How Do Compulsive Habits Develop in People with OCD?

Researchers from the University of Cambridge believe a misfiring in the brain’s control system may be responsible for the compulsions involved in obsessive compulsive disorder or OCD. The findings of their study were published in the American Journal of Psychiatry.

The Study

In a study paid for by the Wellcome Trust, Cambridge researchers scanned and studied information from the brains of 37 people with OCD and 33 healthy control subjects, who didn’t have the disorder. The study participants performed a simple pedal-pressing behavioral response to avoid a low electrical shock administered to the wrist. The team discovered the patients with OCD were less able to stop the pedal-pressing activity, and this was linked to excessive brain activity in the caudate nucleus, an area which must fire correctly in order for a person to control a habit.

Basic imaging studies have long established the caudate is over-active when the symptoms of OCD are aggravated in a patient. That the habits researchers trained in these individuals in the lab also triggered the caudate to become overly stimulated adds credibility to the suggestion that impulses in OCD may be the result of the brain’s habit system.
The Cambridge researchers believe these findings are not specific to OCD and that in fact, habits might be behind many aspects of psychiatry.

Dr. Claire Gillan of the Department of Psychology at Cambridge states, “It’s not just OCD; there are a range of human behaviors that are now considered examples of compulsivity, including drug and alcohol abuse and binge-eating. What all these behaviors have in common is the loss of top-down control, perhaps due to miscommunication between regions that control our habit and those such as the prefrontal cortex that normally help control volitional behavior. As compulsive behaviors become more ingrained over time, our intentions play less and less of a role in what we actually do.”

Co-author of the study Professor Barbara Sahakian of New York University added, “This study emphasizes the importance of treating OCD early and effectively before the dysfunctional behavior becomes entrenched and difficult to treat. We will now focus on the implications of our work for future therapeutic strategies for these compulsive behaviors.”

Conclusion to the Study

Dr. John Isaac, Head of Neuroscience and Mental Health at the Wellcome Trust said, “Research such as this marks a shift in how we understand Obsessive Compulsive Disorder, a condition which affects hundreds of thousands of lives in the UK alone. Unravelling the underlying causes of OCD could lead to improved treatment of the condition, and may provide an important step forward in the management of compulsion in other forms, from binge-eating to alcohol abuse.”