title: Arbitration between Action Strategies in Obsessive-Compulsive Disorder.
abstract: Decision making in a complex world, characterized both by predictable regularities and by frequent departures from the norm, requires dynamic switching between rapid habit-like, automatic processes and slower, more flexible evaluative processes. These strategies, formalized as "model-free" and "model-based" reinforcement learning algorithms, respectively, can lead to divergent behavioral outcomes, requiring a mechanism to arbitrate between them in a context-appropriate manner. Recent data suggest that individuals with obsessive-compulsive disorder (OCD) rely excessively on inflexible habit-like decision making during reinforcement-driven learning. We propose that inflexible reliance on habit in OCD may reflect a functional weakness in the mechanism for context-appropriate dynamic arbitration between model-free and model-based decision making. Support for this hypothesis derives from emerging functional imaging findings. A deficit in arbitration in OCD may help reconcile evidence for excessive reliance on habit in rewarded learning tasks with an older literature suggesting inappropriate recruitment of circuitry associated with model-based decision making in unreinforced procedural learning. The hypothesized deficit and corresponding circuitry may be a particularly fruitful target for interventions, including cognitive remediation.
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, USA Learning Based Recovery Center, VA Connecticut Health System, West Haven, CT, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Gruner
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, USA Department of Psychology, Yale University, New Haven, CT, USA Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Anticevic
authors.affiliation: Department of Psychology, Yale University, New Haven, CT, USA Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA Department of Neurobiology, Yale University, New Haven, CT, USA.
authors.forename: Daeyeol
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, USA Department of Psychology, Yale University, New Haven, CT, USA Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA Child Study Center, Yale University, New Haven, CT, USA christopher.pittenger@yale.edu.
authors.forename: Christopher
authors.initials: C
authors.lastname: Pittenger
mesh_terms: D000818:Animals; D003657:Decision Making / Q000502:physiology*; D006801:Humans; D007858:Learning / Q000502:physiology; D059906:Neuroimaging; D009771:Obsessive-Compulsive Disorder / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: arbitration; fMRI; functional connectivity; habit; obsessive-compulsive disorder (OCD); prefrontal cortex