2022 Breakthrough Award

Neural mechanisms of active avoidance in obsessive compulsive disorder

Emily Stern, PhD, & Mohammed R. Milad, PhD

Nathan Kline Institute for Psychiatric Research/Research Foundation for Mental Hygiene (Orangeburg, NY)

Award Amount: $500,000

According to behavioral models of OCD, compulsions are avoidance behaviors that alleviate distress from obsessions in the short term. Over time, this reinforces beliefs that obsessions are intolerable and that these compulsions must be performed to bring relief. One of the core aspects and main benefits of ERP is eliminating these avoidance behaviors – yet we still do not understand exactly how the brains of people with OCD work as these behaviors unfold. This study will use neuroimaging techniques and an avoidance learning task to learn what happens in the brain during avoidance behaviors in 60 people with OCD and 60 people in a control group. As people with OCD have a wide range of symptoms, it will also look at how brain function during avoidance is associated with this variability of symptoms. By looking at the neural correlates of avoidance behaviors in OCD, this study aims to provide new directions for existing treatments and potentially lead to new interventions.