Goal-Directed Learning and Obsessive-Compulsive Disorder: Gillan & Robbins (2014)

Question 1

2 schools of thoughts regarding the mechanisms of compulsive behaviour

Answer 1

1) cognitive account: compulsivity arises due to cognitive bias in attribution of values (costs of stopping with the compulsions are seen as higher than the benefits). Compulsions are therefore goal-directed responses to obsessions. The behaviour is only deemed compulsive by observers to which the choice appears suboptimal.
2. Habit account: compulsivity arises from goal-directed dysfunction and related excessive habit formation.

Question 2

regions for habitual vs. goal-directed control

Answer 2

goal-directed control: ventromedial prefrontal cortex & caudate
habitual control: putamen & premotor cortex

Question 3

neurobiology of OCD (in detail)

Answer 3

• Fronto-striatal loops: circuits from the frontal lobes to the striatum, and back to the FC via the thalamus show OCD associated changes.
• Caudate & orbital gyrus: specific areas that show elevated patterns of activation in OCD patients.
• Putamen: increased grey matter volumes in OCD patients.
• Putamen, OFC & insula: increased volume as a function of age (normal loss of volume was not observed as patients aged).

Question 3

appetitive instrumental learning=

Answer 3

a research paradigm in which participants learn positively reinforced stimulus-response-outcome associations. After instrumental learning, several tests are done: an outcome-devaluation test and behavioral and explicit tests of contingency knowledge.

Question 4

contingency knowledge =

Answer 4

the extent to which knowledge of one event reduces uncertainty about another

Question 5

wat is de uitkomst van appetitive instrumental learning in mensen met OCD

Answer 5

ocd patients have significant biases towards stimulus-response learning (habitual), at the expense of action-outcome learning (goal-directed)

Question 6

economic choice paradigm=

Answer 6

a research paradigm in which participants choose between 2 wheels depicting points and their respective probabilities. There is no repetition (learning) of stimulus-response-outcome pairings, so that goal-directed choice behavior in the absence of a confounding influence of habit formation over the course of training can be assessed.

Goal-directed behavior was operationalized as the degree to which potential regret influences choice behavior. Healthy adults use this to reduce their chances of experiencing regret when making decisions.

Question 7

potential regret=

Answer 7

a goal-directed computation that relies upon the comparison of prospective action-outcomes (the ability to simulate and compare options).

Question 8

economic choice paradigm in OCD

Answer 8

OCD patients had reduced influence of potential regret on decision-making, pointing to deficits in goal-directed control over action.

Question 9

2 problems with the classical view of OCD

Answer 9

1. There is clear evidence that excessive, automatic compulsive-like behaviors develop in the absence of any prior obsessions relating to them (as seen in the experiments above).
2. OCD is ego-dystonic, characterized by insight, which is something cognitive models cannot account for.

Thus: people consider the possibility that compulsions are not secondary phenomena -> the COD view.

Question 10

Compulsive-obsessive disorder (COD) view

Answer 10

the idea that obsessions are a form of post-hoc rationalization that can reduce the cognitive dissonance which occurs as a result of excessive, habitual compulsions.

Question 11

cognitive dissonance

Answer 11

a state of conflict that arises when 2 or more competing beliefs are simultaneously held. Humans are motivated to reduce this conflict by altering one of the beliefs. The same goes for when behavior contradicts belief: beliefs will be altered to match behavior.

Question 12

hoe kan je cognitive dissonance in OCD plaatsen

Answer 12

In the case of OCD, the irresistible urge to perform a compulsive behavior may engender
cognitive dissonance that is reconciled by the development of a new irrational belief about threat in the environment, making the compulsion ‘make sense’ (‘I feel compelled to clean excessively, so I must
be afraid of contamination’).

Question 13

avoidance habit paradigm=

Answer 13

In the study of the previous article, subjects were asked to provide an explanation for why they continued to make avoidance responses in the absence of the possibility for a shock. A subset reported irrational hypotheses regarding this, such as saying they thought they could still be shocked, even when they had been clearly disconnected from the shock-machine. Furthermore, ratings of shock expectancy and knowledge of contingency did not differ between patients and controls.

-> Like obsessions in OCD, the irrational fear of getting a shock was dissonant from the patients’ knowledge of the task.