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January 2025 — A recent study published in Clinical Psychological Science suggests that individuals with obsessive-compulsive disorder (OCD) make decisions similarly to those without the condition, challenging long-held assumptions about decision-making impairments in psychiatric disorders.
Obsessive-compulsive disorder, while treatable, has long been associated with lower quality of life, affecting education and financial stability. As many struggle to achieve the same outcomes as neurotypical individuals, the cognitive factors contributing to these challenges have been the subject of research. The latest study, led by Karolina Lempert and her co-authors, examines whether decision-making could play a key role in these disparities.
Lempert’s team focused on two cognitive measures: delay discounting and risk tolerance. Delay discounting refers to the tendency to favor immediate rewards over larger, delayed ones, often tied to impulsive behavior. Meanwhile, risk tolerance measures a person’s willingness to take chances when the outcome is uncertain. The researchers hypothesized that people with OCD would exhibit higher delay discounting and lower risk tolerance compared to the general population, potentially making decision-making even more challenging.
The study involved 268 people with OCD and 256 individuals without the disorder from diverse countries, including Brazil, India, the Netherlands, South Africa, and the United States. Over the course of 51 trials, participants were asked to choose between receiving a smaller immediate reward or a larger delayed one. Surprisingly, the results revealed no significant difference in delay discounting between individuals with OCD and those without, even when accounting for factors like age, education, and sex. However, people with both OCD and high levels of anxiety showed a stronger preference for immediate rewards.
The second part of the study involved 60 trials measuring risk aversion, where participants had to choose between a guaranteed smaller reward or a gamble for a larger one. Again, no significant differences were found between those with OCD and the control group.
These findings challenge the assumption that individuals with OCD, or many psychiatric conditions, necessarily experience high delay discounting or low risk tolerance. Instead, Lempert suggests that this might be the case only in certain conditions, providing new insights for diagnosing and understanding decision-making tendencies in psychiatric disorders.
“Understanding how specific symptoms are linked to decision-making could lead to more individualized interventions in the future,” Lempert said.
The researchers hope their findings will pave the way for future cognitive studies that may offer new directions for understanding and treating OCD, emphasizing the need for further exploration into other aspects of cognition and decision-making.
Disclaimer: This study presents findings based on research conducted in a controlled environment. The results should not be generalized to all individuals with OCD or other psychiatric disorders. Further research is necessary to fully understand the implications of these findings and their potential for clinical application.
For further reading, see the full study: Karolina M. Lempert et al, Delay Discounting and Risk Tolerance in Obsessive-Compulsive Disorder: Results From the Global OCD Study, Clinical Psychological Science (2024). DOI: 10.1177/21677026241289927.
