Action-sequence learning, habits and automaticity in obsessive-compulsive disorder

Banca, Paula; Herrojo Ruiz, Maria; Gonzalez-Zalba, Miguel Fernando; Biria, Marjan; Marzuki, Aleya A.; Piercy, Thomas; Sule, Akeem; Fineberg, Naomi Anne and Robbins, Trevor William. 2023. Action-sequence learning, habits and automaticity in obsessive-compulsive disorder. eLife, 12, RP87346. ISSN 2050-084X [Article]

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Abstract or Description

Enhanced habit formation, greater automaticity and impaired goal/habit arbitration in obsessive-compulsive disorder (OCD) are key hypotheses from the goal/habit imbalance theory of compulsion which have not been directly investigated. This article tests these hypotheses using a combination of newly developed behavioral tasks. First, we trained patients with OCD and healthy controls, using a novel smartphone app, to perform chunked action sequences, previously shown to engage habit brain circuitry. The motor training was daily over one month period. There was equivalent procedural learning and attainment of habitual performance (measured with an objective criteria of automaticity) in both groups, despite greater subjective habitual tendencies in patients with OCD, self-reported via a recently developed questionnaire. We then used a combination of follow-up behavioral tasks to further assess the arbitration between previous automatic and new goal-directed action sequences. We found no evidence for impairments of goal/habit arbitration in OCD following re-evaluation based on monetary feedback, although there was a greater preference for engaging in the trained habitual sequence under certain conditions which may have derived from its intrinsic value. These findings may lead to a reformulation of the goal/habit imbalance hypothesis in OCD. Finally, OCD patients with higher compulsivity scores and habitual tendencies showed more engagement with the motor habit-training app and reported symptom alleviation, with implications for its potential use as a form of habit reversal therapy.

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Additional Information:

This research was funded by the Wellcome Trust: a Sir Henry Postdoctoral Research Fellowship (Grant 204727/Z/16/Z) to PB and a Wellcome Trust Senior Investigator Award (Grant 104631/Z/14/Z) to TWR. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted paper version arising from this submission. MB was supported by MHRUK and Angharad-Dodds Bursaries. AAM was supported as a research assistant funded by the aforementioned Wellcome Trust grant TWR.

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The source data for all figures and analyses are provided with this paper. They are available in the Open Science Framework, in the following link:

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1 March 2023Submitted
21 March 2023Accepted
26 June 2023Published Online

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Date Deposited:

24 May 2023 08:23

Last Modified:

30 Apr 2024 14:38

Peer Reviewed:

Yes, this version has been peer-reviewed.


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