title: Compulsivity in obsessive-compulsive disorder and addictions.
abstract: Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating. In this review, we investigate the neurobiological overlap between compulsivity in substance-use disorders, OCD and behavioral addictions as a validation for the construct of compulsivity that could be adopted in the Research Domain Criteria (RDoC). The reviewed data suggest that compulsivity in OCD and addictions is related to impaired reward and punishment processing with attenuated dopamine release in the ventral striatum, negative reinforcement in limbic systems, cognitive and behavioral inflexibility with diminished serotonergic prefrontal control, and habitual responding with imbalances between ventral and dorsal frontostriatal recruitment. Frontostriatal abnormalities of compulsivity are promising targets for neuromodulation and other interventions for OCD and addictions. We conclude that compulsivity encompasses many of the RDoC constructs in a trans-diagnostic fashion with a common brain circuit dysfunction that can help identifying appropriate prevention and treatment targets.
authors.affiliation: Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Figee
authors.affiliation: Neuroscience Campus Amsterdam, Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Tommy
authors.initials: T
authors.lastname: Pattij
authors.affiliation: Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; The Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
authors.forename: Ingo
authors.initials: I
authors.lastname: Willuhn
authors.affiliation: Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands.
authors.forename: Judy
authors.initials: J
authors.lastname: Luigjes
authors.affiliation: Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.affiliation: Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Goudriaan
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
authors.affiliation: Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Robbins
authors.affiliation: Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; The Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands. Electronic address: d.denys@gmail.com.
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
mesh_terms: D000818:Animals; D016739:Behavior, Addictive / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D003131:Combined Modality Therapy; D003192:Compulsive Behavior / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D003193:Compulsive Personality Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D003342:Corpus Striatum / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019317:Evidence-Based Medicine; D005625:Frontal Lobe / Q000503:physiopathology; D006184:Habits; D006801:Humans; D008959:Models, Neurological; D009415:Nerve Net / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D011678:Punishment; D012054:Reinforcement, Psychology; D012201:Reward; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D009626:Terminology as Topic
keywords: Addiction; Behavioral addiction; Frontostriatal network; Obsessive–compulsive disorder; RDoC; Substance-use