Does Punishment Increase Impulsivity in OCD?
February 5th, 2013
According to a recent study led by Sharon Morein-Zamir of the Department of Experimental Psychology at the University of Cambridge in the UK, individuals with obsessive compulsive behavior (OCD) are more impulsive than non-OCD individuals when they experience negative feedback or punishment. Morein-Zamir conducted the study to determine what cognitive control deficiencies, if any, were present in individuals with OCD compared to individuals with depression and anxiety. Because negative bias is present in all of these psychological conditions, Morein-Zamir wanted to see if it was especially pronounced in individuals with OCD, and particularly, if this occurred more under stress and influenced behavioral activation.
For her study, Morein-Zamir conducted a punishment/reward test on 20 individuals with OCD and 32 without. All of the participants were assessed for other mental health issues and were found to have no history of depression or anxiety. The participants were given tasks that allowed them to earn commissions. When they failed at a task, their commissions were decreased. The control participants responded to this punishment by slowing down and decreasing the time it took them to answer. However, the OCD participants did not. In fact, they increased their time to answer in response to punishment. They also exhibited more symptoms of OCD and increases in symptom severity as they received punishments. But when they were rewarded, the OCD participants performed at the same pace as the control participants.
Morein-Zamir believes that these findings demonstrate a cognitive control deficiency in OCD. Unlike the bias toward negative stimuli that is found in depression and anxiety, the behavior exhibited by the participants in this study demonstrated impulsivity. However, the impulsivity that they exhibited was also different than impulsivity and inhibitory deficits found in other mental health conditions, such as addiction or ADHD, which appear to be present continuously and not only under threat of punishment. Overall, these findings show that people with OCD maintain some cognitive flexibility, but have specific cognitive impairments under certain conditions. “The present study stresses abnormal cognitive control processing, particularly during punishment, in OCD,” said Morein-Zamir.
Reference:
Morein-Zamir, S., et al. Punishment promotes response control deficits in obsessive-compulsive disorder: Evidence from a motivational go/no-go task. Psychological medicine 43.2 (2013): 391-400. ProQuest Research Library. Web. 30 Jan. 2013.
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Comments
So what are you supposed to do?
Reward the undesired behavior?
You must take a look at what sort of punishment is being meted out. Is it punishment that is meant to teach someone a lesson in a positive way, or is it punishment that is designed to hurt instead? If it is only designed to be negative, then any other issues that are already there and certain to be exacerbated by such
Do you think that addressing this remaining cognitive flexibility is enough to help stem the OCD in certain patients? I mean, it could be a start, a different way of approaching treatment for these patients.
Nobody likes being punished. And if punishment triggers impulsivity in those with OCD that is not too surprising. After all those with OCD often do and redo things to reach a level of perfection that is ingrained in their minds. Now imagine doing all that and being told they are wrong. It would definitely trigger an impulsive response from them.
Now hoe they should handle and manage this impulsitivity is an entire new topic. But if this topic finds the problem, that would help find a solution.
Heightened levels of self-reported impulsivity may reflect the experience of anxiety in both OCD and ED populations whereas a lack of inhibitory control may represent a specific behavioral deficit in OCD.
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