title: Investigating the role of anticipatory reward and habit strength in obsessive-compulsive disorder.
abstract: Aims To determine the rates and associated illness characteristics of obsessive-compulsive disorder (OCD) patients who describe their symptoms as either rewarding or habitual.
  
  
  METHODS
  Seventy-three treatment-seeking OCD patients had their dominant compulsive behavior assessed with a structured interview (the Temporal Impulsive-Compulsive Scale-Revised) to track the progression of rewarding (ie, gain in positive affect), aversive (ie, decrease in negative affect), and neutral (or non-affective) states and a self-report scale (the Self-Report Habit Index) to evaluate their habitual features. Additional measures included structured diagnostic interviews for axis I and II disorders, measures of OCD symptoms severity, and a battery of instruments to comprehensively assess relevant aspects of sensitivity to reward and fear.
  
  
  RESULTS
  Almost half (49%) of our OCD patients (particularly washers) endorsed that they anticipated obtaining a reward (ie, positive affect) from the enactment of their dominant compulsive behavior. Washers stood out in that their positive affects during and after compulsive behaviors were highly (and positively) correlated with duration of illness. In contrast, habit strength did not differ between washers, checkers, and arrangers, although it also correlated with duration of illness among checkers. Furthermore, the severity of OCD and comorbidity with impulse control disorders predicted up to 35% of the variance in the habit strength of OCD behaviors.
  
  
  CONCLUSIONS
  Compulsive washing may be more clearly characterized by problems in reward processing. In contrast, duration of checking, severity of OCD, and comorbidity with impulse control disorders shape compulsive behaviors by imparting them with habitual tendencies.
authors.affiliation: 1Obsessive,Compulsive,and Anxiety Spectrum Research Program,Institute of Psychiatry,Federal University of Rio de Janeiro,Rio de Janeiro,Brazil.
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Ferreira
authors.affiliation: 2Brain & Mental Health Laboratory,Monash Institute of Cognitive and Clinical Neurosciences,Monash University,Clayton,Victoria,Australia.
authors.forename: Murat
authors.initials: M
authors.lastname: Yücel
authors.affiliation: 2Brain & Mental Health Laboratory,Monash Institute of Cognitive and Clinical Neurosciences,Monash University,Clayton,Victoria,Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Dawson
authors.affiliation: 2Brain & Mental Health Laboratory,Monash Institute of Cognitive and Clinical Neurosciences,Monash University,Clayton,Victoria,Australia.
authors.forename: Valentina
authors.initials: V
authors.lastname: Lorenzetti
authors.affiliation: 1Obsessive,Compulsive,and Anxiety Spectrum Research Program,Institute of Psychiatry,Federal University of Rio de Janeiro,Rio de Janeiro,Brazil.
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
mesh_terms: D000328:Adult; D005260:Female; D006184:Habits; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D012201:Reward
keywords: Habits; obsessive-compulsive disorder; psychopathology; reward