Addicted to compulsion: assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder

ObjectiveSeveral studies suggested that obsessive-compulsive disorder (OCD) patients display increased impulsivity, impaired decision-making, and reward system dysfunction. In a Research Domain Criteria (RDoC) perspective, these findings are prototypical for addiction and have led some authors to view OCD as a behavioral addiction. Thus, the aim of this study was to investigate similarities and differences on impulsivity, decision-making, and reward system, as core dimensions of addiction, across OCD and gambling disorder (GD) patients.MethodsForty-four OCD patients, 26 GD patients, and 40 healthy controls (HCs) were included in the study. Impulsivity was assessed through the Barratt Impulsiveness Scale, decision-making through the Iowa Gambling Task, and reward system through a self-report clinical instrument (the Shaps-Hamilton Anhedonia Scale) assessing hedonic tone and through an olfactory test assessing hedonic appraisal to odors.ResultsBoth OCD and GD patients showed increased impulsivity when compared to HCs. More specifically, the OCD patients showed cognitive impulsivity, and the GD patients showed both increased cognitive and motor impulsivity. Furthermore, both OCD and GD patients showed impaired decision-making performances when compared to HCs. Finally, GD patients showed increased anhedonia and blunted hedonic response to pleasant odors unrelated to gambling or depression/anxiety symptoms, while OCD patients showed only increased anhedonia levels related to OC and depression/anxiety symptoms.ConclusionOCD patients showed several similarities and some differences with GD patients when compared to HCs on impulsivity, decision-making, and reward system, three core dimensions of addiction. These results could have relevant implications for the research of new treatment targets for OCD.

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Obsessive-Compulsive Disorder and Decision Making under Ambiguity: A Systematic Review with Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11020143 ◽

2021 ◽

Vol 11 (2) ◽

pp. 143

Author(s):

Veronica Nisticò ◽

Andrea De Angelis ◽

Roberto Erro ◽

Benedetta Demartini ◽

Lucia Ricciardi

Keyword(s):

Systematic Review ◽

Decision Making ◽

Obsessive Compulsive Disorder ◽

Clinical Manifestation ◽

Iowa Gambling Task ◽

Meta Analysis ◽

Healthy Controls ◽

Gambling Task ◽

Obsessive Compulsive ◽

Compulsive Disorder

In the last decade, decision-making has been proposed to have a central role in obsessive-compulsive disorder (OCD) aetiology, since patients show pathological doubt and an apparent inability to make decisions. Here, we aimed to comprehensively review decision making under ambiguity, as measured by the Iowa Gambling Task (IGT), in OCD, using a meta-analytic approach. According to PRISMA Guidelines, we selected 26 studies for a systematic review and, amongst them, 16 studies were included in a meta-analysis, comprising a total of 846 OCD patients and 763 healthy controls (HC). Our results show that OCD patients perform significantly lower than HC at the IGT, pointing towards the direction of a decision making impairment. In particular, this deficit seems to emerge mainly in the last three blocks of the IGT. IGT scores in OCD patients under the age of 18 were still significantly lower than in HC. Finally, no difference emerged between medicated and unmedicated patients, since they both scored significantly lower at the IGT compared to HC. In conclusion, our results are in line with the hypothesis according to which decision making impairment might represent a potential endophenotype lying between the clinical manifestation of OCD and its neurobiological aetiology.

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Decision-making impairment in obsessive-compulsive disorder as measured by the Iowa Gambling Task

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2011000500013 ◽

2011 ◽

Vol 69 (4) ◽

pp. 642-647 ◽

Cited By ~ 31

Author(s):

Felipe Filardi da Rocha ◽

Nathália Bueno Alvarenga ◽

Leandro Malloy-Diniz ◽

Humberto Corrêa

Keyword(s):

Decision Making ◽

Obsessive Compulsive Disorder ◽

Iowa Gambling Task ◽

Demographic Characteristics ◽

Healthy Controls ◽

Gambling Task ◽

Obsessive Compulsive ◽

Homogeneous Groups ◽

Compulsive Disorder

OBJECTIVE: This study aims to evaluate the process of decision-making in patients with obsessive-compulsive disorder (OCD) using the Iowa Gambling Task (IGT). In addition, we intend to expand the understanding of clinical and demographic characteristics that influence decision-making. METHOD: Our sample consisted of 214 subjects (107 diagnosed with OCD and 107 healthy controls) who were evaluated on their clinical, demographic and neuropsychological features. Moreover, the Iowa Gambling Task (IGT), a task that detects and measures decision-making impairments, was used. RESULTS: We found that OCD patients performed significantly worse on the IGT. Furthermore, features such as symptoms of anxiety did not influence IGT performance. CONCLUSION: Impaired decision-making seems to be a key feature of OCD. Given that OCD is a complex heterogeneous disorder, homogeneous groups are necessary for an accurate characterization of our findings.

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Decision-making under uncertainty in obsessive–compulsive disorder

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2015.08.011 ◽

2015 ◽

Vol 69 ◽

pp. 166-173 ◽

Cited By ~ 30

Author(s):

Helen Pushkarskaya ◽

David Tolin ◽

Lital Ruderman ◽

Ariel Kirshenbaum ◽

J. MacLaren Kelly ◽

...

Keyword(s):

Decision Making ◽

Obsessive Compulsive Disorder ◽

Decision Making Under Uncertainty ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Further evidence of a dissociation between decision-making under ambiguity and decision-making under risk in obsessive–compulsive disorder

Journal of Affective Disorders ◽

10.1016/j.jad.2015.01.060 ◽

2015 ◽

Vol 176 ◽

pp. 118-124 ◽

Cited By ~ 28

Author(s):

Hae Won Kim ◽

Jee In Kang ◽

Kee Namkoong ◽

Kyungun Jhung ◽

Ra Yeon Ha ◽

...

Keyword(s):

Decision Making ◽

Obsessive Compulsive Disorder ◽

Decision Making Under Risk ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Initial Data on Recollections of Pathways to Inflated Responsibility Beliefs in Patients with Obsessive-Compulsive Disorder

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465813001112 ◽

2014 ◽

Vol 43 (4) ◽

pp. 385-395 ◽

Cited By ~ 7

Author(s):

Meredith E. Coles ◽

Casey A. Schofield ◽

Jacob A. Nota

Keyword(s):

Initial Data ◽

Obsessive Compulsive Disorder ◽

Self Report ◽

Published Data ◽

Obsessive Compulsive ◽

Childhood Experiences ◽

Childhood Exposure ◽

Compulsive Disorder ◽

Inflated Responsibility ◽

Maladaptive Beliefs

Background: Despite literature establishing a relationship between maladaptive beliefs and symptoms of obsessive-compulsive disorder (OCD), there are few studies addressing how these beliefs develop. Salkovskis and colleagues (1999) proposed specific domains of childhood experiences leading to heightened beliefs regarding responsibility. Prior studies in students and individuals who just completed treatment for OCD have found support for this theory. However, we are not aware of published data from individuals with current OCD. Aims: This paper presents initial data from adults currently meeting criteria for OCD as well as both anxious and non-anxious controls. Method: Recollections of childhood experiences, current OCD-related beliefs, and OCD symptoms were assessed using self-report measures in 39 individuals seeking treatment for OCD, 36 anxious controls and 39 healthy controls. Results: Initial data suggested that in individuals with OCD, increased reports of childhood exposure to overprotection and experiences where one's actions caused or influenced misfortune were associated with stronger OCD-related beliefs. Further, compared to community controls, individuals with OCD reported more childhood experiences where one's actions caused or influenced misfortune, though they did not differ from anxious controls in childhood responsibility experiences. Conclusions: These initial findings provide minimal support for the proposed model of the development of inflated responsibility beliefs, and highlight the need for research examining the etiology of OCD related beliefs with updated models, larger samples, and ultimately using prospective methods.

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Predicting Eating Disorder and Anxiety Symptoms Using Anorexia Nervosa and Obsessive-Compulsive Disorder Polygenic Scores

10.1101/2020.07.02.20142844 ◽

2020 ◽

Author(s):

Zeynep Yilmaz ◽

Katherine Schaumberg ◽

Matt Halvorsen ◽

Erica L. Goodman ◽

Leigh C. Brosof ◽

...

Keyword(s):

Eating Disorders ◽

Sex Differences ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Obsessive Compulsive Disorder ◽

Genetic Risk ◽

Anxiety Symptoms ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Polygenic Scores

Clinical, epidemiological, and genetic findings support an overlap between eating disorders, obsessive-compulsive disorder (OCD), and anxiety symptoms. However, little research has examined the role of genetic factors in the expression of eating disorders and OCD/anxiety phenotypes. We examined whether the anorexia nervosa (AN), OCD, or AN/OCD transdiagnostic polygenic scores (PGS) predict eating disorders, OCD, and anxiety symptoms in a large population-based developmental cohort. Using summary statistics files from the Psychiatric Genomics Consortium Freeze 2 AN and Freeze 1 OCD GWAS, we first conducted an AN/OCD transdiagnostic GWAS meta-analysis and then calculated PGS for AN, OCD, and AN/OCD in participants from the Avon Longitudinal Study of Parents and Children with available genetic and phenotype data on eating disorder, OCD, and anxiety diagnoses and symptoms (sample size 3,212-5,369 per phenotype). We observed sex differences in the PGS prediction of eating disorder, OCD, and anxiety-related phenotypes, with AN genetic risk manifesting at an earlier age and playing a more prominent role in eating disorder phenotypes in boys than in girls. Compulsive exercise was the only phenotype predicted by all three PGS (e.g., PAN(boys)=0.0141 at age 14; POCD(girls)=0.0070 at age 16; PAN/OCD(all)=0.0297 at age 14). Our results suggest that earlier detection of eating disorder, OCD, and anxiety-related symptoms could be made possible by including measurement of genetic risk for these psychiatric conditions while being mindful of sex differences.

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