Counterfactual processing of economic action-outcome alternatives in obsessive-compulsive disorder: further evidence of impaired goal-directed behavior.
Counterfactual processing of economic action-outcome alternatives in obsessive-compulsive disorder: further evidence of impaired goal-directed behavior.
复制标题
DOI：
10.1016/j.biopsych.2013.01.018
复制
发表时间：
2014-04-15
影响因子：
10.6
通讯作者：
Robbins, Trevor W.
中科院分区：
文献类型：
--
作者：
Gillan, Claire M.;Morein-Zamir, Sharon;Kaser, Muzaffer;Fineberg, Naomi A.;Sule, Akeem;Sahakian, Barbara J.;Cardinal, Rudolf N.;Robbins, Trevor W.
强迫症（OCD）是一种自动的、不可控的行为和强迫性反思的障碍。有证据表明，强迫症患者很难执行目标导向的行动，而是表现出重复的刺激反应习惯行为。这可能是由于刺激-反应习惯关联的过度形成，或者是由于使用结果价值来指导行为的能力受损。我们通过检查反事实决策来研究后者，这是一种利用比较预期行动-结果情景来指导经济选择的能力。我们使用经济选择范式测试了20名强迫症患者和20名匹配的健康对照受试者的决策（正向反事实）和情感反应（反向反事实），该范式先前揭示了精神分裂症患者和眶额皮质病变患者对反事实情绪的体验和回避的衰减。使用反事实比较来指导决策的强迫症患者减少了，他们主要依赖于期望值。与之前显示的伴随这种决策风格的冷漠情感反应不同，强迫症患者报告对他们选择的结果以及典型的后悔和宽慰的反事实比较的情感反应增加。强迫症患者表现出一种决策模式，与目标导向的正向模型的中断一致，将决策建立在暂时存在的（更理性的）期望值计算上。与这种决策方式相反，强迫症患者的情绪反应比对照组更为极端和被动。这些结果与强迫症中目标导向认知控制被破坏的描述一致。
Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD.
登录
查看更多内容
影响因子：
3.6
作者：
Foa, EB;Huppert, JD;Salkovskis, PM
通讯作者：
Salkovskis, PM
影响因子：
2.9
作者：
Camille, N.;Pironti, V. A.;Clark, L.
通讯作者：
Clark, L.
影响因子：
14.5
作者：
Berlin, HA;Rolls, ET;Kischka, U
通讯作者：
Kischka, U
影响因子：
56.9
作者：
Camille, N;Coricelli, G;Sirigu, A
通讯作者：
Sirigu, A
影响因子：
6.1
作者：
KAHNEMAN, D;TVERSKY, A
通讯作者：
TVERSKY, A