{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:29:51Z","timestamp":1786368591657,"version":"build-2736575974"},"reference-count":58,"publisher":"Ubiquity Press, Ltd.","issue":"1","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CPSY"],"abstract":"<jats:p>Recent years have seen unprecedented increases in compulsive behaviors, even in previously undiagnosed populations. Yet, despite their rising prevalence and the fact that compulsions\u2014notably associated with obsessive-compulsive disorder (OCD), but also a key feature of other disorders such a hoarding or body dysmorphic disorder\u2014significantly hamper daily function, the specific mechanisms of their formation remain unknown. Previous research holds mixed findings on compulsivity-linked cognitive deficits, and, while many accounts assume that compulsions aim to reduce anxiety, most individuals with anxiety do not develop compulsions\u2014suggesting that the anxiety-reduction account is incomplete. We propose here a broader, uncertainty-resolving account of compulsivity, that bypasses the commonly-used, single-goal structure of many cognitive tasks to leverage the real-world hierarchical structure of goals\u2014with \u201clocal\u201d, short-term subgoals (e.g., \u201chow do I clean my hands?\u201d) in the service of long-term, \u201cglobal\u201d goals (\u201chow do I stay healthy?\u201d). In that framework, we suggest that compulsivity may reflect a deficit in integrating uncertainty from local to global goals, which still spares the basic circuitry of reward and learning. We tested 20 OCD patients and 20 healthy volunteers in a predictive inference task with a hierarchical structure of local uncertainty reduction in the service of global uncertainty reduction. Both groups learned the reward structure of the local environment based on observed data; however, only the healthy volunteers showed evidence of integrating learned knowledge at the local level to reduce uncertainty about the higher level of the task hierarchy. This indicates a potential mechanism for compulsions that relies on the inability to adaptively integrate, prioritize, and \u201ctoggle\u201d among different local goals in the service of global goals.<\/jats:p>","DOI":"10.5334\/cpsy.145","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:55:16Z","timestamp":1786362916000},"page":"142-158","source":"Crossref","is-referenced-by-count":0,"title":["OCD Compulsions as Aberrant Integration of Uncertainty from Local Goals to Global Goals"],"prefix":"10.5334","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5496-150X","authenticated-orcid":false,"given":"Andra","family":"Geana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0925-1917","authenticated-orcid":false,"given":"Christina L.","family":"Boisseau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Rasmussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8451-0523","authenticated-orcid":false,"given":"Michael J.","family":"Frank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"key20260810115511_B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cobeha.2015.06.001","article-title":"Hierarchical control of goal-directed action in the cortical\u2013basal ganglia network","volume":"5","year":"2015","journal-title":"Current opinion in behavioral sciences"},{"key":"key20260810115511_B2","article-title":"Habitual or hyper-controlled behavior: OCD symptoms and explicit sequence learning","volume":"75","year":"2022","journal-title":"Journal of Behavior Therapy and Experimental Psychiatry"},{"key":"key20260810115511_B3","article-title":"Attention allocation in OCD: A systematic review and meta-analysis of eye-tracking-based research","year":"2023","journal-title":"Journal of Affective Disorders"},{"issue":"6","key":"key20260810115511_B4","article-title":"An inventory for measuring clinical anxiety: psychometric properties","volume":"56","year":"1988","journal-title":"Journal of consulting and clinical psychology"},{"key":"key20260810115511_B5","year":"1996","journal-title":"Beck depression inventory"},{"issue":"2","key":"key20260810115511_B6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1080\/13854048908403285","article-title":"Predicting premorbid IQ: a revision of the National Adult Reading Test","volume":"3","year":"1989","journal-title":"The Clinical Neuropsychologist"},{"key":"key20260810115511_B7","volume-title":"Obsessive-compulsive disorder: phenomenology, pathophysiology, and treatment","year":"2017"},{"key":"key20260810115511_B8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jbtep.2016.03.005","article-title":"Stove checking behaviour in people with OCD vs. anxious controls","volume":"53","year":"2016","journal-title":"Journal of behavior therapy and experimental psychiatry"},{"issue":"2","key":"key20260810115511_B9","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.janxdis.2004.12.004","article-title":"Investigating the construct validity ofintolerance of uncertainty and its unique relationship with worry","volume":"20","year":"2006","journal-title":"Journal of anxiety disorders"},{"issue":"3","key":"key20260810115511_B10","article-title":"Motor demands constrain cognitive rule structures","volume":"12","year":"2016","journal-title":"PLoS computational biology"},{"issue":"2","key":"key20260810115511_B11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jbtep.2004.04.006","article-title":"\u201cElucidating the mechanism of uncertainty and doubt in obsessive-compulsive checkers.\u201d","volume":"35","year":"2004","journal-title":"Journal of behavior therapy and experimental psychiatry"},{"key":"key20260810115511_B12","first-page":"1","article-title":"Are people with obsessive-compulsive disorder under-confident in their memory and perception? 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