The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Decision-making under uncertainty in obsessive–compulsive disorder
Open accessAbstract
Obsessive compulsive disorder (OCD) produces profound morbidity. Difficulties with decision-making and intolerance of uncertainty are prominent clinical features in many patients. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants' choices were used to assess individual decision-making characteristics. OCD participants did not differ from healthy controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than healthy controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). Compared to healthy controls, individuals with OCD were less consistent in their choices and less able to identify options that should be clearly preferable. These abnormalities correlated with symptom severity. These results suggest that value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention.
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“Third, previous studies reported impaired adaption of the decision strategy during a decision-making task, suggesting lower flexibility in OCD [69, 70].”
From P300 and delay-discounting in obsessive–compulsive disorder (2022) · cites this paper as [70]
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Citations
Cites
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“, 1989a)) and severity of depression using Hamilton Depression–17 scale (HAM-D17 (Hamilton, 1960)).”
MethodThe Yale-Brown Obsessive Compulsive Scale: I. Development, Use, and Reliability
Goodman, W. K. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110048007 · Cited by 7,712 · cited 1×
“Within 1 week of behavioral testing we assessed severity of obsessions and compulsions using Yale-Brown Obsessive Compulsive Scale (Y-BOCS (Goodman et al., 1989b; Goodman et al., 1989a)) and severity of depression using Hamilton Depression–17 scale (HAM-D17 (Hamilton, 1960)).”
MethodInsel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C., & Wang, P. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09091379 · Cited by 7,067 · cited 1×
“Impairments in value-based decision formation may cut across traditional diagnostic boundaries (Insel et al., 2010; Dichter et al., 2012), which calls for measures that can detect both an overall impairment in value-based decision formation and particular abnormalities in distinct disease states.”
Insensitivity to future consequences following damage to human prefrontal cortex
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“Past studies, however, have used more complicated decision tasks, the IGT (Bechara et al., 1994) and the Game of Dice Task (Brand et al.”
MethodInfluentialMaxmin expected utility with non-unique prior
Gilboa, I., & Schmeidler, D. (1989) · Journal of Mathematical Economics · doi:10.1016/0304-4068(89)90018-9 · Cited by 4,180 · cited 5×
“The results from the two models were almost identical for both OCD patients and Controls (SM S.10); we present the results from one of the two models (Gilboa and Schmeidler, 1989).”
MethodResultInfluentialThe Yale-Brown Obsessive Compulsive Scale: II. Validity
Goodman, W. K. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110054008 · Cited by 2,799 · cited 1×
“Within 1 week of behavioral testing we assessed severity of obsessions and compulsions using Yale-Brown Obsessive Compulsive Scale (Y-BOCS (Goodman et al., 1989b; Goodman et al., 1989a)) and severity of depression using Hamilton Depression–17 scale (HAM-D17 (Hamilton, 1960)).”
MethodThe Yale-Brown Obsessive-Compulsive Scale: measures of internal consistency.
Kim, S.-W., Dysken, M., Pheley, A., & Hoover, K. M. (1994) · Psychiatry Research · doi:10.1016/0165-1781(94)90039-6 · Cited by 2,333
A framework for studying the neurobiology of value-based decision making
Rangel, A., Camerer, C., & Montague, P. R. (2008) · Nature Reviews Neuroscience · doi:10.1038/nrn2357 · Cited by 2,184 · cited 1×
“Decision-making studies, across psychology, economics, and neurobiology, generally assume that individuals aim to maximize some subjective measure of expected value (Rangel et al., 2008).”
BackgroundBartra, O., McGuire, J. T., & Kable, J. W. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2013.02.063 · Cited by 1,927 · cited 2×
“Of note, the circuitry that is linked to valuation (Bartra et al, 2013) is abnormal in OCD (Maia et al., 2008; Menzies et al., 2008).”
BackgroundRecent developments in modeling preferences: Uncertainty and ambiguity
Camerer, C., & Weber, M. (1992) · Journal of Risk and Uncertainty · doi:10.1007/bf00122575 · Cited by 1,795 · cited 3×
“Previous research has shown that individual risk attitudes are largely independent of individual ambiguity attitudes (Camerer and Weber, 1992; Huettel et al., 2006; Cohen et al., 1987; Tymula et al., 2012), stressing the significance of examining both in clinical populations.”
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Items 101–126 of 126
Perfectionism and Preference Cycles: A Behavioral Model of Deficiency-Penalized UtilityPreprint
Bayer, Y. M. (2025) · Preprints.org · doi:10.20944/preprints202504.1514.v4
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Couto, M. B., & Morgado, P. F. (2025) · Springer eBooks · doi:10.1007/978-3-031-73368-0_14
Domain-General and Domain-Specific Values and Their Role in Psychopathology
Rich, A., & Levy, I. (2026) · Springer eBooks · doi:10.1007/978-3-032-02925-6_32
Self-citationCheng, A., Konova, A. B., Powers, A. R., Corlett, P., Levy, I., Gu, X., Huys, Q. J. M., Pushkarskaya, H., Fineberg, S. K., Hauser, T. U., et al. (2026) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2026.02.009
Self-citationThe neurobiology of normal and pathological prior beliefs during cognitive control
Rondot, L. (2020) · theses.fr (ABES) · doi:10.70675/de55dc43ze329z41adz92f4z21076f73ccf6
Smithson, M. J. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0006
Creating Ignorance through Absences
Smithson, M. J. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0010
Closing Gaps and Making Connections
Smithson, M. J. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0012
Smithson, M. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.002.0005
Smithson, M. J. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0009
Smithson, M. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.002.0004
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Smithson, M. J. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0007
Smithson, M. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0004
Smithson, M. J. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0008
Ignorance Studies, Where Is Psychology?
Smithson, M. J. (2026) · Oxford University Press eBooks · doi:10.1093/9780198960614.003.0001
What Do We Think Others Are Missing?
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Altered social and cognitive control interactions during decision-making in social anxiety
Li, Y., Dam, N. T. V., Wang, Z., Luo, Y., & Xu, P. (2026) · Psychological Medicine · doi:10.1017/s0033291726103936
“However, previous decision-making studies in clinical populations have shown that risk avoidance and social avoidance are not equivalent constructs and can arise from different mechanisms (Knowles & Olatunji, 2023; Pushkarskaya et al., 2015; Starcevic et al., 2011).”
A dimensional link between gain–loss economic preferences and psychopathologyPreprint
Feng, Y.-Y., & Monosov, I. E. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.09.09.750300
Wang, Z., Wang, X., Yu, Q., Gao, F., Liu, Q., Han, Y., Jiang, Y., Li, C., Fan, J., & Zhu, X. (2026) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2026.152746
Holz, P., Hoeppner, S. S., Wilhelm, S., & Jacoby, R. J. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-026-10789-0
Актуальные вопросы диагностики, патофизиологии и лечения обсессивно-компульсивного расстройства
Сергеев, А. В., & Емельянцева, Т. А. (2026) · Психиатрия психотерапия и клиническая психология · doi:10.34883/pi.2026.17.3.024
Metadata
- Authors
- Pushkarskaya, H., Tolin, D., Ruderman, L., Kirshenbaum, A., Kelly, J. M., Pittenger, C., & Levy, I.
- Affiliations
- Yale University (US)
- Hartford Hospital (US)
- Corresponding author
- Pushkarskaya, Helen
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 69
- Pages
- 166-173
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC4562025
- OpenAlex
- W2155549704
- Cited by
- 127
- References
- 34
- Citations by year
- 2026: 23 · 2025: 12 · 2024: 14 · 2023: 18 · 2022: 9 · 2021: 12 · 2020: 11 · 2019: 12 · 2018: 6 · 2017: 7 · 2016: 3
- FWCI
- 6.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K01 MH101326-01, R01MH095790)
- National Institute on Aging (R01AG033406)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, decision making under uncertainty, intolerance of uncertainty, ambiguity, risk, value-based choice, behavioral economics, outcome valuation, decision consistency, symptom severity
- MeSH terms
- Attitude, Decision Making, Humans, Obsessive-Compulsive Disorder, Psychiatric Status Rating Scales, Psychological Tests, Risk-Taking, Severity of Illness Index, Uncertainty
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