Reward learning in obsessive-compulsive disorder: an attentional perspective

Abstract Obsessive-compulsive disorder (OCD) has been recently associated with aberrant reward learning. In the realm of attention, a previous study using an eye-tracking version of the reward-based value modulated attentional capture (VMAC) task showed a greater interference by high-reward signaling distractors than low-reward signaling distractors among obsessive-compulsive individuals compared with controls. However, this study used individuals with high and low levels of obsessive-compulsive symptoms, restricting generalizability to clinical OCD, while also inherently confounding OCD and anxiety. The present study addressed both these limitations. The eye-tracking-based VMAC task was completed by clinically diagnosed OCD participants ( n =32), participants with anxiety disorders (AN; n =30), and healthy controls (HC; n =31). Attentional capture by high and low reward-signaling distractors was assessed via number of fixations on these distractors and number of first saccades toward them. Both fixation and saccade data showed a heightened VMAC effect (i.e., higher attentional capture by high-reward signaling distractors than low-reward signaling distractors) among OCD participants, compared with both AN and HC participants. Surprisingly, the AN group showed no VMAC effect, reflecting blunted attentional reward learning. The current VMAC task did not include an extinction phase, and hence could not examine the endurance of the VMAC effect when no reward is available. Also, the study did not explore potential performance differences across different OCD subtypes.