How adolescent-OCD impacts learning and decision-making

Obsessive-compulsive disorder (OCD) is a highly disabling condition with an average age of onset in adolescence. Despite this, OCD and its effects on cognitive functioning is largely understudied in youths. Thus, my PhD research aimed to understand how learning and decision-making may be atypical in young people diagnosed with OCD.

Using cognitive tasks (like simple computer games) and computational modelling (a fancy way of analysing cognitive data using mathematical formulas), I found that learning in adolescent-OCD is particularly impacted when conditions are highly uncertain (i.e., when payoffs after making decisions is probabilistic); affected adolescents feel compelled to switch choices often and (over)explore different possibilities, at the expense of task performance.

This research has important implications for how excessively careful decision-making and indecisiveness make it difficult for youths with OCD to navigate daily life, particularly in academic settings.

Relevant publications:

Marzuki, A. A., Sahakian, B. J., & Robbins, T. W. (2020). Are candidate neurocognitive endophenotypes of OCD present in paediatric patients? A systematic review. Neuroscience & Biobehavioral Reviews, 108, 617-645. Link

Marzuki, A. A., Tomić, I., Ip, S. H. Y., Gottwald, J., Kanen, J. W., Kaser, M., … & Robbins, T. W. (2021). Association of environmental uncertainty with altered decision-making and learning mechanisms in youths with obsessive-compulsive disorder. JAMA network open, 4(11), e2136195-e2136195. Link

Marzuki, A. A., Vaghi, M. M., Conway‐Morris, A., Kaser, M., Sule, A., Apergis‐Schoute, A., … & Robbins, T. W. (2022). Atypical action updating in a dynamic environment associated with adolescent obsessive–compulsive disorder. Journal of Child Psychology and Psychiatry, 63(12), 1591-1601. Link

Marzuki, A. A., Banca, P., Garofalo, S., Degni, L. A., Dalbagno, D., Badioli, M., … & Robbins, T. W. (2024). Compulsive avoidance in youths and adults with OCD: an aversive pavlovian-to-instrumental transfer study. Translational Psychiatry, 14(1), 308. Link