Risk-aversion with both high and low ambiguity: Elevated OCD symptom severity and intolerance of uncertainty are associated with less risk-taking in an OCD patient sub-sample

In clinical settings, patients with obsessive compulsive disorder (OCD) are generally risk-averse, especially in the context of uncertainty. However, the literature examining risk-taking in OCD is conflicting, and studies directly comparing risk-taking under conditions of high versus low ambiguity are scant. In the current study, 60 participants (30 OCD, 30 non-psychiatric controls) completed a modified version of the Balloon Analogue Risk Task (BART) in which they “pumped” a virtual balloon and earned five cents for each pump; however, if the balloon popped, they lost the money accumulated in that round. The task had two levels of ambiguity: the risk level of each balloon (i.e., likelihood of it exploding) was either visually displayed (low ambiguity) or unknown (high ambiguity). The outcome was the average number of pumps for balloons that did not explode, with higher scores indicating more risk-taking. There was a main effect of ambiguity, such that participants took more risks on the low ambiguity BART compared to the high ambiguity version. Contrary to hypotheses, there was no ambiguity level x diagnostic group interaction. Within the OCD group, however, intolerance of uncertainty, OCD symptom severity, trait anxiety, and depression severity were negatively associated with risk-taking. Without a clinical control group, we're unable to determine specificity of these effects to OCD. The within-subjects design may have contributed to carryover effects. Findings underscore the importance of symptom dimensional measurement beyond mere presence or absence of diagnosis when predicting risk-aversion in OCD.