Patients with obsessive–compulsive disorder are impaired in associative learning based on external feedback

Patients with obsessive-compulsive disorder (OCD) have to repeat their actions before feeling satisfied that the action reached its intended goal. Learning theory predicts that this may be due to a failure in the processing of external feedback. We examined the performance of 29 OCD patients and 28...

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Bibliographic Details
Published in:Psychological medicine 2009-09, Vol.39 (9), p.1519-1526
Main Authors: Nielen, M. M., den Boer, J. A., Smid, H. G. O. M.
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Anxiety disorders. Neuroses
Association Learning
Associative learning
Attention
Biological and medical sciences
Choice Behavior
Cognition & reasoning
External feedback
Feedback
Feedback, Psychological
Female
Humans
Learning
Learning theory
Male
Medical sciences
Neuropsychology
Neuroses
Obsessive compulsive disorder
Obsessive-Compulsive Disorder - diagnosis
Obsessive-Compulsive Disorder - psychology
Obsessive-compulsive disorders
Obsessive-Compulsive neuroses
Pattern Recognition, Visual
Personality Inventory - statistics & numerical data
Psychology. Psychoanalysis. Psychiatry
Psychometrics
Psychomotor Performance
Psychopathology. Psychiatry
Punishment
Reward
Signals
Statistics as Topic
Young Adult
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Summary:Patients with obsessive-compulsive disorder (OCD) have to repeat their actions before feeling satisfied that the action reached its intended goal. Learning theory predicts that this may be due to a failure in the processing of external feedback. We examined the performance of 29 OCD patients and 28 healthy volunteers on an associative learning task, in which initial learning is based solely on external feedback signals. Feedback valence was manipulated with monetary gains and losses. As predicted, OCD patients were impaired during initial, external feedback-driven learning but not during later learning stages. The emotional salience of the feedback modulated learning during the initial stage in patients and controls alike. During later learning stages, however, patients approached near-normal performance with rewarding feedback but continued to produce deficient learning with punishing feedback. OCD patients have a fundamental impairment in updating behavior based on the external outcome of their actions, possibly mediated by faulty error signals in response selection processes.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291709005297