Habitual versus affective motivations in obsessive-compulsive disorder and alcohol use disorder

Abstract

Objective. To (1) confirm whether the Habit, Reward, and Fear Scale is able to generate a 3-factor solution in a population of obsessive-compulsive disorder and alcohol use disorder (AUD) patients; (2) compare these clinical groups in their habit, reward, and fear motivations; and (3) investigate whether homogenous subgroups can be identified to resolve heterogeneity within and across disorders based on the motivations driving ritualistic and drinking behaviors. Methods. One hundred and thirty-four obsessive-compulsive disorder (n = 76) or AUD (n = 58) patients were assessed with a battery of scales including the Habit, Reward, and Fear Scale, the Yale-Brown Obsessive-Compulsive Scale, the Alcohol Dependence Scale, the Behavioral Inhibition/Activation System Scale, and the Urgency, (lack of ) Premeditation, (lack of ) Perseverance, Sensation Seeking, and Positive Urgency Impulsive Behavior Scale. Results. A 3-factor solution reflecting habit, reward, and fear subscores explained 56.6% of the total variance of the Habit, Reward, and Fear Scale. Although the habit and fear subscores were significantly higher in obsessive-compulsive disorder (OCD) and the reward subscores were significantly greater in AUD patients, a cluster analysis identified that the 3 clusters were each characterized by differing proportions of OCD and AUD patients. Conclusions. While affective (reward- and fear-driven) and nonaffective (habitual) motivations for repetitive behaviors seem dissociable from each other, it is possible to identify subgroups in a transdiagnostic manner based on motivations that do not match perfectly motivations that usually described in OCD and AUD patients.

Psychometric investigation of the Chinese version of the Habit, Reward and Fear Scale (HRFS)

“…Besides, there is evidence that motivation can be a predictor of alcohol cravings (Pombo et al., 2016 ). The results of this study and the use of the HRFS in people with obsessive‐compulsive disorder and alcohol use disorders (Ferreira et al., 2020 ) suggest the potential clinical value of the HRFS‐C. In general, HRFS provides a theoretical motivation model that can be used to understand different forms of psychopathology, such as substance use disorders, behavioral disorders, and obsessive‐compulsive related disorders.…”

Transdiagnosis of alcohol use and psychopathologies: A systematic review

“…According to the literature employed in this study, the main disorders associated with AUD are: post-traumatic stress disorder (PTSD) ( Acuff et al, 2018 , Hawn et al, 2019 , Lebeaut et al, 2021 , Pezzoli et al, 2017 , Simons et al, 2018 , Weiss et al, 2018 , Weiss et al, 2020 , Wolitzky-Taylor et al, 2023 ); other substance use disorders (SUD) ( Den Ouden et al, 2020 , Girard et al, 2017 , McCallum et al, 2019 , Rodriguez-Seijas et al, 2017 , Rosenström et al, 2021 , Yoon et al, 2021 ); personality disorders (PD) ( Girard et al, 2017 , Helle et al, 2021 , Mattingley et al, 2022 , Rodriguez-Seijas et al, 2017 , Rosenström et al, 2021 ); obsessive–compulsive disorder (OCD) ( Albertella et al, 2020 , Den Ouden et al, 2020 , Ferreira et al, 2021 , Pezzoli et al, 2017 ); eating disorders (ED) ( Den Ouden et al, 2020 , Hasking and Claes, 2020 , Mattingley et al, 2022 , Pezzoli et al, 2017 ), in particular, binge eating disorder ( Schag et al, 2019 ); anxiety ( McCallum et al, 2019 , Paulus et al, 2017 , Pezzoli et al, 2017 , Swerdlow et al, 2019 , Yoon et al, 2021 ); depression ( Akeman et al, 2022 , Anderson et al, 2018 , Anker et al, 2017 , Barbotin et al, 2022 , Paulus et al, 2017 , Swerdlow et al, 2019 , Weiss et al, 2018 , Weiss et al, 2020 ); disruptive, impulse control and conduct disorders (DICCD) ( Rodriguez-Seijas et al, 2017 ); attention deficit hyperactivity disorder (ADHD) ( Oddo et al, 2022 , Rodriguez-Seijas et al, 2017 ); and oppositional defiant disorder (ODD) ( Rodriguez-Seijas et al, 2017 ).…”

“… 1 2.7 Reward as motivation for repetitive behaviors Search for a pleasurable sensation, emotional gratification that leads someone to repeat compulsive or addictive behaviors, as in OCD and AUD. Motivation is considered affective because it is related to emotional regulation ( Ferreira et al, 2021 ). 1 2.7 Disinhibition Personality traits related to disinhibition: sensation seeking, impulsivity and aggression ( Rodriguez-Seijas et al, 2017 ).…”

Fear driven compulsive behaviour is associated with worse long‐term outcome in obsessive–compulsive disorder

“…For instance, despite being identified as specific and independent factors in factor analytic studies (Ferreira et al, in press), it is unclear whether habit, reward, and fear are biologically homogeneous constructs. In fact, one cluster analytic study, which aims at identifying (biologically) homogenous subgroups of OCD and AUD patients, reported three different clusters combining different levels of habit, reward, and fear, including one cluster with high habit, high fear and high reward (the “mixed reactive” group) and another group with high habit, high fear, and low reward (the “anhedonic” cluster; Ferreira et al, in press). Thus, it would be interesting to assess the associations between highly habit repetitive behavioural clusters (either OCD or AUD patients) and SRIs in the short term (12 weeks) administered in a controlled (non‐naturalistic) prospective fashion.…”