Action sequence learning, habits, and automaticity in obsessive-compulsive disorder

This study investigates the goal/habit imbalance theory of compulsion in obsessive-compulsive disorder (OCD), which postulates enhanced habit formation, increased automaticity, and impaired goal/habit arbitration. It directly tests these hypotheses using newly developed behavioral tasks. First, OCD patients and healthy participants were trained daily for a month using a smartphone app to perform chunked action sequences. Despite similar procedural learning and attainment of habitual performance (measured by an objective automaticity criterion) by both groups, OCD patients self-reported higher subjective habitual tendencies via a recently developed questionnaire. Subsequently, in a re-evaluation task assessing choices between established automatic and novel goal-directed actions, both groups were sensitive to re-evaluation based on monetary feedback. However, OCD patients, especially those with higher compulsive symptoms and habitual tendencies, showed a clear preference for trained/habitual sequences when choices were based on physical effort, possibly due to their higher attributed intrinsic value. These patients also used the habit-training app more extensively and reported symptom relief post-study. The tendency to attribute higher intrinsic value to familiar actions may be a potential mechanism leading to compulsions and an important addition to the goal/habit imbalance hypothesis in OCD. We also highlight the potential of smartphone app training as a habit reversal therapeutic tool

Action-sequence learning, habits and automaticity in obsessive-compulsive disorder

Enhanced habit formation, greater automaticity and impaired goal/habit arbitration in obsessive-compulsive disorder (OCD) are key hypotheses from the goal/habit imbalance theory of compulsion which have not been directly investigated. This article tests these hypotheses using a combination of newly developed behavioral tasks. First, we trained patients with OCD and healthy controls, using a novel smartphone app, to perform chunked action sequences, previously shown to engage habit brain circuitry. The motor training was daily over one month period. There was equivalent procedural learning and attainment of habitual performance (measured with an objective criteria of automaticity) in both groups, despite greater subjective habitual tendencies in patients with OCD, self-reported via a recently developed questionnaire. We then used a combination of follow-up behavioral tasks to further assess the arbitration between previous automatic and new goal-directed action sequences. We found no evidence for impairments of goal/habit arbitration in OCD following re-evaluation based on monetary feedback, although there was a greater preference for engaging in the trained habitual sequence under certain conditions which may have derived from its intrinsic value. These findings may lead to a reformulation of the goal/habit imbalance hypothesis in OCD. Finally, OCD patients with higher compulsivity scores and habitual tendencies showed more engagement with the motor habit-training app and reported symptom alleviation, with implications for its potential use as a form of habit reversal therapy

Cortical glutamate and GABA are related to compulsive behaviour in individuals with obsessive compulsive disorder and healthy controls

There has been little analysis of neurochemical correlates of compulsive behaviour to illuminate its underlying neural mechanisms. We use 7-Tesla proton magnetic resonance spectroscopy (1H-MRS) to assess the balance of excitatory and inhibitory neurotransmission by measuring glutamate and GABA levels in anterior cingulate cortex (ACC) and supplementary motor area (SMA) of healthy volunteers and participants with Obsessive-Compulsive Disorder (OCD). Within the SMA, trait and clinical measures of compulsive behaviour are related to glutamate levels, whereas a behavioural index of habitual control correlates with the glutamate:GABA ratio. Participants with OCD also show the latter relationship in the ACC while exhibiting elevated glutamate and lower GABA levels in that region. This study highlights SMA mechanisms of habitual control relevant to compulsive behaviour, common to the healthy sub-clinical and OCD populations. The results also demonstrate additional involvement of anterior cingulate in the balance between goal-directed and habitual responding in OCD

One hundred years of EEG for brain and behaviour research

On the centenary of the first human EEG recording, more than 500 experts reflect on the impact that this discovery has had on our understanding of the brain and behaviour. We document their priorities and call for collective action focusing on validity, democratization and responsibility to realize the potential of EEG in science and society over the next 100 years

Bridging minds and policies: supporting early career researchers in translating computational psychiatry research.

A significant challenge for psychiatry is to explain precisely how the brain generates psychopathology, as its translation is presumed to advance effective mechanism-based treatments. Computational psychiatry – a mathematical understanding of mental illness – has emerged to bridge this explanatory gap [1]. Broadly, computational psychiatry uses mathematical models to study psychiatric disorders, typically done via 1) an explanatory quantitative modelling approach to explain how aberrant computations of the mind produce psychiatric symptoms, and 2) data-driven modelling, commonly used to predict and track symptom progression. These methods have been applied to identify clinically relevant markers in psychiatry [2–4]. Recently, start-ups have been applying these principles to clinical settings for aiding diagnosis (e.g., https://limbic.ai/) and delivering personalized psychotherapy (e.g., https://alena.com/)

Bridging minds and policies: supporting early career researchers in translating computational psychiatry research

A significant challenge for psychiatry is to explain precisely how the brain generates psychopathology, as its translation is presumed to advance effective mechanism-based treatments. Computational psychiatry – a mathematical understanding of mental illness – has emerged to bridge this explanatory gap [1]. Broadly, computational psychiatry uses mathematical models to study psychiatric disorders, typically done via 1) an explanatory quantitative modelling approach to explain how aberrant computations of the mind produce psychiatric symptoms, and 2) data-driven modelling, commonly used to predict and track symptom progression. These methods have been applied to identify clinically relevant markers in psychiatry [2–4]. Recently, start-ups have been applying these principles to clinical settings for aiding diagnosis (e.g., https://limbic.ai/) and delivering personalised psychotherapy (e.g., https://alena.com/). Early career researchers (ECRs) are uniquely positioned to advance the translation of computational psychiatry. However, during our own academic training, we encountered barriers that may limit its uptake amongst ECRs. Here, we highlight these barriers and propose potential solutions

Bridging minds and policies: supporting early career researchers in translating computational psychiatry research

Acknowledgements: The authors would like to thank the NPP Special Projects Team for providing the opportunity and the platform to voice their ideas. The authors are grateful to Dorothy Langton and her family for their support.Funder: NIHR Cambridge Biomedical Research Centre (NIHR203312

Are candidate neurocognitive endophenotypes of OCD present in paediatric patients? A systematic review.

To-date it has been difficult to ascertain the exact cognitive profile of childhood OCD as studies report variable results. Adult OCD research lately utilises the endophenotype approach; studying cognitive traits that are present in both patients and their unaffected first-degree relatives, and are thought to lie closer to the genotype than the full-blown disorder. By observing whether candidate endopenotypes of adult OCD are present in child patients, we can determine whether the two subtypes show cognitive overlap. We conducted a systematic review of the paediatric OCD literature focussing on proposed neurocognitive endophenotypes of OCD: cognitive flexibility, response inhibition, memory, planning, decision-making, action monitoring, and reversal learning. We found that paediatric patients present robust increases in brain error related negativity associated with abnormal action monitoring, impaired decision-making under uncertainty, planning, and visual working memory, but there is less evidence for deficits in other cognitive domains. This implies that children with OCD show some cognitive similarities with adult patients, but other dysfunctions may only manifest later in the disorder trajectory

Atypical action updating in a dynamic environment associated with adolescent obsessive-compulsive disorder.

BACKGROUND: Computational research had determined that adults with obsessive-compulsive disorder (OCD) display heightened action updating in response to noise in the environment and neglect metacognitive information (such as confidence) when making decisions. These features are proposed to underlie patients' compulsions despite the knowledge they are irrational. Nonetheless, it is unclear whether this extends to adolescents with OCD as research in this population is lacking. Thus, this study aimed to investigate the interplay between action and confidence in adolescents with OCD. METHODS: Twenty-seven adolescents with OCD and 46 controls completed a predictive-inference task, designed to probe how subjects' actions and confidence ratings fluctuate in response to unexpected outcomes. We investigated how subjects update actions in response to prediction errors (indexing mismatches between expectations and outcomes) and used parameters from a Bayesian model to predict how confidence and action evolve over time. Confidence-action association strength was assessed using a regression model. We also investigated the effects of serotonergic medication. RESULTS: Adolescents with OCD showed significantly increased learning rates, particularly following small prediction errors. Results were driven primarily by unmedicated patients. Confidence ratings appeared equivalent between groups, although model-based analysis revealed that patients' confidence was less affected by prediction errors compared to controls. Patients and controls did not differ in the extent to which they updated actions and confidence in tandem. CONCLUSIONS: Adolescents with OCD showed enhanced action adjustments, especially in the face of small prediction errors, consistent with previous research establishing 'just-right' compulsions, enhanced error-related negativity, and greater decision uncertainty in paediatric-OCD. These tendencies were ameliorated in patients receiving serotonergic medication, emphasising the importance of early intervention in preventing disorder-related cognitive deficits. Confidence ratings were equivalent between young patients and controls, mirroring findings in adult OCD research

Action sequence learning, habits, and automaticity in obsessive-compulsive disorder

© The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/This study investigates the goal/habit imbalance theory of compulsion in obsessive-compulsive disorder (OCD), which postulates enhanced habit formation, increased automaticity, and impaired goal/habit arbitration. It directly tests these hypotheses using newly developed behavioral tasks. First, OCD patients and healthy participants were trained daily for a month using a smartphone app to perform chunked action sequences. Despite similar procedural learning and attainment of habitual performance (measured by an objective automaticity criterion) by both groups, OCD patients self-reported higher subjective habitual tendencies via a recently developed questionnaire. Subsequently, in a re-evaluation task assessing choices between established automatic and novel goal-directed actions, both groups were sensitive to re-evaluation based on monetary feedback. However, OCD patients, especially those with higher compulsive symptoms and habitual tendencies, showed a clear preference for trained/habitual sequences when choices were based on physical effort, possibly due to their higher attributed intrinsic value. These patients also used the habit-training app more extensively and reported symptom relief post-study. The tendency to attribute higher intrinsic value to familiar actions may be a potential mechanism leading to compulsions and an important addition to the goal/habit imbalance hypothesis in OCD. We also highlight the potential of smartphone app training as a habit reversal therapeutic tool.Peer reviewe