The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index.
Functional Neuroimaging of Avoidance Habits in Obsessive-Compulsive Disorder
Open accessAbstract
OBJECTIVE: The purpose of this study was to determine the neural correlates of excessive habit formation in obsessive-compulsive disorder (OCD). The authors aimed to test for neurobiological convergence with the known pathophysiology of OCD and to infer, based on abnormalities in brain activation, whether these habits arise from dysfunction in the goal-directed or habit system. METHOD: Thirty-seven OCD patients and 33 healthy comparison subjects learned to avoid shocks while undergoing a functional MRI scan. Following four blocks of training, the authors tested whether the avoidance response had become a habit by removing the threat of shock and measuring continued avoidance. Task-related differences in brain activity in three regions of interest (the caudate, the putamen, and the medial orbitofrontal cortex) were tested at a statistical threshold set at <0.05 (family-wise-error corrected). RESULTS: Excessive habit formation in OCD patients, which was associated with hyperactivation in the caudate, was observed. Activation in this region was also associated with subjective ratings of increased urge to perform habits. The OCD group, as a whole, showed hyperactivation in the medial orbitofrontal cortex during the acquisition of avoidance; however, this did not relate directly to habit formation. CONCLUSIONS: OCD patients exhibited excessive habits that were associated with hyperactivation in a key region implicated in the pathophysiology of OCD, the caudate nucleus. Previous studies indicate that this region is important for goal-directed behavior, suggesting that habit-forming biases in OCD may be a result of impairments in this system, rather than differences in the buildup of stimulus-response habits themselves.
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“Moreover, impaired functional connectivity between these regions disrupts the balance between goal-directed and habitual systems, causing excessive habitual responding and a struggle to shift to goal-directed actions (16, 198, 199).”
From Neural mechanisms underlying cognitive inflexibility in obsessive-compulsive disorder: a review (2026) · cites this paper as [199]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The functional/causal relationship between obsessions and compulsions is not always clear—despite a traditional view that obsessions lead to compulsions, this may not always be the case (Abramowitz & Jacoby, 2014; Gillan et al., 2015; Gillan et al., 2016; Robbins et al., 2019).”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Gillan et al., 2015
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“Dysfunction in these areas disrupts the balance between goal-directed and habitual behaviors, contributing to the characteristic symptoms of OCD (193, 199).”
From Neural mechanisms underlying cognitive inflexibility in obsessive-compulsive disorder: a review (2026) · cites this paper as [199]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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“and that anxiety is not always causal in triggering compulsive‐like behaviors (Gillan & Robbins, 2014; Gillan et al., 2015; Gillan et al., 2014).”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Gillan et al., 2015
In the citing paper
“this bias towards increased habit formation in OCD not only applies to appetitive habits, it also extends to avoidant habits that may be more relevant to the clinical symptoms seen in patients76,77.”
From DISSECTING OCD CIRCUITS: FROM ANIMAL MODELS TO TARGETED TREATMENTS: Review: Dissecting OCD Circuits: Animals to Treatments (2015) · cites this paper as [77]
In the citing paper
“Using fMRI, the authors further found that these increased avoidance habits in OCD patients were associated with hyper-activation in the caudate nucleus, a key region in the pathophysiology of OCD and goal-directed system (Gillan et al., 2015).”
From Imbalance between the caudate and putamen connectivity in obsessive–compulsive disorder (2022) · cites this paper as Gillan et al., 2015
In the citing paper
“Together, these findings provide evidence that compulsion is associated with an imbalance between the goal-directed and habit-based system, caused by an impairment of the former system (Gillan et al., 2015).”
From Imbalance between the caudate and putamen connectivity in obsessive–compulsive disorder (2022) · cites this paper as Gillan et al., 2015
In the citing paper
“Further support for this hypothesis comes from experimental studies, which report excessive habit formation and/or an over-reliance on habitual behavior at the expense of flexible goal-directed behavior on experimental tasks in OCD [90–91], as well as in other disorders characterized by compulsive behavior including TS [92–93].”
From Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder (2021) · cites this paper as [91]
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Citations
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Metadata
- Authors
- Gillan, C. M., Apergis-Schoute, A. M., Morein-Zamir, S., Urcelay, G. P., Sule, A., Fineberg, N. A., Sahakian, B. J., & Robbins, T. W.
- Affiliations
- University of Hertfordshire (GB)
- New York University (US)
- Queen Elizabeth II Hospital (GB)
- Corresponding author
- Gillan, Claire M.
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2015-03
- Volume
- 172
- Issue
- 3
- Pages
- 284-293
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC4910868
- OpenAlex
- W2132598305
- Cited by
- 265
- References
- 49
- Citations by year
- 2026: 15 · 2025: 17 · 2024: 22 · 2023: 16 · 2022: 18 · 2021: 41 · 2020: 30 · 2019: 24 · 2018: 27 · 2017: 21 · 2016: 20 · 2015: 13
- FWCI
- 21.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Anglia Ruskin Research Online (Anglia Ruskin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, other-oa)
- Apollo (University of Cambridge) (submittedVersion)
- Funders
- Wellcome Trust (089589/Z/09/Z, 101521, 104631/Z/14/Z, 089589, G00001354, 104631)
- Medical Research Council (MR/J012084/1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, avoidance behavior, habit formation, caudate nucleus, putamen, medial orbitofrontal cortex, goal-directed behavior
- MeSH terms
- Adult, Avoidance Learning, Caudate Nucleus, Female, Habits, Humans, Male, Obsessive-Compulsive Disorder, Psychopathology, Putamen, Research Design, Prefrontal Cortex, Functional Neuroimaging
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