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Compulsivity Reveals a Novel Dissociation between Action and Confidence

Published version
Peer-reviewed

Type

Article

Change log

Authors

Vaghi, MMS 
Luyckx, F 
Sule, A 
Fineberg, NA 
Robbins, TW 

Abstract

Confidence and actions are normally tightly interwoven—if I am sure that it is going to rain, I will take an umbrella—therefore, it is difficult to understand their interplay. Stimulated by the ego-dystonic nature of obsessive-compulsive disorder (OCD), where compulsive actions are recognized as disproportionate, we hypothesized that action and confidence might be independently updated during learning. Participants completed a predictive-inference task designed to identify how action and confidence evolve in response to surprising changes in the environment. While OCD patients (like controls) correctly updated their confidence according to changes in the environment, their actions (unlike those of controls) mostly disregarded this knowledge. Therefore, OCD patients develop an accurate, internal model of the environment but fail to use it to guide behavior. Results demonstrated a novel dissociation between confidence and action, suggesting a cognitive architecture whereby confidence estimates can accurately track the statistic of the environment independently from performance.

Description

Keywords

beliefs, action, confidence, metacognition, compulsivity, learning, uncertainty, computational psychiatry, obsessive-compulsive disorder

Journal Title

Neuron

Conference Name

Journal ISSN

0896-6273
1097-4199

Volume Title

96

Publisher

Elsevier
Sponsorship
Wellcome Trust (102612/Z/13/Z)
Wellcome Trust (104631/Z/14/Z)
Medical Research Council (G1000183)
B.D.M. was supported by Wellcome Trust and Royal Society (Sir Henry Dale Fellowship 102612/A/13/Z). T.W.R. was supported by Wellcome Trust (Senior Investigator Award 104631/Z/14/Z). M.M.V. is supported by a Pinsent Darwin Scholarship in Mental Pathology and an Angharad Dodds John Bursary in Mental Health and Neuropsychiatry.
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