Loosen, Alisa M.;
(2023)
Complex Decision Making and Uncertainty in Obsessive-Compulsive Disorder.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Obsessive-Compulsive Disorder (OCD) is a prevalent and highly debilitating mental health disorder that is not yet well understood. This thesis offers a comprehensive investigation of OCD from a range of cognitive and computational perspectives. It begins with a review of existing studies relevant to the computational psychiatry of OCD. Based on the review, I propose a neurocomputational framework and highlight consistent findings and open questions in the field. In the first empirical study in Chapter 3, I probe the ecological validity of a dominant finding: the critical role of uncertainty for obsessive-compulsive (OC) symptoms and its link to information search. I show that in the general public, OC symptoms were disproportionately affected by the Covid-19 pandemic, a situation of high uncertainty, and positively associated with increased information seeking. Next, I evaluate the psychometric quality of a widely used cognitive behavioural task that yielded important findings on OCD (Chapter 4). I provide support for the task and guidance on which measures should and should not be used in future studies while pointing out that its link to sub-clinical psychiatric symptoms is unclear. In Chapter 5, I combine two dominant lines of research on OCD by investigating cognitive flexibility and confidence in a study that compares patients with OCD to healthy controls. The results showed no significant differences in accuracy between groups, but patients with OCD exhibited longer reaction times and lower confidence ratings with increased susceptibility to external feedback. In Chapter 6, I examine these findings further using a novel cognitive flexibility task that includes measures of decision-making uncertainty and attentional patterns. Overall, this thesis contributes to the field of OCD research by highlighting and challenging existing cognitive findings on OCD. It identifies important research avenues and adds novel findings pointing out the important role of decision making and uncertainty in OCD.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Complex Decision Making and Uncertainty in Obsessive-Compulsive Disorder |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10169417 |
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