Stopping a Response When You Really Care about the Action: Considerations from a Clinical Perspective.

Sharon Morein-Zamir,Gideon Anholt

doi:10.3390/brainsci11080979

Sharon Morein-Zamir, Gideon Anholt

Open Access

https://doi.org/10.3390/brainsci11080979

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Abstract

Response inhibition, whether reactive or proactive, is mostly investigated in a narrow cognitive framework. We argue that it be viewed within a broader frame than the action being inhibited, i.e., in the context of emotion and motivation of the individual at large. This is particularly important in the clinical domain, where the motivational strength of an action can be driven by threat avoidance or reward seeking. The cognitive response inhibition literature has focused on stopping reactively with responses in anticipation of clearly delineated external signals, or proactively in limited contexts, largely independent of clinical phenomena. Moreover, the focus has often been on stopping efficiency and its correlates rather than on inhibition failures. Currently, the cognitive and clinical perspectives are incommensurable. A broader context may explain the apparent paradox where individuals with disorders characterised by maladaptive action control have difficulty inhibiting their actions only in specific circumstances. Using Obsessive Compulsive Disorder as a case study, clinical theorising has focused largely on compulsions as failures of inhibition in relation to specific internal or external triggers. We propose that the concept of action tendencies may constitute a useful common denominator bridging research into motor, emotional, motivational, and contextual aspects of action control failure. The success of action control may depend on the interaction between the strength of action tendencies, the ability to withhold urges, and contextual factors.

Highlights

Effective stopping of maladaptive or inappropriate actions is closely linked to behavioural control and has long been of great interest to clinicians, cognitive psychologists, and neuroscientists
It is these difficulties in response inhibition that are apparent in mental health conditions such as Obsessive Compulsive Disorder (OCD)
We argue that clinically relevant behaviours to an even greater degree are embedded in specific contexts and are shaped by affect and motivation driven by perceived rewards, or in the case of OCD, perceived threats

Summary

Introduction

Effective stopping of maladaptive or inappropriate actions is closely linked to behavioural control and has long been of great interest to clinicians, cognitive psychologists, and neuroscientists. Stopping of actions appears in the conceptualisation of control processes such as executive functioning [1], and in this capacity could be representative of other self-regulation and control functions It is useful in clinically related theorising of numerous mental health disorders [2]. The staircase procedure introduces additional strategic demands as task parameters shift depending on participant performance These inhibition tasks allow the measurement of response execution in the form of latencies to the go stimuli and their accuracy, but crucially provide assessment of stopping performance, and as such are versatile in offering measures of multiple related outcome measures. A challenge to clinical research is the adequate capture and identification of proactive versus reactive stopping given the potentially confounding roles of strategic demands across groups

Response Inhibition Tasks in Clinical Research

On Caring about a Response

The Utility of Action Tendencies

Conclusions