Feeling uncertain despite knowing the risk: Patients with OCD (but not controls) experience known and unknown probabilistic decisions as similarly distressing and uncertain

Jacoby, Ryan J.; Szkutak, Abigail; Shin, Jin; Lerner, Jennifer; Wilhelm, Sabine

doi:10.1016/j.jocrd.2023.100842

Cited by 2 publications

(3 citation statements)

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“…Further, mechanisms of risk aversion observed during a gambling task, in which losses and gains are objective, may differ from risk aversion observed during a task in which reward is defined by subjective personal preferences. Findings from a direct comparison of decision-making under ambiguity versus risk suggest that those with OCD are similarly averse to both conditions, although it is unclear whether this was purely due to OCD or comorbid affective/anxiety symptoms (Jacoby et al, 2023). In the case of the present study, the risk aversion demonstrated by those high in OCPD traits most closely resembled that seen in AN.…”

Section: Impact Of Trait Domains On Decision-makingsupporting

confidence: 48%

“…Evidence that individuals with post-acute AN are also more risk averse, choosing the "safe" or more predictable option more often (Bernardoni et al, 2020;Haynos, Lavender, et al, 2020); thus, traits related to risk aversion may be responsible for shared mechanistic pathways to rigidity for AN and OCPD. Clinically, those with OCD also appear risk averse, but the literature is more mixed regarding risk aversion during decision-making tasks in this population, which may reflect the distinction between risk aversion (i.e., when outcome probability is known) and ambiguity aversion (i.e., when outcome probability is unknown) (Jacoby et al, 2023). Further, mechanisms of risk aversion observed during a gambling task, in which losses and gains are objective, may differ from risk aversion observed during a task in which reward is defined by subjective personal preferences.…”

Section: Impact Of Trait Domains On Decision-makingmentioning

confidence: 96%

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Identifying mechanistic pathways to rigidity associated with Obsessive-Compulsive Personality Disorder traits using a novel decision-making paradigm

Heintz,

Haynos

2024

Preprint

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Cognitive and behavioral rigidity is observed across several mental disorders and is a defining characteristic of Obsessive-Compulsive Personality Disorder (OCPD), a highly prevalent and debilitating, yet understudied, disorder. In particular, treatments for OCPD are underdeveloped due to our poor understanding of the mechanisms leading to the disorder’s key feature of rigidity. Two related disorders, anorexia nervosa (AN) and obsessive-compulsive disorder (OCD), have shown distinct mechanistic pathways leading to symptoms of rigidity, indicating that this trait can arise as a result of a number of differentially impaired cognitive processes, each requiring unique interventions. To examine the relationship between symptoms of OCPD and abnormalities in the decision-making processes which may manifest in rigidity, participants (n=83) completed the Web-Surf task, a novel decision-making paradigm, in addition to the Five-Factor Obsessive-Compulsive Inventory (FFOCI-SF), a self-reported continuous measure of OCPD traits. Results indicated that, similar to the pattern observed in AN, OCPD traits predicted heightened selectivity relative to reward (p = .009). In addition, OCPD traits predicted accelerated behavioral adaptation following experiences of cost or reward (p < .001), which deviated from patterns expected in AN and OCD. An exploratory analysis revealed decreased selectivity relative to cost among individuals with the highest OCPD traits (p = .016). Results further indicated that specific OCPD trait domains, particularly conscientiousness, may be influenced by distinct aberrations in these decision-making processes. Our findings provide valuable insight into shared mechanisms between OCPD and AN as well as the distinction between OCPD and OCD. Implications for treatments and directions for future research are discussed.

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Section: Impact Of Trait Domains On Decision-makingsupporting

confidence: 48%

Section: Impact Of Trait Domains On Decision-makingmentioning

confidence: 96%

Identifying mechanistic pathways to rigidity associated with Obsessive-Compulsive Personality Disorder traits using a novel decision-making paradigm

Heintz,

Haynos

2024

Preprint

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“…OCD patients are biased towards appraising negative emotional stimuli (Kajs et al, 2022), have faster acquisition from negative versus positive outcomes (Endrass et al, 2011), and show more intolerance and distress during uncertainty, even in situations with low uncertainty or known risk (Jacoby et al, 2023). We therefore wanted to examine avoidance learning in an OCD-relevant mouse model to begin to address mechanisms underlying threat- and risk-assessment.…”

Section: Discussionmentioning

confidence: 99%

Sapap3knockout mice show threat bias under conflict during platform mediated avoidance task: implications for obsessive compulsive disorder

Manning,

Crummy,

LaPalombara

et al. 2024

Preprint

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Obsessive compulsive disorder (OCD) typically involves cycling between symptoms of intrusive aversive thoughts (obsessions) and repetitive rituals aimed at avoiding these aversive outcomes (compulsions), which interferes with patients' engagement with other important aspects of their lives. This cycling relationship between obsessions and compulsions highlights a potential role of impaired threat processing and avoidance behavior in OCD symptoms. The most effective behavioral therapy for OCD, exposure with response prevention (ERP), aims to break this cycle. However, it can be difficult for patients to access and engage with, suggesting a need for improved understanding of the neural mechanisms of threat processing and avoidance behavior in OCD to guide development of new and more effective treatments. Platform mediated avoidance (PMA) has proven to be a useful translational paradigm for use in rodents to examine avoidance neurobiology and models relevant to OCD, such as ERP and overtraining-induced persistent avoidance. However, to date this protocol has only been used in rats, and studies in transgenic mouse models relevant to OCD may shed further light on neural mechanisms relevant to disturbances in avoidance and threat processing in the disorder. To address this gap, we tested Sapap3 knockout (KO) mice, a leading preclinical model in OCD research, in the PMA task. Using this paradigm, we examined avoidance acquisition, expression, and extinction, as well as reward seeking under motivational conflict in two separate cohorts conditioned using higher (0.4 mA) or lower (0.24 mA) intensity shock. Surprisingly, the most striking difference observed in Sapap3-KOs vs control mice was heightened suppression of lever pressing for rewards during a tone signaling impending threat, suggesting a shift in action selection under motivational conflict (genotype effect avoidance conditioning: 0.24 mA cohort p=0.011, 0.4 mA cohort p=0.07; avoidance extinction: 0.24 mA p=0.057, 0.4 mA p=0.042). Avoidance responding was also acquired more slowly in Sapap3-KOs trained with a low intensity shock (time x genotype interaction p=0.025) and was extinguished more robustly following ERP (genotype effect p=0.043). In contrast, avoidance was similar between Sapap3 KOs and WT littermate controls trained using higher intensity shock (0.4 mA cohort time effect p<0.0001). Expression of the immediate early gene c-Fos associated with reinstatement of avoidance after ERP showed preliminary evidence for decreased activity of medial orbitofrontal cortex (mOFC) in KOs which may contribute to observed differences in PMA performance (KO vs WT mOFC c-Fos t-test p=0.0456). Together these findings suggest that mOFC dysfunction may contribute to increases in the influence of threats vs rewards over action selection in an animal model with relevance to OCD, and that the Sapap3-KO model presents valuable opportunities for deeper mechanistic investigation of avoidance and threat processing relevant to the human disorder.

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Feeling uncertain despite knowing the risk: Patients with OCD (but not controls) experience known and unknown probabilistic decisions as similarly distressing and uncertain

Cited by 2 publications

References 70 publications

Identifying mechanistic pathways to rigidity associated with Obsessive-Compulsive Personality Disorder traits using a novel decision-making paradigm

Identifying mechanistic pathways to rigidity associated with Obsessive-Compulsive Personality Disorder traits using a novel decision-making paradigm

Sapap3knockout mice show threat bias under conflict during platform mediated avoidance task: implications for obsessive compulsive disorder

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