Stopping a Response When You Really Care about the Action: Considerations from a Clinical Perspective

Abstract

Response inhibition, whether reactive or proactive, is mostly investigated in a narrow cognitive framework. We argue that it be viewed within a broader frame than the action being inhibited, i.e., in the context of emotion and motivation of the individual at large. This is particularly important in the clinical domain, where the motivational strength of an action can be driven by threat avoidance or reward seeking. The cognitive response inhibition literature has focused on stopping reactively with responses in anticipation of clearly delineated external signals, or proactively in limited contexts, largely independent of clinical phenomena. Moreover, the focus has often been on stopping efficiency and its correlates rather than on inhibition failures. Currently, the cognitive and clinical perspectives are incommensurable. A broader context may explain the apparent paradox where individuals with disorders characterised by maladaptive action control have difficulty inhibiting their actions only in specific circumstances. Using Obsessive Compulsive Disorder as a case study, clinical theorising has focused largely on compulsions as failures of inhibition in relation to specific internal or external triggers. We propose that the concept of action tendencies may constitute a useful common denominator bridging research into motor, emotional, motivational, and contextual aspects of action control failure. The success of action control may depend on the interaction between the strength of action tendencies, the ability to withhold urges, and contextual factors.

Beyond Reactive Inhibition: Unpacking the Multifaceted Nature of Motor Inhibition

“…However, evidence from behavioral studies is exceptionally mixed [5]. As nicely explained in the review by Morein-Zamir and Anholt [9], part of the reason is that impulsivity and inhibition are complex, partially overlapping constructs. Furthermore, most studies have focused just on reactive inhibition, disregarding proactive stopping, and the possible interactions between the two domains.…”

“…Thus, future clinical research should assess both proactive and reactive inhibition in the same patients to gain a deeper insight into the neurocognitive mechanisms of such diseases. Morein-Zamir and Anholt [9] also underlined another crucial element that must be considered when investigating inhibition impairments in mental diseases, i.e., the fact that patients often experience failures of control under specific circumstances, e.g., when in certain affective states or under motivational pressure. To be maximally effective, laboratory tests should be performed in conditions as close as possible to those that, in real life, bring patients to experience inhibitory deficits.…”