Searching for an Anchor in an Unpredictable World: A Computational Model of Obsessive Compulsive Disorder
Searching for an Anchor in an Unpredictable World: A Computational Model of Obsessive Compulsive Disorder
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DOI：
10.1037/rev0000188
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发表时间：
2020-10-01
影响因子：
5.4
通讯作者：
Huppert, Jonathan D.
中科院分区：
文献类型：
--
作者：
Fradkin, Isaac;Adams, Rick A.;Huppert, Jonathan D.
在这篇文章中，我们开发了一个强迫症（OCD）的计算模型。我们认为，强迫症的特点是难以依靠过去的事件来预测患者自己的行为的后果和可能的事件的展开。在临床上，这既与患者难以信任自己的行为（因此重复这些行为）相对应，也与他们对不太可能的事件链的普遍关注相对应。重要的是，我们在贝叶斯大脑的成熟框架的基础上发展了这个想法，在贝叶斯大脑中，这种损伤被形式化为关于状态转换的过度不确定性。我们用定量模拟来说明这个想法的有效性，并用这些来形成具体的经验预测。这些预测与现有的证据进行评估，并用于描绘未来研究的方向。我们展示了强迫症中看似无关的发现和现象如何可以用模型来解释，包括持续的经验，即行动没有得到充分执行和重复行动的倾向;过度的信息收集（即，checking）;优柔寡断和病态的怀疑;过度依赖习惯而牺牲目标导向的行为;以及对感官刺激和思想的过度反应。和反馈。我们讨论了我们的模型和其他突出的强迫症模型之间的关系和相互作用，包括专注于避免伤害的模型，不只是正确的经验，或目标导向行为的障碍。最后，我们概述了潜在的临床意义，并为未来的研究提出了建议。
In this article, we develop a computational model of obsessive-compulsive disorder (OCD). We propose that OCD is characterized by a difficulty in relying on past events to predict the consequences of patients' own actions and the unfolding of possible events. Clinically, this corresponds both to patients' difficulty in trusting their own actions (and therefore repeating them), and to their common preoccupation with unlikely chains of events. Critically, we develop this idea on the basis of the well-developed framework of the Bayesian brain, where this impairment is formalized as excessive uncertainty regarding state transitions. We illustrate the validity of this idea using quantitative simulations and use these to form specific empirical predictions. These predictions are evaluated in relation to existing evidence, and are used to delineate directions for future research. We show how seemingly unrelated findings and phenomena in OCD can be explained by the model, including a persistent experience that actions were not adequately performed and a tendency to repeat actions; excessive information gathering (i.e., checking); indecisiveness and pathological doubt; overreliance on habits at the expense of goal-directed behavior; and overresponsiveness to sensory stimuli, thoughts. and feedback. We discuss the relationship and interaction between our model and other prominent models of OCD, including models focusing on harm-avoidance, not-just-right experiences, or impairments in goal-directed behavior. Finally, we outline potential clinical implications and suggest lines for future research.