title: A model-based analysis of decision making under risk in obsessive-compulsive and hoarding disorders.
abstract: Attitudes towards risk are highly consequential in clinical disorders thought to be prone to "risky behavior", such as substance dependence, as well as those commonly associated with excessive risk aversion, such as obsessive-compulsive disorder (OCD) and hoarding disorder (HD). Moreover, it has recently been suggested that attitudes towards risk may serve as a behavioral biomarker for OCD. We investigated the risk preferences of participants with OCD and HD using a novel adaptive task and a quantitative model from behavioral economics that decomposes risk preferences into outcome sensitivity and probability sensitivity. Contrary to expectation, compared to healthy controls, participants with OCD and HD exhibited less outcome sensitivity, implying less risk aversion in the standard economic framework. In addition, risk attitudes were strongly correlated with depression, hoarding, and compulsion scores, while compulsion (hoarding) scores were associated with more (less) "rational" risk preferences. These results demonstrate how fundamental attitudes towards risk relate to specific psychopathology and thereby contribute to our understanding of the cognitive manifestations of mental disorders. In addition, our findings indicate that the conclusion made in recent work that decision making under risk is unaltered in OCD is premature.
authors.affiliation: Department of Neurology, University of California, San Francisco, United States. Electronic address: garanovich@gmail.com.
authors.forename: Gabriel J
authors.initials: GJ
authors.lastname: Aranovich
authors.affiliation: Information Systems and Decision Sciences, California State University, Fullerton, United States.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Cavagnaro
authors.affiliation: Department of Psychology, The Ohio State University, United States.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pitt
authors.affiliation: Department of Psychology, The Ohio State University, United States.
authors.forename: Jay I
authors.initials: JI
authors.lastname: Myung
authors.affiliation: Department of Psychiatry, University of Florida, United States.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mathews
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001290:Attitude; D003657:Decision Making / Q000502:physiology*; D004569:Electroencephalography; D005260:Female; D005717:Games, Experimental; D000067836:Hoarding Disorder / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D000069550:Machine Learning; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000523:psychology; D011336:Probability; D011569:Psychiatric Status Rating Scales
keywords: Computational psychiatry; Decision making; Hoarding disorder; Obsessive-compulsive disorder; Risk aversion; Value-based decision making