Arbitration between Action Strategies in Obsessive-Compulsive Disorder

Neuroscientist. 2016 Apr;22(2):188-98. doi: 10.1177/1073858414568317. Epub 2015 Jan 20.

Abstract

Decision making in a complex world, characterized both by predictable regularities and by frequent departures from the norm, requires dynamic switching between rapid habit-like, automatic processes and slower, more flexible evaluative processes. These strategies, formalized as "model-free" and "model-based" reinforcement learning algorithms, respectively, can lead to divergent behavioral outcomes, requiring a mechanism to arbitrate between them in a context-appropriate manner. Recent data suggest that individuals with obsessive-compulsive disorder (OCD) rely excessively on inflexible habit-like decision making during reinforcement-driven learning. We propose that inflexible reliance on habit in OCD may reflect a functional weakness in the mechanism for context-appropriate dynamic arbitration between model-free and model-based decision making. Support for this hypothesis derives from emerging functional imaging findings. A deficit in arbitration in OCD may help reconcile evidence for excessive reliance on habit in rewarded learning tasks with an older literature suggesting inappropriate recruitment of circuitry associated with model-based decision making in unreinforced procedural learning. The hypothesized deficit and corresponding circuitry may be a particularly fruitful target for interventions, including cognitive remediation.

Keywords: arbitration; fMRI; functional connectivity; habit; obsessive-compulsive disorder (OCD); prefrontal cortex.

Publication types

  • Review

MeSH terms

  • Animals
  • Decision Making / physiology*
  • Humans
  • Learning / physiology
  • Neuroimaging
  • Obsessive-Compulsive Disorder / diagnostic imaging
  • Obsessive-Compulsive Disorder / pathology*
  • Obsessive-Compulsive Disorder / physiopathology*
  • Prefrontal Cortex / diagnostic imaging
  • Prefrontal Cortex / pathology*