Processing uncertainty in obsessive-compulsive disorder: Study

A neurological illness called obsessive-compulsive disorder is characterised by compulsive repetitive behaviours like cleaning and checking even when there is obvious objective proof that the environment is clean, orderly, and proper. Now, a recent study in the Elsevier journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging employs brain imaging to take a deeper look at the mechanisms underlying uncertainty processing in OCD. Because these impairments appeared in both the OCD patients and those who had improved after capsulotomy surgery, that suggests this cognitive mechanism might be a core feature underlying why OCD develops, irrespective of how severe the symptoms might be.” Dr Voon added, “The imaging data may provide a representation of how OCD patients might struggle with their symptoms. Whereas healthy individuals might be able to say, 'this is clean' and stop cleaning, people with OCD might struggle with that sense of certainty, and perhaps spend more time wondering 'is this still a bit dirty, or is this clean enough,' and clean further.” The findings make clear that OCD is not a disorder of over-cleanliness but one of disordered brain processing of certainty. Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said of the work, “This very interesting study provides an important new perspective on the mechanism underlying the disabling symptoms of OCD and suggests that developing new therapies targeting uncertainty processing in the disorder, as well as the neural systems underlying these processes, such as the dACC and AI, may offer new hope to those suffering from this difficult to treat and disabling disorder.”