People with obsessive-compulsive disorder (OCD) suffer from intrusive and obsessive thoughts. In response to these thoughts, we are often forced to engage in repetitive behaviors and rituals to relieve our pain. For people diagnosed with OCD, performing these elaborate rituals can interfere with daily life. Although rituals provide short-term relief, they have long-term negative consequences (such as decreased productivity). Therefore, people with OCD are often characterized as impulsive or lacking self-control.
But how do they perform on typical impulsivity tasks?One characteristic measure of impulsivity is delay discounting. This is the extent to which people prefer smaller, faster rewards over larger, slower rewards. Delay discounting allows people to make a series of choices between a small amount of money they can receive today (e.g., $10 now) and a larger amount of money they can receive after a delay (e.g., $20 in 7 days). will be measured.
Delay discounting is higher in people with disorders such as substance use disorders and borderline personality disorder, where impulsivity is a major symptom. However, most previous studies on delay discounting in OCD have been inconclusive, with some studies finding normal delay discounting in OCD patients and others finding higher-than-average delay discounting. There was also a study that showed. These previous studies had small sample sizes and often recruited OCD patients treated with pharmacotherapy (e.g., selective serotonin reuptake inhibitors), so we wonder if there really is no effect of OCD on discounting. , or whether the effect was simply there was difficult to know. Since it is small, it may be hidden due to the effects of medication.
To address these limitations, I recently collaborated with a global team of OCD researchers from Brazil, India, the Netherlands, South Africa, and the United States to investigate whether OCD patients differ from healthy participants in delay discounting. I investigated. Approximately 50 OCD patients (not on medication) and 50 healthy participants were recruited from each site, resulting in a total sample size of 268 OCD patients and 256 healthy control participants. Great care was taken to harmonize discount tasks across sites. The results were conclusive: OCD patients did not differ from healthy participants in delay discounting.
How do we reconcile this invalid finding with the reality that OCD patients are unable to resist the urge for immediate relief provided by rituals? Now, how can the results of this task be interpreted? Despite their popularity, delay discounting tasks may not actually measure the ability to resist immediate gratification. Rather, it may be measuring negative expectations about the future. Indeed, within the OCD group in our study, delay discounting was not associated with impulsive (e.g., drug use) or compulsive (e.g., hand washing) behaviors. Rather, people with OCD were more depressed, anxious, and reluctant to wait for delayed rewards. Depressed and anxious people tend to prefer immediate rewards over delayed ones, perhaps because they have a pessimistic view of future outcomes.
In summary, this recent study has two major implications. First, the tendency to prioritize immediate rewards is more likely due to a negative view of the future than an inability to resist temptation. Second, people with OCD are not necessarily impulsive and can become compulsive. They may have difficulty resisting the urge to perform rituals, but that doesn’t mean they don’t see value in pursuing long-term rewards or planning for the future. (In fact, one study of people with obsessive-compulsive personality disorder found that they were more future-oriented than healthy participants.)
This study’s conclusion is due not only to its large and diverse sample, but also to the fact that it controlled for other factors that may influence delay discounting, such as age, gender, education, socio-economic status, and general intelligence. will also be strengthened. Large-scale research collaborations like the Global OCD Study are accelerating our ability to gain psychological insight, allowing us to better understand decision-making processes and develop more effective treatments for disorders such as OCD. Helpful.
