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Obsessive-compulsive behaviour: a disorder of decision-making
Perminder S Sachdev1, Gin S Malhi
1School of Psychiatry, University of New South Wales, Sydney, Australia. p.sachdev@unsw.edu.au
The Australian and New Zealand Journal of Psychiatry
|September 20, 2005
Summary
Obsessive-compulsive disorder (OCD) may be understood as a decision-making disorder. Neurobiological research on decision-making and OCD reveals shared brain region abnormalities, suggesting new treatment avenues.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Science
Background:
- Compulsive indecisiveness is a hallmark of obsessive-compulsive disorder (OCD).
- Growing interest in the neurobiology of decision-making offers a new perspective on OCD.
- Conceptualizing OCD through the lens of decision-making processes is increasingly relevant.
Purpose of the Study:
- To review neurobiological decision-making studies.
- To examine the convergence between decision-making neurobiology and OCD neurobiology.
- To propose a decision-making framework for understanding and treating OCD.
Main Methods:
- Selective review of neurobiological decision-making research.
- Examination of neurobiological findings in obsessive-compulsive disorder.
- Synthesis of findings to identify common neural substrates.
Main Results:
- Decision-making involves interconnected neural systems including the dorsolateral, orbitofrontal, and anterior cingulate cortices.
- These systems interact with limbic regions (amygdala) and basal ganglia for choice, reward, and behavioral execution.
- Abnormalities in these brain regions are implicated in OCD, leading to decision-making deficits, particularly with affect-laden choices.
Conclusions:
- Viewing OCD as a decision-making disorder provides novel avenues for research.
- This conceptualization may lead to innovative physical and behavioral-cognitive treatment strategies for OCD.
- Understanding the neurobiology of decision-making is crucial for advancing OCD therapeutics.