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Related Experiment Video

Updated: Mar 18, 2026

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
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Doubt in the Insula: Risk Processing in Obsessive-Compulsive Disorder.

Judy Luigjes1, Martijn Figee1, Philippe N Tobler2

  • 1Department of Psychiatry, Academic Medical Center, University of AmsterdamAmsterdam, Netherlands; Brain Imaging Center, Academic Medical Center, University of AmsterdamAmsterdam, Netherlands.

Frontiers in Human Neuroscience
|July 6, 2016
PubMed
Summary
This summary is machine-generated.

Obsessive-compulsive disorder (OCD) patients show reversed insula responses to risk compared to healthy individuals. This suggests the insula plays a key role in the excessive risk-avoidance seen in some OCD patients.

Keywords:
fMRIinsulaobsessive-compulsive disorderrisk avoidancerisk processing

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Science

Background:

  • Obsessive-compulsive disorder (OCD) involves extensive cleaning or checking, often seen as harm avoidance.
  • The neural basis of risk attitude in OCD remains largely unknown.
  • Previous beliefs suggest OCD patients are generally more risk-averse.

Purpose of the Study:

  • To investigate the neural basis of risk attitude in OCD patients.
  • To compare neural activity during risk processing between OCD patients and healthy controls (HCs).
  • To examine the relationship between specific OCD symptoms and risk aversion.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) to measure neural activity during risk processing.
  • Behavioral paradigm to assess risk attitude in OCD patients and HCs.
  • Analysis of insula responses in relation to risk levels and aversion.

Main Results:

  • OCD patients exhibited opposite insula responses to high versus low risk compared to HCs.
  • A positive correlation between insula activity and risk aversion was found in OCD patients, versus a negative correlation in controls.
  • Patients with doubt/checking symptoms were significantly more risk-averse than other OCD subgroups.

Conclusions:

  • OCD patients demonstrate a reversed pattern of risk processing mediated by the insula compared to HCs.
  • Increased insula activation may signal an abnormal urge to avoid risks in OCD patients with doubt/checking symptoms.
  • The insula is implicated in the excessive risk-avoidance characteristic of certain OCD presentations.