Characterizing a psychiatric symptom dimension related to deficits in goal-directed control

Gillan, Claire M and Kosinski, Michal and Whelan, Robert and Phelps, Elizabeth A and Daw, Nathaniel D
Elife, 5: e11305, 2016

Prominent theories suggest that compulsive behaviors, characteristic of obsessivecompulsive
disorder and addiction, are driven by shared deficits in goal-directed control, which
confers vulnerability for developing rigid habits. However, recent studies have shown that deficient
goal-directed control accompanies several disorders, including those without an obvious
compulsive element. Reasoning that this lack of clinical specificity might reflect broader issues with
psychiatric diagnostic categories, we investigated whether a dimensional approach would better
delineate the clinical manifestations of goal-directed deficits. Using large-scale online assessment of
psychiatric symptoms and neurocognitive performance in two independent general-population
samples, we found that deficits in goal-directed control were most strongly associated with a
symptom dimension comprising compulsive behavior and intrusive thought. This association was
highly specific when compared to other non-compulsive aspects of psychopathology. These data
showcase a powerful new methodology and highlight the potential of a dimensional, biologicallygrounded
approach to psychiatry research.