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Goal-Directed Learning Deficits in Patients with OCD: A Bayesian Analysis

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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).

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Notes

  1. Due to space constraints, we offer details of the psychometric properties of the tests herein in Appendix A of the online supplementary materials (OSM).

  2. 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.

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Funding

An anonymous donation supported the current study.

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Correspondence to Nur Hani Zainal.

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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.

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Supplementary file1 (DOCX 13784 kb)

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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

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  • DOI: https://doi.org/10.1007/s10608-022-10348-3

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