Action sequence learning, habits, and automaticity in obsessive-compulsive disorder

Paula Banca, Maria Herrojo Ruiz, Miguel Fernando Gonzalez-Zalba, Marjan Biria, Aleya A Marzuki, Thomas Piercy, Akeem Sule, Naomi A Fineberg, Trevor W Robbins

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This study investigates the goal/habit imbalance theory of compulsion in obsessive-compulsive disorder (OCD), which postulates enhanced habit formation, increased automaticity, and impaired goal/habit arbitration. It directly tests these hypotheses using newly developed behavioral tasks. First, OCD patients and healthy participants were trained daily for a month using a smartphone app to perform chunked action sequences. Despite similar procedural learning and attainment of habitual performance (measured by an objective automaticity criterion) by both groups, OCD patients self-reported higher subjective habitual tendencies via a recently developed questionnaire. Subsequently, in a re-evaluation task assessing choices between established automatic and novel goal-directed actions, both groups were sensitive to re-evaluation based on monetary feedback. However, OCD patients, especially those with higher compulsive symptoms and habitual tendencies, showed a clear preference for trained/habitual sequences when choices were based on physical effort, possibly due to their higher attributed intrinsic value. These patients also used the habit-training app more extensively and reported symptom relief post-study. The tendency to attribute higher intrinsic value to familiar actions may be a potential mechanism leading to compulsions and an important addition to the goal/habit imbalance hypothesis in OCD. We also highlight the potential of smartphone app training as a habit reversal therapeutic tool.
Original languageEnglish
Article numberRP87346
Pages (from-to)1-39
Number of pages39
Early online date9 May 2024
Publication statusPublished - 9 May 2024


  • habits
  • action sequences
  • Human
  • goal-directed behavior
  • automaticity
  • obsessive-compulsive disorder
  • motor sequence learning
  • neuroscience
  • human
  • Humans
  • Middle Aged
  • Male
  • Learning
  • Young Adult
  • Mobile Applications
  • Adult
  • Female
  • Surveys and Questionnaires
  • Obsessive-Compulsive Disorder/psychology
  • Habits


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