Atypical action updating in a dynamic environment associated with adolescent obsessive-compulsive disorder

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Science

Background:

• Adults with obsessive-compulsive disorder (OCD) exhibit altered action updating and decision-making, potentially explaining irrational compulsions.
• Research on these cognitive mechanisms in adolescent OCD is limited, necessitating further investigation.

Purpose of the Study:

• To examine the relationship between action adjustment and confidence in adolescents diagnosed with OCD.
• To determine if cognitive patterns observed in adult OCD extend to the adolescent population.

Main Methods:

• A predictive-inference task was administered to 27 adolescents with OCD and 46 controls.
• Bayesian modeling analyzed how actions and confidence change with prediction errors.
• The influence of serotonergic medication on these cognitive processes was assessed.

Main Results:

• Adolescents with OCD demonstrated heightened learning rates, especially after minor prediction errors, primarily in unmedicated individuals.
• While confidence levels appeared similar, model analysis indicated OCD patients' confidence was less sensitive to prediction errors.
• No significant difference was found in the synchronized updating of actions and confidence between groups.

Conclusions:

• Adolescent OCD involves enhanced action adjustments to small errors, aligning with 'just-right' compulsions and decision uncertainty.
• Serotonergic medication mitigated these cognitive tendencies, highlighting the importance of early intervention.
• Confidence ratings in adolescents with OCD mirrored adult findings, remaining largely unaffected by prediction errors.