Link Between Confidence and Action Broken in People with OCD

“When you have Obsessive Compulsive Disorder, you don’t really get quiet moments,” says poet Neil Hilborn in his renowned poem “OCD”. What he means is you don’t really get a break from your obsessions and your compulsions, characteristic of the disorder. You experience repetitive thoughts and urges and feel compelled to act on them—even despite your efforts to forget them or distract yourself from their manifestation. In the poem, Neil is led by his OCD to repeat sentences, turn the lights “on and off, and on and off”, and lock the door a million times. And while it is clear that he feels powerfully inclined to do so, scientists just aren’t sure why—yet. However, a recent study “Compulsivity Reveals a Novel Dissociation between Action and Confidence” published in Neuron claims that a much better understanding is in the near future, thanks to the utilization of an emerging mathematical model.

With the goal of studying the connection between confidence and action, the researchers behind this study created and administered a test to 49 volunteers, 24 of which had OCD and 25 of which made up a control group. This test required the subjects to play a video game that involved catching coins in a bucket. After a few rounds, both groups of participants were confident in where they believed the coins to be coming from. However, only those in the control group (whom did not have OCD) were able to guide their buckets based on that belief; those with OCD instead second guessed themselves, despite the confidence they felt, and continuously moved the bucket around in pursuit of each coin.

Thanks to this experiment, the research team was able to better understand this suspected “broken link” in individuals with OCD. “Someone with OCD will tell you that they know their hands are clean, but nevertheless they can’t stop washing them. Two things that are normally linked together—confidence and action—have become uncoupled,” senior author Benedetto De Martino explains. “This study shows that the actions of people with OCD don’t often take into account what they’ve already learned,” he continues.

The researchers made great advancements in that they were able to successfully measure the degree of dissociation between one’s beliefs and actions and discover that this degree could predict OCD symptom severity. “It’s the first time anyone has been able to calculate the degree of dissociation and show that it correlates with the severity of the disease,” says De Martino.

This study is of rare kind, as it’s part of a fairly new field of research called computational psychiatry, which concentrates its efforts on developing mathematical models to better understand brain defects and their detrimental behaviors. “This model not only gives us greater insight into OCD, but also into the normal, healthy brain as well,” says De Martino. “Just as studying people with lesions in the hippocampus has historically taught us about the inner workings of memory, studying people with OCD can give us new insights into how beliefs and actions are linked.”

In addition to unveiling this groundbreaking discovery, these tools and technology may also lead to earlier detection and earlier intervention of diagnosis, according to De Martino. This only promises a better future for people like Neil dealing with Obsessive Compulsive Disorder or other mental illnesses—it would be a “gamechanger”.

Source: Cell Press “Actions Are At Odds With Beliefs For People With OCD.” NeuroscienceNews. NeuroscienceNews, 28 September 2017. <http://neurosciencenews.com/ocd-action-belief-7612/>.

Original Research: Full open access research for “Compulsivity Reveals a Novel Dissociation between Action and Confidence” by Matilde M. Vaghi, Fabrice Luyckx, Akeem Sule, Naomi A. Fineberg, Trevor W. Robbins, and Benedetto De Martino in Neuron. Published online September 28 2017 doi:10.1016/j.neuron.2017.09.006

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