Cognitive performance and specific deficits in OCD symptom dimensions : III. Decision-making and impairments in risky choices

Objective : To investigate ambiguous and risky decision-making in obsessive-compulsive disorder (OCD) patients grouped according to established primary symptom dimensions. The difficulties of OCD patients in real-life quite often seem related to situations of decision-making, for example, whether to check the door or clean the house. Decisionmaking appears on the face of it impaired in the clinical OCD setting in the context of doubting and uncertainty. Methods : The participants were administered the Iowa Gambling Task and the Cambridge Gambling Task, reputed to be established measures of ambiguous and risky decision-making respectively. Background measures included assessments with standard clinical and psychological questionnaires. The OCD patients (n=72) were grouped according to their primary symptom dimensions using the Dimensional Yale-Brown Obsessive-Compulsive Scale and compared with a healthy control group (n=66). Results : Risky decision-making related to rationality was impaired for patients in the dimensions symmetry/order and sexual/religious, and the deliberation time to make a decision was particularly slow for patients in the dimensions safety and contamination. A deficit in ambiguous decision-making was found in patients showing aggressive and symmetry/ order symptoms. Conclusion : This study is believed to be the first to present selective deficits in different OCD symptom dimensions related to decision-making. The data confirm the necessary role of intact interactions between cognitive and emotional processing.