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. 2015 Dec;4(4):263-72.
doi: 10.1556/2006.4.2015.039.

Think twice: Impulsivity and decision making in obsessive-compulsive disorder

Giacomo Grassi  1 , Stefano Pallanti  1 , Lorenzo Righi  2 , Martijn Figee  3 , Mariska Mantione  3 , Damiaan Denys  3 , Daniele Piccagliani  1 , Alessandro Rossi  4 , Paolo Stratta  4
Affiliations

Think twice: Impulsivity and decision making in obsessive-compulsive disorder

Giacomo Grassi et al. J Behav Addict. 2015 Dec.

Abstract

Background and aims: Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls.

Methods: We assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task.

Results: OCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task.

Conclusions: OCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.

Keywords: OCD; behavioral addiction; decision making; impulsivity; neuroeconomics; probabilistic reasoning.

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Figures

Figure 1.
Figure 1.
Net score’s mean and standard error for each block for OCD patients and healthy controls
Figure 2.
Figure 2.
On the left the mean beads draws (and standard errors) for OCD patients and healthy controls. On the right the percentage of subjects who drew 1 or 2 beads in the OCD and the control group
See this image and copyright information in PMC

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