title: Motivation and value influences in the relative balance of goal-directed and habitual behaviours in obsessive-compulsive disorder.
abstract: Our decisions are based on parallel and competing systems of goal-directed and habitual learning, systems which can be impaired in pathological behaviours. Here we focus on the influence of motivation and compare reward and loss outcomes in subjects with obsessive-compulsive disorder (OCD) on model-based goal-directed and model-free habitual behaviours using the two-step task. We further investigate the relationship with acquisition learning using a one-step probabilistic learning task. Forty-eight OCD subjects and 96 healthy volunteers were tested on a reward and 30 OCD subjects and 53 healthy volunteers on the loss version of the two-step task. Thirty-six OCD subjects and 72 healthy volunteers were also tested on a one-step reversal task. OCD subjects compared with healthy volunteers were less goal oriented (model-based) and more habitual (model-free) to reward outcomes with a shift towards greater model-based and lower habitual choices to loss outcomes. OCD subjects also had enhanced acquisition learning to loss outcomes on the one-step task, which correlated with goal-directed learning in the two-step task. OCD subjects had greater stay behaviours or perseveration in the one-step task irrespective of outcome. Compulsion severity was correlated with habitual learning in the reward condition. Obsession severity was correlated with greater switching after loss outcomes. In healthy volunteers, we further show that greater reward magnitudes are associated with a shift towards greater goal-directed learning further emphasizing the role of outcome salience. Our results highlight an important influence of motivation on learning processes in OCD and suggest that distinct clinical strategies based on valence may be warranted.
authors.affiliation: Department of Psychiatry, Addenbrookes Hospital, University of Cambridge, Cambridge, UK.|Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.|Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
authors.forename: V
authors.initials: V
authors.lastname: Voon
authors.affiliation: Department of Psychiatry, Addenbrookes Hospital, University of Cambridge, Cambridge, UK.
authors.forename: K
authors.initials: K
authors.lastname: Baek
authors.affiliation: Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Enander
authors.affiliation: Department of Psychiatry, Addenbrookes Hospital, University of Cambridge, Cambridge, UK.|Department of Psychology, University of Cambridge, Cambridge, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Worbe
authors.affiliation: Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.|Department of Psychology, University of Cambridge, Cambridge, UK.
authors.forename: L S
authors.initials: LS
authors.lastname: Morris
authors.affiliation: Department of Psychiatry, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
authors.forename: N A
authors.initials: NA
authors.lastname: Harrison
authors.affiliation: Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.|Department of Psychology, University of Cambridge, Cambridge, UK.
authors.forename: T W
authors.initials: TW
authors.lastname: Robbins
authors.affiliation: Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Rück
authors.affiliation: Center for Neural Science, Department of Psychology, New York University, New York, NY, USA.
authors.forename: N
authors.initials: N
authors.lastname: Daw
mesh_terms: D000328:Adult; D005260:Female; D006040:Goals; D006184:Habits; D006801:Humans; D008297:Male; D009042:Motivation; D009771:Obsessive-Compulsive Disorder / Q000523:psychology; D011597:Psychomotor Performance; D012201:Reward