How habits become compulsions? Exploring the neural basis of habit perseveration in Obsessive-Compulsive Disorder.


Study ID: 32570
Short Title: Investigation of neural basis of habit perseveration in OCD
Organisation: Southern Health NHS Foundation Trust
Location: Southern Health NHS Foundation Trust
Condition: Mental Health
Main Specialty: Mental Health
Expected End Date: 30/12/2019
Postcode: SO30 3JB
Contact Name: SHFT Research
Contact Email: research@southernhealth.nhs.uk
Active: Yes

Inclusion Criteria

All participants will be between the age of 18 and 70 years old and meet DSM−V diagnostic criteria for OCD.


For the OCD groups, the inclusion criteria will be a score of 12 or above on the YBOCS scale (obsessive­-compulsive disorder rating scale).

Exclusion Criteria

Control Groups: Exclusion criteria are a significant comorbid axis−1 disorder (e.g. Schizophrenia) as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM­ V­), any current or previous neurological deficits, history of excessive drug or alcohol use, any medication affecting central nervous system central nervous system function, and problems with eyesight that are not being corrected by lenses. To avoid misunderstanding of tasks and instructions, non−English speakers will also be excluded. OCD group: Exclusion criteria are, apart from OCD, any other significant comorbid axis−1 disorder as defined by the DSM­ V­ (e.g. Major Depressive Disorder, Schizophrenia), any current or previous neurological deficits, history of excessive drug or alcohol use, and problems with eyesight that are not being corrected by lenses. To avoid misunderstanding of tasks and instructions, non−English speakers will also be excluded.

Study summary:

Obsessive-compulsive disorder (OCD) is an extremely disabling psychiatric illness, with enormous socio-economic burden. Intrusive thoughts and compulsive stereotyped behaviours are the most prominent symptoms. A novel neurobiological account of OCD (the habit model) has recently emerged, proposing that compulsions might result from a disruption in the balance between two distinct but interactive brain systems: the goal directed system, which supports behaviours that are intentional and sensitive to goal value and the habitual system, which underlies more automatic actions. This imbalance favours the habitual system, hence OCD has been characterised as a disorder of maladaptive habit learning. Although promising, the habit model needs further testing. First, the mechanism by which habits become compulsions have yet to be specified. Second, because of their theoretical need for extended training, habits are difficult to measure directly in OCD. Through exploring the power of smart phones, this research proposal aims to overcome these limitations by creating real habits in the laboratory to directly investigate the neural mechanisms underlying the transition from habits to compulsions. We plan to use functional and resting state magnetic resonance imaging and magnetic resonance spectroscopy to test the hypothesis that the cortico-striatal imbalance underpinning habit-based responding dominance in behavioural performance is driven by a frontal functional and neurochemical dyscontrol. This research is crucial for further understanding of the neural basis of compulsions and for the development of new therapeutical approaches to help patients flexibly adjust their behaviour and thus resist compulsions.


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