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Capacity to Delay Reward Differentiates Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder
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Background Although the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has long been debated, clinical samples of OCD (without OCPD) and OCPD (without OCD) have never been systematically compared. We studied whether individuals with OCD, OCPD, or both conditions differ on symptomatology, functioning, and a measure of self-control: the capacity to delay reward.Methods Twenty-five OCD, 25 OCPD, 25 comorbid OCD + OCPD, and 25 healthy control subjects completed clinical assessments and a validated intertemporal choice task that measures capacity to forego small immediate rewards for larger delayed rewards.Results OCD and OCPD subjects both showed impairment in psychosocial functioning and quality of life, as well as compulsive behavior, but only subjects with OCD reported obsessions. Individuals with OCPD, with or without comorbid OCD, discounted the value of delayed monetary rewards significantly less than OCD and healthy control subjects. This excessive capacity to delay reward discriminates OCPD from OCD and is associated with perfectionism and rigidity.Conclusions OCD and OCPD are both impairing disorders marked by compulsive behaviors, but they can be differentiated by the presence of obsessions in OCD and by excessive capacity to delay reward in OCPD. That individuals with OCPD show less temporal discounting (suggestive of excessive self-control), whereas prior studies have shown that individuals with substance use disorders show greater discounting (suggestive of impulsivity), supports the premise that this component of self-control lies on a continuum in which both extremes (impulsivity and overcontrol) contribute to psychopathology.
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“Some studies have found significantly higher delay discounting rates in OCD patients, indicating increased impulsivity, while other studies have reported no significant differences in delay discounting between OCD patients and healthy controls (See Table 3).”
From Neural mechanisms underlying cognitive inflexibility in obsessive-compulsive disorder: a review (2026) · cites this paper as [150]
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“However, few empirical data is available on delayed reward discounting in patients with OCD [35].”
From P300 and delay-discounting in obsessive–compulsive disorder (2022) · cites this paper as [35]
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Metadata
- Authors
- Pinto, A., Steinglass, J. E., Greene, A. L., Weber, E. U., & Simpson, H. B.
- Affiliations
- New York State Psychiatric Institute (US)
- Columbia University (US)
- Corresponding author
- Pinto, Anthony
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 75
- Issue
- 8
- Pages
- 653-659
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC3969772
- OpenAlex
- W2091961865
- Cited by
- 169
- References
- 55
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 9 · 2023: 14 · 2022: 7 · 2021: 12 · 2020: 9 · 2019: 35 · 2018: 12 · 2017: 15 · 2016: 14 · 2015: 10 · 2014: 9
- FWCI
- 12.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23 MH080221, K23 MH076195, K24 MH091555)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, obsessive-compulsive personality disorder, intertemporal choice, delay discounting, self-control, impulsivity, overcontrol, obsession, compulsive behavior, perfectionism, rigidity, comorbidities, psychosocial functioning, quality of life
- MeSH terms
- Adolescent, Adult, Compulsive Personality Disorder, Diagnosis, Differential, Female, Humans, Impulsive Behavior, Male, Middle Aged, Obsessive-Compulsive Disorder, Psychiatric Status Rating Scales, Psychological Tests, Quality of Life, Reward, ROC Curve, Time Factors, Comorbidity, Young Adult
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