title: Think twice: Impulsivity and decision making in obsessive-compulsive disorder.
abstract: OBJECTIVE
  Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls.
  
  
  METHODS
  We assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task.
  
  
  RESULTS
  OCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task.
  
  
  CONCLUSIONS
  OCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.
authors.affiliation: Department of Neurofarba, University of Florence , Florence, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Grassi
authors.affiliation: Department of Neurofarba, University of Florence , Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pallanti
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena , Siena, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Righi
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam , Amsterdam, the Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Figee
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam , Amsterdam, the Netherlands.
authors.forename: Mariska
authors.initials: M
authors.lastname: Mantione
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam , Amsterdam, the Netherlands.
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
authors.affiliation: Department of Neurofarba, University of Florence , Florence, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Piccagliani
authors.affiliation: Department of Mental Health, University of L'Aquila , L'Aquila, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Department of Mental Health, University of L'Aquila , L'Aquila, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Stratta
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000175:diagnosis / Q000523:psychology; D003657:Decision Making; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology; D012201:Reward; D012309:Risk-Taking; D000068356:Self-Control / Q000523:psychology*; D013850:Thinking
keywords: OCD; behavioral addiction; decision making; impulsivity; neuroeconomics; probabilistic reasoning