Characterizing a psychiatric symptom dimension related to deficits in goal-directed control.

Claire M Gillan,Robert Whelan,Elizabeth A Phelps,Michal Kosinski,Nathaniel D Daw

doi:10.7554/elife.11305

Abstract

Prominent theories suggest that compulsive behaviors, characteristic of obsessive-compulsive disorder and addiction, are driven by shared deficits in goal-directed control, which confers vulnerability for developing rigid habits. However, recent studies have shown that deficient goal-directed control accompanies several disorders, including those without an obvious compulsive element. Reasoning that this lack of clinical specificity might reflect broader issues with psychiatric diagnostic categories, we investigated whether a dimensional approach would better delineate the clinical manifestations of goal-directed deficits. Using large-scale online assessment of psychiatric symptoms and neurocognitive performance in two independent general-population samples, we found that deficits in goal-directed control were most strongly associated with a symptom dimension comprising compulsive behavior and intrusive thought. This association was highly specific when compared to other non-compulsive aspects of psychopathology. These data showcase a powerful new methodology and highlight the potential of a dimensional, biologically-grounded approach to psychiatry research.

Highlights

Compulsivity is a theoretical clinical phenomenon that reflects the loss of control over repetitive selfdeleterious behavior seen in a range of disorders, most notably obsessive-compulsive disorder (OCD) and addiction (Everitt and Robbins, 2005; Gillan and Robbins, 2014)
In line with our hypothesis, there was a significant association between scores on the OCD questionnaire and goaldirected deficits (i.e. a negative relationship between OCD severity and model-based learning; b = À0.040, Standard Error (SE) = 0.02, p=0.049) when controlling for age, Intelligence Quotient (IQ) and gender, which have been previously reported to covary with goal-directed behavior (Eppinger et al, 2013; Schad et al, 2014; Sandstrom et al, 1998)
We tested the utility of a dimensional approach to investigating the neurocognitive basis of compulsivity using two large-scale general population samples

Summary

Introduction

Compulsivity is a theoretical clinical phenomenon that reflects the loss of control over repetitive selfdeleterious behavior seen in a range of disorders, most notably obsessive-compulsive disorder (OCD) and addiction (Everitt and Robbins, 2005; Gillan and Robbins, 2014). Researchers have suggested that compulsivity in these disorders may be partially explained by an imbalance between two different modes of control, which are more and less flexible (Everitt and Robbins, 2005; Graybiel and Rauch, 2000). Habits are behaviors that animals and humans learn to execute automatically when presented with familiar environmental cues (Dickinson, 1985). While habits are typically very useful, allowing us to efficiently perform routine actions while expending minimal cognitive effort, they cannot adapt flexibly to new situations.

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