ArticleJournal of child psychology and psychiatry, and allied disciplines2022
Atypical action updating in a dynamic environment associated with adolescent obsessive-compulsive disorder.
Article in Journal of child psychology and psychiatry, and allied disciplines, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 20 citations in OpenAlex.
- Drops in confidence precede symptoms of obsessive-compulsive disorder.Nature communications · 2026Article
- The metacognitive paradox of OCD: confidence is globally reduced but shows increased sensitivity to local evidence.Research square · 2025Article
- Article
- Compulsive avoidance in youths and adults with OCD: an aversive pavlovian-to-instrumental transfer study.Translational psychiatry · 2024Article
- Learning and metacognition under volatility in GD: Lower learning rates and distorted coupling between action and confidence.Journal of behavioral addictions · 2024Article
- How computational psychiatry can advance the understanding and treatment of obsessive-compulsive disorder.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2023Article
- Computational mechanisms of belief updating in relation to psychotic-like experiences.Frontiers in psychiatry · 2023Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundComputational research had determined that adults with obsessive-compulsive disorder (OCD) display heightened action updating in response to noise in the environment and neglect metacognitive information (such as confidence) when making decisions. These features are proposed to underlie patients' compulsions despite the knowledge they are irrational. Nonetheless, it is unclear whether this extends to adolescents with OCD as research in this population is lacking. Thus, this study aimed to investigate the interplay between action and confidence in adolescents with OCD.
methodsTwenty-seven adolescents with OCD and 46 controls completed a predictive-inference task, designed to probe how subjects' actions and confidence ratings fluctuate in response to unexpected outcomes. We investigated how subjects update actions in response to prediction errors (indexing mismatches between expectations and outcomes) and used parameters from a Bayesian model to predict how confidence and action evolve over time. Confidence-action association strength was assessed using a regression model. We also investigated the effects of serotonergic medication.
resultsAdolescents with OCD showed significantly increased learning rates, particularly following small prediction errors. Results were driven primarily by unmedicated patients. Confidence ratings appeared equivalent between groups, although model-based analysis revealed that patients' confidence was less affected by prediction errors compared to controls. Patients and controls did not differ in the extent to which they updated actions and confidence in tandem.
conclusionsAdolescents with OCD showed enhanced action adjustments, especially in the face of small prediction errors, consistent with previous research establishing 'just-right' compulsions, enhanced error-related negativity, and greater decision uncertainty in paediatric-OCD. These tendencies were ameliorated in patients receiving serotonergic medication, emphasising the importance of early intervention in preventing disorder-related cognitive deficits. Confidence ratings were equivalent between young patients and controls, mirroring findings in adult OCD research.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.