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Depress Anxiety. 2019 Feb;36(2):121-129. doi: 10.1002/da.22857. Epub 2018 Nov 28.

Impaired generalization of reward but not loss in obsessive-compulsive disorder.

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Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey.
Department of Psychology, Princeton University, Princeton, New Jersey.
Max Planck UCL Centre for Computational Psychiatry and Ageing Research and Wellcome Centre for Human Neuroimaging, University College London, London, UK.
Columbia University College of Physicians and Surgeons, Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York.
Department of Psychology, Columbia University, New York, New York.
Zuckerman Mind Brain Behavior Institute and Kavli Institute for Brain Science, Columbia University, New York, New York.



Generalizing from past experiences can be adaptive by allowing those experiences to guide behavior in new situations. Generalizing too much, however, can be maladaptive. For example, individuals with pathological anxiety are believed to overgeneralize emotional responses from past threats, broadening their scope of fears. Whether individuals with pathological anxiety overgeneralize in other situations remains unclear.


The present study (N = 57) used a monetary sensory preconditioning paradigm with rewards and losses to address this question in individuals with obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD), comparing them to healthy comparison subjects (HC). In all groups, we tested direct learning of associations between cues and reward vs. loss outcomes, as well as generalization of learning to novel choice options.


We found no differences between the three groups in the direct learning of stimuli with their outcomes: all subjects demonstrated intact stimulus-response learning by choosing rewarding options and avoiding negative ones. However, OCD subjects were less likely to generalize from rewards than either the SAD or HC groups, and this impairment was not found for losses. Additionally, greater deficits in reward generalization were correlated with severity of threat estimation, as measured by a subscale of the Obsessive Beliefs Questionnaire, both within OCD and across all groups.


These findings suggest that a compromised ability to generalize from rewarding events may impede adaptive behavior in OCD and in those susceptible to high estimation of threat.


cognition; decision-making; reinforcement learning; reward generalization; sensory preconditioning


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