Manipulating levels of uncertainty in a decision making task for obsessive-compulsive disorder.

Objective: The study aims to investigate whether manipulating levels of uncertainty would influence performance in a decision-making task in obsessive-compulsive disorder (OCD).

Methods: This case-control study compares the performance in beads task (measuring reflection/decisional impulsivity) performance and trait impulsivity (Short Urgency-Premeditation-Perseverance-Sensation Seeking-Positive Urgency (UPPS-P)) in patients with OCD (n=65) and non-clinical controls (n=45). Mann Whitney U test was carried out to assess between-group differences.

Results: The OCD group had significantly lesser draws to decision (U=1845 , p=.019) and subjective decisional-certainty (U=1518, p=0.00) in the low-uncertainty (85:15) condition , higher scores of negative urgency (U= 2163, p=<0.001) and lower scores on sensation-seeking (U= 907.5, p=.001) in the UPPS-P. However, the comparison of beads task performance does not survive correction for multiple comparisons.

Conclusion: Patients with OCD engage in impulsive decision-making in the lower-uncertainty condition in comparison to healthy controls, despite low subjective certainty of the decision. They also had increased scores on the trait impulsivity factor of negative urgency. Future studies may explore the relationship between trait impulsivity as well as the contributions of symptom severity, anxiety and decisional certainty to impulsivity in OCD.