title: Enhanced avoidance habits in obsessive-compulsive disorder.
abstract: BACKGROUND
  Obsessive-compulsive disorder (OCD) is a psychiatric condition that typically manifests in compulsive urges to perform irrational or excessive avoidance behaviors. A recent account has suggested that compulsivity in OCD might arise from excessive stimulus-response habit formation, rendering behavior insensitive to goal value. We tested if OCD patients have a bias toward habits using a novel shock avoidance task. To explore how habits, as a putative model of compulsivity, might relate to obsessions and anxiety, we recorded measures of contingency knowledge, explicit fear, and physiological arousal.
  
  
  METHODS
  Twenty-five OCD patients and 25 control subjects completed a shock avoidance task designed to induce habits through overtraining, which were identified using goal-devaluation. The relationship between habitual behavior, erroneous cognitions, and physiological arousal was assessed using behavior, questionnaires, subjective report, and skin conductance responses.
  
  
  RESULTS
  A devaluation sensitivity test revealed that both groups could inhibit unnecessary behavioral responses before overtraining. Following overtraining, OCD patients showed greater avoidance habits than control subjects. Groups did not differ in conditioned arousal (skin conductance responses) at any stage. Additionally, groups did not differ in contingency knowledge or explicit ratings of shock expectancy following the habit test. Habit responses were associated with a subjective urge to respond.
  
  
  CONCLUSIONS
  These data indicate that OCD patients have a tendency to develop excessive avoidance habits, providing support for a habit account of OCD. Future research is needed to fully characterize the causal role of physiological arousal and explicit fear in habit formation in OCD.
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; Department of Psychology, University of Cambridge, Cambridge. Electronic address: claire.gillan@gmail.com.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Gillan
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; Department of Psychology, University of Cambridge, Cambridge.
authors.forename: Sharon
authors.initials: S
authors.lastname: Morein-Zamir
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge.
authors.forename: Gonzalo P
authors.initials: GP
authors.lastname: Urcelay
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; South Essex Partnership Trust, Springhouse, Biggleswade Hospital, Bedfordshire; Department of Psychiatry, University of Cambridge, Cambridge.
authors.forename: Akeem
authors.initials: A
authors.lastname: Sule
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; Department of Psychiatry, University of Cambridge, Cambridge.
authors.forename: Valerie
authors.initials: V
authors.lastname: Voon
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; Department of Psychiatry, University of Cambridge, Cambridge.
authors.forename: Annemieke M
authors.initials: AM
authors.lastname: Apergis-Schoute
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; Department of Psychiatry, Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire; Postgraduate Medical School, University of Hertfordshire, Hatfield, United Kingdom.
authors.forename: Naomi A
authors.initials: NA
authors.lastname: Fineberg
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; Department of Psychiatry, University of Cambridge, Cambridge.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Sahakian
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge; Department of Psychology, University of Cambridge, Cambridge.
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Robbins
mesh_terms: D001143:Arousal / Q000502:physiology; D001362:Avoidance Learning; D001364:Awareness; D003071:Cognition; D003213:Conditioning, Psychological; D004597:Electroshock; D005260:Female; D005712:Galvanic Skin Response; D006184:Habits; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology / Q000523:psychology*; D057566:Self Report; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis
keywords: Avoidance; cognitive neuroscience; goal-directed learning; habit; obsessive-compulsive disorder; psychophysiology