Abstract
Introduction
Dual system learning theories posit an overreliance characterizes obsessive–compulsive disorder on habitual decision-making at the expense of goal-directed learning. However, most studies on this topic used frequentist statistics and did not evaluate the discriminant validity of goal-directed learning indices.
Methods
We recruited 55 OCD patients, used Bayesian statistics to examine goal-directed learning in OCD, and tested whether goal-directed learning indices showed discriminant validity. Patients completed self-reports, a two-stage reinforcement learning task, executive functioning (EF), and related tests (Rey Complex Figure, Wisconsin Card Sorting, Stroop tests).
Results
Analyses showed that goal-directed learning deficits were related to compulsions and self-reported OCD severity, but not obsessions, OCD-related beliefs, trait anxiety, anxiety sensitivity, or depression. Moreover, increased compulsivity and self-reported OCD (vs. all other dimensions examined) were linked to faster responses. Evidence for discriminant validity was found. Goal-directed learning coefficients were unrelated to set-shifting, inhibitory control, and visuospatial memory. Compulsivity was unrelated to memory and set-shifting but associated with poorer inhibition.
Conclusions
Findings highlight the importance of conceptualizing psychopathology dimensionally, such as the relevance of imbalanced habitual vs. goal-directed behavior in OCD. Results also underscore the importance of examining unique associations of goal-directed behaviors in OCD with clinical/syndromal measures (compulsions vs. obsessions).
Similar content being viewed by others
Notes
Due to space constraints, we offer details of the psychometric properties of the tests herein in Appendix A of the online supplementary materials (OSM).
Appendix E offers details on the interpretation of Bayes Factor (BF10) values. Appendix F provides information on the impact of multiple testing of non-independent inter-related tests from a Bayesian perspective.
References
Abramovitch, A., Short, T., & Schweiger, A. (2021). The C Factor: Cognitive dysfunction as a transdiagnostic dimension in psychopathology. Clinical Psychology Review. https://doi.org/10.1016/j.cpr.2021.102007
Adams, T. G., Jr., Riemann, B. C., Wetterneck, C. T., & Cisler, J. M. (2012). Obsessive beliefs predict cognitive behavior therapy outcome for obsessive compulsive disorder. Cognitive Behaviour Therapy, 41(3), 203–211. https://doi.org/10.1080/16506073.2011.621969
Alvares, G. A., Balleine, B. W., & Guastella, A. J. (2014). Impairments in goal-directed actions predict treatment response to cognitive-behavioral therapy in social anxiety disorder. PLoS ONE, 9(4), e94778. https://doi.org/10.1371/journal.pone.0094778
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). APA Press. https://doi.org/10.1176/appi.books.9780890425596
Baldwin, S. A., & Larson, M. J. (2017). An introduction to using Bayesian linear regression with clinical data. Behaviour Research and Therapy, 98, 58–75. https://doi.org/10.1016/j.brat.2016.12.016
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory–II. (2nd ed.). The Psychological Corporation.
Bennett, D., Sutcliffe, K., Tan, N. P., Smillie, L. D., & Bode, S. (2021). Anxious and obsessive-compulsive traits are independently associated with valuation of noninstrumental information. Journal of Experimental Psychology: General, 150(4), 739–755. https://doi.org/10.1037/xge0000966
Blakey, S. M., Abramowitz, J. S., Reuman, L., Leonard, R. C., & Riemann, B. C. (2017). Anxiety sensitivity as a predictor of outcome in the treatment of obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 57, 113–117. https://doi.org/10.1016/j.jbtep.2017.05.003
Bürkner, P.-C. (2017). brms: An R package for Bayesian multilevel models using Stan. Journal of Statistical Software, 80(1), 1–28.
Bürkner, P.-C. (2018). Advanced Bayesian multilevel modeling with the R package brms. The R Journal, 10(1), 395–411.
Carpenter, B., Gelman, A., Hoffman, M. D., Lee, D., Goodrich, B., Betancourt, M., Brubaker, M., Guo, J., Li, P., & Riddell, A. (2017). Stan: A probabilistic programming language. Journal of Statistical Software, 76(1), 1–32. https://doi.org/10.18637/jss.v076.i01
Cohen, J. (1988). Statistical power for the social sciences. Hillsdale, NJ: Laurence Erlbaum and Associates.
Cuttler, C., & Taylor, S. (2012). Did I forget to lock the door? The link between prospective memory failures and doubt in the compulsion to check. Journal of Experimental Psychopathology, 3(3), 437–454. https://doi.org/10.5127/jep.021811
Daw, N. D., Gershman, S. J., Seymour, B., Dayan, P., & Dolan, R. J. (2011). Model-based influences on humans’ choices and striatal prediction errors. Neuron, 69(6), 1204–1215. https://doi.org/10.1016/j.neuron.2011.02.027
de Wit, S., & Dickinson, A. (2009). Associative theories of goal-directed behaviour: A case for animal-human translational models. Psychological Research Psychologische Forschung, 73(4), 463–476. https://doi.org/10.1007/s00426-009-0230-6
Decker, J. H., Otto, A. R., Daw, N. D., & Hartley, C. A. (2016). From creatures of habit to goal-directed learners: Tracking the developmental emergence of model-based reinforcement learning. Psychological Science, 27(6), 848–858. https://doi.org/10.1177/0956797616639301
Denman, S. B. (1984). Denman Neuropsychology Memory Scale. S.B. Denman.
Deserno, L., Huys, Q. J., Boehme, R., Buchert, R., Heinze, H. J., Grace, A. A., & Schlagenhauf, F. (2015). Ventral striatal dopamine reflects behavioral and neural signatures of model-based control during sequential decision making. Proceedings of the National Academy of Sciences, 112(5), 1595–1600. https://doi.org/10.1073/pnas.1417219112
Dickinson, A., & Balleine, B. (1994). Motivational control of goal-directed action. Animal Learning & Behavior, 22(1), 1–18. https://doi.org/10.3758/BF03199951
Diedrich, A., Sckopke, P., Schwartz, C., Schlegl, S., Osen, B., Stierle, C., & Voderholzer, U. (2016). Change in obsessive beliefs as predictor and mediator of symptom change during treatment of obsessive-compulsive disorder - a process-outcome study. BMC Psychiatry, 16, 220. https://doi.org/10.1186/s12888-016-0914-6
Dunlap, W. P., Cortina, J. M., Vaslow, J. B., & Burke, M. J. (1996). Meta-analysis of experiments with matched groups or repeated measures designs. Psychological Methods, 1(2), 170–177. https://doi.org/10.1037/1082-989x.1.2.170
Exner, C., Kohl, A., Zaudig, M., Langs, G., Lincoln, T. M., & Rief, W. (2009). Metacognition and episodic memory in obsessive-compulsive disorder. Journal of Anxiety Disorders, 23(5), 624–631. https://doi.org/10.1016/j.janxdis.2009.01.010
First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015). Structured Clinical Interview for DSM-5 Disorders. American Psychiatric Publishing, American Psychiatric Association.
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The obsessive-compulsive inventory: development and validation of a short version. Psychological Assessment, 14(4), 485–496. https://doi.org/10.1037/1040-3590.14.4.485
Gelman, A., & Hill, J. (2007). Data analysis using regression and multilevel/hierarchical models. Cambridge University Press.
Gillan, C. M. (2021). Recent developments in the habit hypothesis of OCD and compulsive disorders. Current Topics in Behavioral Neurosciences, 49, 147–167. https://doi.org/10.1007/7854_2020_199
Gillan, C. M., Kalanthroff, E., Evans, M., Weingarden, H. M., Jacoby, R. J., Gershkovich, M., & Simpson, H. B. (2020). Comparison of the association between goal-directed planning and self-reported compulsivity vs obsessive-compulsive disorder diagnosis. JAMA Psychiatry, 77(1), 77–85. https://doi.org/10.1001/jamapsychiatry.2019.2998
Gillan, C. M., Kosinski, M., Whelan, R., Phelps, E. A., & Daw, N. D. (2016a). Characterizing a psychiatric symptom dimension related to deficits in goal-directed control. eLife. https://doi.org/10.7554/eLife.11305
Gillan, C. M., Otto, A. R., Phelps, E. A., & Daw, N. D. (2015). Model-based learning protects against forming habits. Cognitive, Affective, & Behavioral Neuroscience, 15(3), 523–536. https://doi.org/10.3758/s13415-015-0347-6
Gillan, C. M., Papmeyer, M., Morein-Zamir, S., Sahakian, B. J., Fineberg, N. A., Robbins, T. W., & de Wit, S. (2011). Disruption in the balance between goal-directed behavior and habit learning in obsessive-compulsive disorder. American Journal of Psychiatry, 168(7), 718–726. https://doi.org/10.1176/appi.ajp.2011.10071062
Gillan, C. M., & Robbins, T. W. (2014). Goal-directed learning and obsessive-compulsive disorder. Philosophical Transactions of the Royal Society B. https://doi.org/10.1098/rstb.2013.0475
Gillan, C. M., Robbins, T. W., Sahakian, B. J., van den Heuvel, O. A., & van Wingen, G. (2016b). The role of habit in compulsivity. European Neuropsychopharmacology, 26(5), 828–840. https://doi.org/10.1016/j.euroneuro.2015.12.033
Gillan, C. M., Vaghi, M. M., Hezemans, F. H., van Ghesel Grothe, S., Dafflon, J., Bruhl, A. B., & Robbins, T. W. (2021). Experimentally induced and real-world anxiety have no demonstrable effect on goal-directed behaviour. Psychological Medicine, 51(9), 1467–1478. https://doi.org/10.1017/S0033291720000203
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Heninger, G. R., & Charney, D. S. (1989). The yale-brown obsessive compulsive scale. I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006–1011. https://doi.org/10.1001/archpsyc.1989.01810110048007
Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60(1), 549–576. https://doi.org/10.1146/annurev.psych.58.110405.085530
Grant, D. A., & Berg, E. A. (1948). A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. Journal of Experimental Psychology: General, 38(4), 404–411. https://doi.org/10.1037/h0059831
Griffiths, K. R., Morris, R. W., & Balleine, B. W. (2014). Translational studies of goal-directed action as a framework for classifying deficits across psychiatric disorders. Frontiers in Systems Neuroscience, 8, 101. https://doi.org/10.3389/fnsys.2014.00101
Gruner, P., Anticevic, A., Lee, D., & Pittenger, C. (2016). Arbitration between action strategies in obsessive-compulsive disorder. The Neuroscientist, 22(2), 188–198. https://doi.org/10.1177/1073858414568317
Isobe, M., Vaghi, M., Fineberg, N. A., Apergis-Schoute, A. M., Bullmore, E. T., Sahakian, B. J., Robbins, T. W., & Chamberlain, S. R. (2021). Set-shifting-related basal ganglia deformation as a novel familial marker of obsessive-compulsive disorder. British Journal of Psychiatry. https://doi.org/10.1192/bjp.2021.45
Jeffreys, H. (1998). The theory of probability (3rd ed.).
Johnson, L. N., & Baldwin, S. A. (2020). An introduction and illustration of Bayesian modeling in couple and family therapy research. Journal of Marital and Family Therapy, 46(4), 620–637. https://doi.org/10.1111/jmft.12461
Kass, R. E., & Raftery, A. E. (1995). Bayes factors. Journal of the American Statistical Association, 90(430), 773–795. https://doi.org/10.2307/2291091
Keshavan, M. S., Vinogradov, S., Rumsey, J., Sherrill, J., & Wagner, A. (2014). Cognitive training in mental disorders: Update and future directions. American Journal of Psychiatry, 171(5), 510–522. https://doi.org/10.1176/appi.ajp.2013.13081075
Kruschke, J. K., & Liddell, T. M. (2018). The Bayesian new statistics: Hypothesis testing, estimation, meta-analysis, and power analysis from a Bayesian perspective. Psychonomic Bulletin & Review, 25(1), 178–206. https://doi.org/10.3758/s13423-016-1221-4
Lavine, M., & Schervish, M. J. (1999). Bayes factors: What they are and what they are not. The American Statistician, 53(2), 119–122. https://doi.org/10.2307/2685729
Nalborczyk, L., Batailler, C., Lœvenbruck, H., Vilain, A., & Bürkner, P.-C. (2019). An introduction to Bayesian multilevel models using brms: A case study of gender effects on vowel variability in standard Indonesian. Journal of Speech, Language, and Hearing Research, 62(5), 1225–1242. https://doi.org/10.1044/2018_JSLHR-S-18-0006
OCCWG. (2003). Psychometric validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory: Part I. Behaviour Research and Therapy, 41(8), 863–878. https://doi.org/10.1016/S0005-7967(02)00099-2
Olley, A., Malhi, G., & Sachdev, P. (2007). Memory and executive functioning in obsessive-compulsive disorder: A selective review. Journal of Affective Disorders, 104(1–3), 15–23. https://doi.org/10.1016/j.jad.2007.02.023
Osterrieth, P. A. (1944). Le test de copie d’une figure complexe; contribution à l’étude de la perception et de la mémoire. [Test of copying a complex figure; contribution to the study of perception and memory.]. Archives De Psychologie, 30, 206–356.
Price, R. B., Gillan, C. M., Hanlon, C., Ferrarelli, F., Kim, T., Karim, H. T., & Ahmari, S. E. (2021). Effect of experimental manipulation of the orbitofrontal cortex on short-term markers of compulsive behavior: A theta burst stimulation study. American Journal of Psychiatry, 178(5), 459–468. https://doi.org/10.1176/appi.ajp.2020.20060821
R Core Team. (2021). R: A language and environment for statistical computing. R Foundation for Statistical Computing. URL: https://www.R-project.org/.
Rey, A. (1941). L’examen psychologique dans les cas d’encéphalopathie traumatique. (Les problems.). [The psychological examination in cases of traumatic encepholopathy. Problems.]. Archives De Psychologie, 28, 215–285.
Robbins, T. W., Gillan, C. M., Smith, D. G., de Wit, S., & Ersche, K. D. (2012). Neurocognitive endophenotypes of impulsivity and compulsivity: Towards dimensional psychiatry. Trends in Cognitive Sciences, 16(1), 81–91. https://doi.org/10.1016/j.tics.2011.11.009
Rouder, J. N., Speckman, P. L., Sun, D., Morey, R. D., & Iverson, G. (2009). Bayesian t tests for accepting and rejecting the null hypothesis. Psychonomic Bulletin & Review, 16(2), 225–237. https://doi.org/10.3758/PBR.16.2.225
Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53–63. https://doi.org/10.1038/mp.2008.94
Savage, C. R., Baer, L., Keuthen, N. J., Brown, H. D., Rauch, S. L., & Jenike, M. A. (1999). Organizational strategies mediate nonverbal memory impairment in obsessive–compulsive disorder. Biological Psychiatry, 45(7), 905–916. https://doi.org/10.1016/S0006-3223(98)00278-9
Seow, T. X. F., Benoit, E., Dempsey, C., Jennings, M., Maxwell, A., McDonough, M., & Gillan, C. M. (2020). A dimensional investigation of error-related negativity (ERN) and self-reported psychiatric symptoms. International Journal of Psychophysiology, 158, 340–348. https://doi.org/10.1016/j.ijpsycho.2020.09.019
Seow, T. X. F., Benoit, E., Dempsey, C., Jennings, M., Maxwell, A., O’Connell, R., & Gillan, C. M. (2021). Model-based planning deficits in compulsivity are linked to faulty neural representations of task structure. Journal of Neuroscience, 41(30), 6539–6550. https://doi.org/10.1523/jneurosci.0031-21.2021
Shahar, N., Hauser, T. U., Moutoussis, M., Moran, R., Keramati, M., NSPN consortium, & Dolan, R. J. (2019). Improving the reliability of model-based decision-making estimates in the two-stage decision task with reaction-times and drift-diffusion modeling. PLOS Computational Biology, 15(2), e1006803. https://doi.org/10.1371/journal.pcbi.1006803
Sharp, P. B., Dolan, R. J., & Eldar, E. (2021). Disrupted state transition learning as a computational marker of compulsivity. Psychological Medicine. https://doi.org/10.1017/s0033291721003846
Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory STAI (Form Y). Mind Garden.
Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18(6), 643–662. https://doi.org/10.1037/h0054651
Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., & Cardenas, S. J. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19(2), 176–188. https://doi.org/10.1037/1040-3590.19.2.176
van Buuren, S., & Groothuis-Oudshoorn, K. (2011). mice: Multivariate imputation by chained equations in R. Journal of Statistical Software, 45(3), 1–67.
van der Straten, A., van Leeuwen, W., Denys, D., van Marle, H., & van Wingen, G. (2020). The effect of distress on the balance between goal-directed and habit networks in obsessive-compulsive disorder. Translational Psychiatry, 10(1), 73. https://doi.org/10.1038/s41398-020-0744-7
Wagenmakers, E. J., Love, J., Marsman, M., Jamil, T., Ly, A., Verhagen, J., Selker, R., Gronau, Q. F., Dropmann, D., Boutin, B., & Meerhoff, F. (2018). Bayesian inference for psychology. Part II: Example applications with JASP. Psychonomic Bulletin & Review, 25(1), 58–76. https://doi.org/10.3758/s13423-017-1323-7
Wheaton, M. G., Gillan, C. M., & Simpson, H. B. (2019). Does cognitive-behavioral therapy affect goal-directed planning in obsessive-compulsive disorder? Psychiatry Research, 273, 94–99. https://doi.org/10.1016/j.psychres.2018.12.079
Zainal, N. H., & Newman, M. G. (2018). Worry amplifies theory-of-mind reasoning for negatively valenced social stimuli in generalized anxiety disorder. Journal of Affective Disorders, 227, 824–833. https://doi.org/10.1016/j.jad.2017.11.084
Zondervan-Zwijnenburg, M., Peeters, M., Depaoli, S., & Van de Schoot, R. (2017). Where do priors come from? Applying guidelines to construct informative priors in small sample research. Research in Human Development, 14(4), 305–320. https://doi.org/10.1080/15427609.2017.1370966
Funding
An anonymous donation supported the current study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Nur Hani Zainal, Joan Camprodon, Jennifer L. Greenberg, Aura M. Hurtado, Joshua E. Curtiss, Rebecca Matilde Berger-Gutierrez, Claire M. Gillan, Sabine Wilhelm declare that they have no conflict of interest.
Ethical Approval
Ethics approval was obtained from the IRB of each data collection site.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Animal Rights
No animal studies were carried out by the authors for this article.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Zainal, N.H., Camprodon, J.A., Greenberg, J.L. et al. Goal-Directed Learning Deficits in Patients with OCD: A Bayesian Analysis. Cogn Ther Res 47, 243–254 (2023). https://doi.org/10.1007/s10608-022-10348-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10608-022-10348-3