Hostname: page-component-745bb68f8f-f46jp Total loading time: 0 Render date: 2025-02-07T02:10:45.750Z Has data issue: false hasContentIssue false

Unconscious habit systems in compulsive and impulsive disorders

Published online by Cambridge University Press:  29 April 2014

Natalie L. Cuzen
Affiliation:
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7925, South Africa. natalie.cuzen@uct.ac.zadan.stein@uct.ac.zahttp://www.health.uct.ac.za/departments/psychiatry/about/ ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town 7701, South Africa. http://www.humanities.uct.ac.za/hum/departments/psychology/about
Naomi A. Fineberg
Affiliation:
National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership NHS University Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City AL7 4HQ, United Kingdom. naomi.fineberg@hpft.nhs.ukhttp://www.hpft.nhs.uk/ University of Hertfordshire Postgraduate Medical School, Hatfield, Hertfordshire AL10 9AB, United Kingdom
Dan J. Stein
Affiliation:
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7925, South Africa. natalie.cuzen@uct.ac.zadan.stein@uct.ac.zahttp://www.health.uct.ac.za/departments/psychiatry/about/

Abstract

It may be useful to consider the application of Huang & Bargh's (H&B's) theory of unconscious motivational processes to psychopathology. In disorders of compulsivity and impulsivity, an unconscious habit system may play a key role in explaining ego-dystonic or self-destructive behaviour. H&B's theory may provide some insights into understanding conditions such as obsessive-compulsive disorder (OCD) and drug addiction; however, additional work is needed to address the neurocircuitry and neurochemistry mediating their abnormal underlying motivational processes.

Type
Open Peer Commentary
Copyright
Copyright © Cambridge University Press 2014 

Huang & Bargh (H&B) propose an interesting theory of unconscious motivation, based in part on evolutionary principles. Early clinical notions of unconscious processes highlighted their importance in compulsive and impulsive disorders, and the target article does refer on occasion to such conditions (e.g., drug addiction). It may, however, be useful to pay additional emphasis to such psychopathology, with particular reference to the question of whether H&B's arguments are valuable in explaining not only normal, but also abnormal motivational processes.

The inconsistency principle, for example, seems particularly apparent in individuals with compulsive and impulsive disorders, such as obsessive-compulsive disorder (OCD) and addiction. Early on Freud emphasized the important contrast between obsessional and hysterical neurosis. More recent work continues to describe how individuals with OCD engage in repetitive behaviour despite acknowledging the absurdity of such compulsions (Foa et al. Reference Foa, Kozak, Goodman, Hollander, Jenike and Rasmussen1995); similarly, individuals with addiction are unable to cease drug consumption despite being aware that this is not in their bests interests (Loewenstein Reference Loewenstein1996).

There is growing evidence that an unconscious habit system may play a crucial role in explaining the inconsistency seen in both OCD and drug addiction. OCD may be characterized by an underlying vulnerability to habit formation (Gillan et al. Reference Gillan, Morein-Zamir, Urcelay, Sule, Voon, Apergis-Schoute, Fineberg, Sahakian and Robbins2013). Although drug addiction may be precipitated by an underlying vulnerability to impulsivity, the addiction process is stimulus-driven and characterized by repetitive, inflexible, and persistent behaviour despite associated negative consequences (Everitt & Robbins Reference Everitt and Robbins2005; Volkow & Fowler Reference Volkow and Fowler2000). Put differently, habits restrict agency by prompting automatic responses to environmental cues (e.g., a dirty toilet in OCD, an inviting pub in alcoholism), regardless of whether or not the outcome is detrimental to the individual (Dickinson Reference Dickinson1985). Crucially, habits may be a driving mechanism in both avoidant (e.g., OCD) and appetitive (e.g., drug addiction) motivational processes (Gillan et al. Reference Gillan, Morein-Zamir, Urcelay, Sule, Voon, Apergis-Schoute, Fineberg, Sahakian and Robbins2013). Typically, behavioural control is maintained through a balance between the goal-directed system and the habitual system (Dickinson Reference Dickinson1985; de Wit & Dickinson Reference de Wit and Dickinson2009). The appropriation of control away from the goal-directed system toward the habitual system in OCD and drug addiction may be underpinned by anomalies in the frontostriatal circuits governing these functions (Balleine & O'Doherty Reference Balleine and O'Doherty2010; de Wit et al. Reference de Wit, Watson, Harsay, Cohen, van de Vijver and Ridderinkhof2012).

Although habitual behaviour in drug addiction and OCD seems to be defined by a relative lack of goal-directedness, H&B's theory of the “selfish” nature of goals may well have some application to abnormal motivational processes in these disorders. Specifically, one may consider habits characterizing OCD and drug addiction to be “selfish,” insofar as they involve adaptive systems. Thus, several authors have emphasized that precautionary behaviours and reward-seeking behaviours have an evolutionary basis (Nesse & Berridge Reference Nesse and Berridge1997).

We suggest that H&B's theory provides some useful insights into understanding compulsive and impulsive disorders insofar as it emphasizes continuity between unconscious and conscious motivational processes, in addition to the notion of the “selfish” or adaptive nature of habitual processes. However, we would argue that additional work is needed in order to address the neurocircuitry and neurochemistry that characterize the relevant motivational processes; there is a good deal of relevant literature (e.g., Everitt & Robbins Reference Everitt and Robbins2005; Graybiel & Rauch Reference Graybiel and Rauch2000) that may contribute to delineating the precise way in which such processes operate, and which may be of specific value in the treatment of psychopathology.

References

Balleine, B. W. & O'Doherty, J. P. (2010) Human and rodent homologies in action control: Corticostriatal determinants of goal-directed and habitual action. Neuropsychopharmacology Review 35:4869.Google Scholar
de Wit, S. & Dickinson, A. (2009) Associative theories of goal-directed behaviour: A case for animal–human translational models. Psychological Research 73:463–76.Google Scholar
de Wit, S., Watson, P., Harsay, H. A., Cohen, M. X., van de Vijver, I. & Ridderinkhof, K. R. (2012) Corticostriatal connectivity underlies individual differences in the balance between habitual and goal-directed action control. Journal of Neuroscience 32:12066–75.Google Scholar
Dickinson, A. (1985) Actions and habits: The development of behavioural autonomy. Philosophical Transactions of the Royal Society B: Biological Sciences 308:6778.Google Scholar
Everitt, B. J. & Robbins, T. W. (2005) Neural systems of reinforcement for drug addiction: From actions to habits to compulsion. Nature Neuroscience 8:1481–89.CrossRefGoogle ScholarPubMed
Foa, E. B., Kozak, M. J., Goodman, W. K., Hollander, E., Jenike, M. A. & Rasmussen, S. A. (1995) DSM-IV field trial: Obsessive-compulsive disorder. American Journal of Psychiatry 152:9096.Google ScholarPubMed
Gillan, C. M., Morein-Zamir, S., Urcelay, G. P., Sule, A., Voon, V., Apergis-Schoute, A. M., Fineberg, N. A., Sahakian, B. J. & Robbins, T. W. (2013) Enhanced avoidance habits in obsessive-compulsive diesorder. Biological Psychiatry. doi: 10.1016/j.biopsych.2013.02.002. [ePub ahead of print]Google Scholar
Graybiel, A. M. & Rauch, S. L. (2000) Toward a neurobiology of obsessive-compulsive disorder. Neuron 28:343–47.Google Scholar
Loewenstein, G. (1996) Out of control: Visceral influences on behavior. Organizational Behavior and Human Decision Processes 65:272–92.Google Scholar
Nesse, R. M. & Berridge, K. C. (1997) Psychoactive drug use in evolutionary perspective. Science 278:6366.Google Scholar
Volkow, N. D. & Fowler, J. S. (2000) Addiction, a disease of compulsion and drive: Involvement of the orbitofrontal cortex. Cerebral Cortex 10:318–25.Google Scholar