). A multidimensional model of obsessive–compulsive disorder. American Journal of Psychiatry 162, 228–238.CrossRefGoogle ScholarPubMed
Murphy, R, Nutzinger, DO, Paul, T, Leplow, B (2004). Conditional-associative learning in eating disorders: a comparison with OCD. Journal of Clinical and Experimental Neuropsychology 26, 190–199.CrossRefGoogle ScholarPubMed
Nie, NH, Hadlai Hull, C, Jenkins, JG, Steinbrenner, K, Bent, DH (1986). SPSS: Statistical Package for the Social Sciences, 2nd edn. McGraw-Hill: New York.Google Scholar
O'Doherty, J, Kringelbach, ML, Rolls, ET, Hornak, J, Andrews, C (2001). Abstract reward and punishment representations in the human orbitofrontal cortex. Nature Neuroscience 4, 95–102.Google Scholar
Olley, A, Malhi, G, Sachdev, P (2007). Memory and executive functioning in obsessive–compulsive disorder: a selective review. Journal of Affective Disorders 104, 15–23.Google Scholar
Otto, MW (1992). Normal and abnormal information processing. A neuropsychological perspective on obsessive compulsive disorder. Psychiatric Clinics of North America 15, 825–848.CrossRefGoogle ScholarPubMed
Passingham, RE, Toni, I, Rushworth, MF (2000). Specialization within the prefrontal cortex: the ventral prefrontal cortex and associative learning. Experimental Brain Research 133, 103–113.CrossRefGoogle ScholarPubMed
Pitman, RK (1987). A cybernetic model of obsessive–compulsive psychopathology. Comprehensive Psychiatry 28, 334–343.Google Scholar
Purcell, R, Maruff, P, Kyrios, M, Pantelis, C (1998). Neuropsychological deficits in obsessive–compulsive disorder: a comparison with unipolar depression, panic disorder, and normal controls. Archives of General Psychiatry 55, 415–423.CrossRefGoogle ScholarPubMed
Remijnse, PL, Nielen, MM, van Balkom, AJ, Cath, DC, van Oppen, P, Uylings, HB, Veltman, DJ (2006). Reduced orbitofrontal-striatal activity on a reversal learning task in obsessive–compulsive disorder. Archives of General Psychiatry 63, 1225–1236.Google Scholar
Schwartz, JM (1999). A role of volition and attention in the generation of new brain circuitry. Toward a neurobiology of mental force. Journal of Consciousness Studies 6, 115–142.Google Scholar
Sutton, RS, Barto, AG (1998). Reinforcement Learning: An Introduction. MIT Press: Cambridge, MA.Google Scholar
Szechtman, H, Woody, E (2004). Obsessive–compulsive disorder as a disturbance of security motivation. Psychological Review 111, 111–127.Google Scholar
Toni, I, Passingham, RE (1999). Prefrontal-basal ganglia pathways are involved in the learning of arbitrary visuomotor associations: a PET study. Experimental Brain Research 127, 19–32.Google Scholar
Veale, DM, Sahakian, BJ, Owen, AM, Marks, IM (1996). Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive–compulsive disorder. Psychological Medicine 26, 1261–1269.Google Scholar