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]
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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
Cites
Maldjian, J. A., Laurienti, P. J., Kraft, R., & Burdette, J. H. (2003) · NeuroImage · doi:10.1016/s1053-8119(03)00169-1 · Cited by 5,066 · cited 1×
“We used the PickAtlas software toolbox in SPM8 (36) to define regions of interest according to the Anatomical Automatic Labeling atlas.”
MethodBalleine, B. W., & O'Doherty, J. P. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.131 · Cited by 1,775 · cited 1×
“The present study aimed to test for neurobiological convergence in support of this possibility, drawing on a rich cross-species neuroscience literature, which has identified dissociable neural substrates of these two systems (9).”
Baxter, L. R. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820090009002 · Cited by 1,293
Yin, H. H., Knowlton, B. J., & Balleine, B. W. (2004) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2004.03095.x · Cited by 1,226 · cited 2×
“Another region in the basal ganglia, the putamen, is necessary for the formation of stimulus-response habits with practice (11, 15, 16).”
Actions and habits: The development of behavioural autonomy
Dickinson, A. (1985) · Philosophical Transactions of the Royal Society of London. B, Biological Sciences · doi:10.1098/rstb.1985.0010 · Cited by 1,217 · cited 1×
“Habits are automatic stimulus-driven behaviors that can arise under many conditions, the most commonly accepted of which is the overtraining of simple responses (2).”
The role of the dorsomedial striatum in instrumental conditioning
Yin, H. H., Ostlund, S. B., Knowlton, B. J., & Balleine, B. W. (2005) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2005.04218.x · Cited by 1,099 · cited 3×
“However, habits can also arise from failures in goal-directed control, which can render behavior habitual even very early on in training (3, 4).”
Rauch, S. L. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950010062008 · Cited by 880
Toward a neurobiology of obsessive-compulsive disorder
Graybiel, A. M., & Rauch, S. L. (2000) · Neuron · doi:10.1016/s0896-6273(00)00113-6 · Cited by 864
Local Cerebral Glucose Metabolic Rates in Obsessive-Compulsive Disorder
Baxter, L. R. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800150017003 · Cited by 860
Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder
Saxena, S., & Rauch, S. L. (2000) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70181-7 · Cited by 840 · cited 1×
“Hyperactivation in the caudate is one of the most consistent neurobiological markers of OCD symptoms (with medial orbitofrontal cortex hyperactivation being the other) (18, 19), and our data therefore lend strong support to a model of OCD centered on deficits in goal-directed control over actions, resulting in compuls…”
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Drug addiction: updating actions to habits to compulsions ten years on
Everitt, B. J., & Robbins, T. W. (2016) · Annual Review of Psychology · doi:10.1146/annurev-psych-122414-033457 · Cited by 1,225
Self-citationComputational psychiatry as a bridge from neuroscience to clinical applications
Huys, Q. J. M., Maia, T. V., & Frank, M. J. (2016) · Nature Neuroscience · doi:10.1038/nn.4238 · Cited by 1,002
Characterizing a psychiatric symptom dimension related to deficits in goal-directed control
Gillan, C. M., Kosinski, M., Whelan, R., Phelps, E. A., & Daw, N. D. (2016) · eLife · doi:10.7554/elife.11305 · Cited by 586
“…March 2016 Reviewing editor: Michael J Frank, Brown University, United States Copyright Gillan et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited.”
BackgroundSelf-citationObsessive-compulsive disorder: Puzzles and prospects
Robbins, T. W., Vaghi, M. M., & Banca, P. (2019) · Neuron · doi:10.1016/j.neuron.2019.01.046 · Cited by 510
Self-citationBrain circuitry of compulsivity
van den Heuvel, O. A., van Wingen, G., Soriano-Mas, C., Alonso, P., Chamberlain, S. R., Nakamae, T., Denys, D., Goudriaan, A. E., & Veltman, D. J. (2016) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2015.12.005 · Cited by 374
“In a recent fMRI study on habit formation in OCD patients, Gillan et al. (2015) tested, using a shock avoidance paradigm, whether habits in OCD primarily arise from dysfunction in the goal-directed (ventral) or the habit (dorsal) system.”
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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