Decision-making Impairments in OCD: An Integrated Behavioral Economics Model
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 69
- Locations
- 1
- Primary Endpoint
- Ambiguity aversion score on the Risk and Ambiguity Task
Study Overview
Brief Summary
The investigators are examining whether conditions of ambiguity during decision-making may prime intolerance of uncertainty beliefs (i.e., difficulties coping with ambiguity, unpredictability, and the future) and lead to impaired performance when individuals with obsessive-compulsive disorder (OCD) are making uncertain decisions compared to non-psychiatric controls.
Detailed Description
The primary aims of this study are to examine the extent to which individuals with OCD avoid decisions that involve ambiguity through the use of self-report and behavioral measures. Specifically, the investigators will examine how individuals with OCD minimize risk at the expense of monetary profit under conditions of ambiguity (relative to risky but unambiguous options) compared to non-psychiatric controls utilizing a series of judgment and decision-making (JDM) tasks.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Diagnostic
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Adults (age 18+)
- •Meet DSM-5 criteria for principal OCD (OCD group) or no current DSM-5 diagnosis (NPC group).
- •Sufficient fluency of English to understand study procedures and questionnaires
- •Ability to provide informed consent.
- •Comfortable and capable of using a computer to complete computer-based decision-making tasks.
Exclusion Criteria
- •Color-blindness (which prevents completion of certain tasks)
- •Acute psychosis, bipolar disorder, substance use disorder, or suicidality. All other diagnostic comorbidities will be permitted to foster the accrual of a clinically relevant sample.
- •Serious neurological disorder or impairment (e.g., brain damage, blindness), attention deficit hyperactivity disorder (ADHD), intellectual disability, or autism.
Arms & Interventions
OCD Group
Meet Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for principal OCD. These participants will complete clinician interviews, self-report questionnaires, and receive the Decision-Making Tasks Intervention.
Intervention: Decision-Making Tasks (Behavioral)
Non-psychiatric Control Group
No current DSM-5 diagnosis. These participants will also complete clinician interviews, self-report questionnaires, and receive the Decision-Making Tasks Intervention.
Intervention: Decision-Making Tasks (Behavioral)
Outcomes
Primary Outcomes
Ambiguity aversion score on the Risk and Ambiguity Task
Time Frame: Day 1
In the Risk and Ambiguity Task participants make repeated choices between a certain payoff vs. a gamble. On low ambiguity trials, the likelihood of the gamble is known (i.e., "risky" lottery). On high ambiguity trials, the likelihood of the gamble is unknown (i.e., "ambiguous" lottery). Ambiguity aversion = (number of 50% risky lotteries chosen / total number of 50% risky lotteries) - (# of ambiguous lotteries chosen / total number of ambiguous lotteries).
Average adjusted pump scores on the Balloon Analogue Risk Task (BART)
Time Frame: Day 1
In the BART participants blow up a series of virtual balloons. With each pump: (a) they earn 5 cents that accumulate in a temporary reserve, but (b) the likelihood of the balloon exploding increases. When this occurs participants lose the money in their temporary reserve. At any time, participants can choose to transfer their earnings to a permanent savings bank (and move to the next balloon). Thus, participants weigh the likelihood of the negative outcome (i.e., the balloon exploding and losing money) with the potential gains (i.e., 5 cents per pump). In the low ambiguity version of the task, the likelihood of the balloon exploding is known. In the high ambiguity version, the likelihood of the balloon exploding is unknown. The average adjusted pump score = average number of pumps on trials in which the balloons did not explode.
Secondary Outcomes
- Money spent on draws to decision (DTD) in the Beads Task(Day 1)
- Intolerance of Uncertainty Scale (IUS-12)(Day 1)
Investigators
Ryan Jane Jacoby
Ryan Jane Jacoby, Ph.D., Clinical Psychologist, OCD and Related Disorders Program
Massachusetts General Hospital