Deficiency Of Goal-directed Behavior Is Related To The Clinical Symptoms In Obsessive Compulisive Disorder

Objective:To investigate whether there is a defect in goal-directed control in patients with obsessive-compulsive disorder compared to healthy controls,and whether there is an association between the goal-directed control deficiency of obsessive-compulsive patients and their clinical symptoms.Methods:A case-control method was used to study the differences of goal-directed control ability between patients with obsessive-compulsive disorder and healthy controls.30 patients who meet the criteria for obsessive-compulsive disorder diagnosis according to the diagnostic criteria for obsessive-compulsive disorder in the American Diagnostic and Statistical Manual of Mental Disorders?DSM-IV?and the criteria for the enrollment were selected,as well as healthy volunteers with no significant difference in age,gender,and education level.After the brief screening of international neuropsychiatric interview M.I.N.I.5.0 and Obsessive-compulsive personality disorder subscale of SCID-II,patients with obsessive-compulsive disorder and healthy controls were recruited into the research.First of all,some basic demographic information and indexes of medical history were collected from both obsessive-compulsive patients and healthy controls.Secondly,Yale-Brown Obsessive-compulsive disorder scale?Y-BOCS?,Hamilton Anxiety Scale?HAMA?,and 24 items for Hamilton Depression Scale(HAMD₂₄)were adopted to assess obsessive-compulsive symptoms,anxiety symptoms,and depression symptoms.Thirdly,two sets of neuropsychological tests,named Modified Two-step Sequential Learning Tasks and Probabilistic categorization tasks,were conducted to investigate the goal-directed mode of decision-making model of obsessive-compulsive patients and healthy controls.These tests were programmed on Matlab2015b with psychtoolbox package.At last,pre-process of the behavioral data was processed on Matlab2015b,and SPSS21.0 was used to analyze the data with statistical t-test,chi-square test,repeated measure anova analysis,and Pearson correlation analysis.Results:Firstly,as for the demographic information comparison,30cases of obsessive-compulsive disorder and 30 cases of healthy controls has no significant difference in gender,age and education level.Secondly,as for comparison of clinical assessment results,obsessive-compulsive patients score significantly higher than those of the healthy controls.Thirdly,results of neuropsychological test show that in the Modified Two-step Sequential Learning Paradigm,there is no significant difference in the goal-directed index between the obsessive-compulsive patients and the healthy controls and there is a significant difference in the interaction between the transition variable and the outcome variable.Score of interaction between transition variable and outcome variable in obsessive-compulsive patients is significantly higher.In Probabilistic Categorization Tasks,there is no significant difference in the correct rate and subjective value beta,and there is a significant difference in the reaction time,sum weight and slope of the psychometric curve.Reaction time and sum weight of the obsessive-compulsive patients is significantly higher than those of healthy controls,while their slope of psychometric curve is significantly reduced.Finally,as for the association between neuropsychological tests and clinical assessment scale,there is no significant difference between patients at various history index levels in neuropsychological tests.Goal-directed index of obsessive-compulsive patients in the Modified Two-step Sequential Learning Tasks is not significantly correlated with any clinical scale or medical history index.In Probabilistic categorization task,the correct rate of obsessive-compulsive patients is significantly correlated with scores of compulsion subscale,with a moderate,negative correlation.Conclusions:Compared with healthy controls,patients with obsessive-compulsive disorder have deficiency in goal-directed decision-making mode,and their goal-directed deficit is significantly,negatively associated with compulsive behavior in obsessive-compulsive symptoms.