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Obsessive-compulsive disorder (OCD) is frequently conceptualized as a failure of executive control over behavior-generating systems, resulting in anxiety generated by obsessions. This Dutch functional magnetic resonance imaging (fMRI) study of 18 OCD patients (11 with high-risk assessment obsessions; 7 with contamination obsessions) and 19 healthy controls illustrates an additional dimension — dependence on compulsive behavior because of defective reward processing.
Study participants were given a task that involved responding to a cue that signaled either a monetary reward or no reward. All subjects reacted more rapidly to reward cues than to nonreward cues, but OCD patients were significantly slower than controls to respond to reward cues.…