Abstract
Patients with obsessive-compulsive disorder (OCD) can be described as cautious and hesitant, manifesting an excessive indecisiveness that hinders efficient decision making. However, excess caution in decision making may also lead to better performance in specific situations where the cost of extended deliberation is small. We compared 16 juvenile OCD patients with 16 matched healthy controls whilst they performed a sequential information gathering task under different external cost conditions. We found that patients with OCD outperformed healthy controls, winning significantly more points. The groups also differed in the number of draws required prior to committing to a decision, but not in decision accuracy. A novel Bayesian computational model revealed that subjective sampling costs arose as a non-linear function of sampling, closely resembling an escalating urgency signal. Group difference in performance was best explained by a later emergence of these subjective costs in the OCD group, also evident in an increased decision threshold. Our findings present a novel computational model and suggest that enhanced information gathering in OCD can be accounted for by a higher decision threshold arising out of an altered perception of costs that, in some specific contexts, may be advantageous.
Highlights
A core feature of psychiatric illness includes personal suffering and functional impairments in daily life [1,2] often coupled with a negative impact on a sufferer’s social environment [3]
When analyzing the number of points won in the two conditions separately, a repeated-measures ANOVA confirmed a difference in the main effect of group (F(1,30) = 13.48, p = .001, marginal means: obsessive-compulsive disorder (OCD): 964, CI: 861–1067, controls: 703, CI: 600– 806)
Post-hoc t-tests revealed the group difference was primarily driven by the decreasing condition (decreasing condition: OCD: 1104±182, controls: 744±227, t(30) = 4.94, p
Summary
A core feature of psychiatric illness includes personal suffering and functional impairments in daily life [1,2] often coupled with a negative impact on a sufferer’s social environment [3]. Whilst this overall negative impact is well recognised, the possibility that some manifestations of psychopathology might be beneficial is rarely a focus of consideration. Patients with OCD show a high level of indecisiveness that impairs efficiency of decision making, even for decisions of little relevance [2,9,10]. It is interesting to conjecture whether these same features might be beneficial in specific contexts, for example where lengthy deliberation carries little cost relative to the cost of a wrong decision
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