Skip to main content Accessibility help

Punishment promotes response control deficits in obsessive-compulsive disorder: evidence from a motivational go/no-go task

  • S. Morein-Zamir (a1), M. Papmeyer (a1), C. M. Gillan (a1), M. J. Crockett (a1), N. A. Fineberg (a1), B. J. Sahakian (a1) and T. W. Robbins (a1)...



Obsessive-compulsive disorder (OCD) has been associated with response inhibition deficits under motivationally neutral contingencies. We examined response inhibition performance in the presence of reward and punishment. We further investigated whether the hypothesized difficulties in flexibly updating behaviour based on external feedback in OCD would also lead to a reduced ability to adjust to changes in the reward and punishment contingencies.


Participants completed a go/no-go task that used punishments or rewards to promote response activation or suppression. The task was administered to OCD patients free of current Axis-I co-morbidities including major depression (n = 20) and a group of healthy controls (n = 32).


Compared with controls, patients with OCD had increased commission errors in punishment conditions, and failed to slow down immediately after receiving punishment. The punishment-induced increase in commission errors correlated with self-report measures of OCD symptom severity. Additionally, patients did not differ from controls in adapting their overall response style to the changes in task contingencies.


Individuals with OCD showed reduced response control selectively under punishment conditions, manifesting in an impulsive response style that was related to their current symptom severity. This stresses failures of cognitive control in OCD, particularly under negative motivational contingencies.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Punishment promotes response control deficits in obsessive-compulsive disorder: evidence from a motivational go/no-go task
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Punishment promotes response control deficits in obsessive-compulsive disorder: evidence from a motivational go/no-go task
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Punishment promotes response control deficits in obsessive-compulsive disorder: evidence from a motivational go/no-go task
      Available formats


The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence . The written permission of Cambridge University Press must be obtained for commercial re-use.

Corresponding author

*Address for correspondence: S. Morein-Zamir, Ph.D., MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute (BCNI), Department of Experimental Psychology, University of Cambridge, Downing Site, Cambridge CB2 3EB, UK. (Email:


Hide All
APA (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). American Psychiatric Association: Washington, DC.
Bannon, S, Gonsalvez, CJ, Croft, RJ, Boyce, PM (2002). Response inhibition deficits in obsessive-compulsive disorder. Psychiatry Research 110, 165174.
Bohne, A, Savage, CR, Deckersbach, T, Keuthen, NJ, Wilhelm, S (2008). Motor inhibition in trichotillomania and obsessive-compulsive disorder. Journal of Psychiatric Research 42, 141150.
Bollini, P, Pampallona, S, Tibaldi, G, Kupelnick, B, Munizza, C (1999). Effectiveness of antidepressants – meta-analysis of dose–effect relationships in randomised clinical trials. British Journal of Psychiatry 174, 297303.
Burns, GL, Keortge, SG, Formea, GM, Sternberger, LG (1996). Revision of the Padua Inventory of Obsessive Compulsive Disorder Symptoms: distinctions between worry, obsessions, and compulsions. Behavioural Research and Therapy 34, 163173.
Chamberlain, SR, Fineberg, NA, Blackwell, AD, Clark, L, Robbins, TW, Sahakian, BJ (2007 a). A neuropsychological comparison of obsessive-compulsive disorder and trichotillomania. Neuropsychologia 45, 654662.
Chamberlain, SR, Fineberg, NA, Menzies, LA, Blackwell, AD, Bullmore, ET, Robbins, TW, Sahakian, BJ (2007 b). Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. American Journal of Psychiatry 164, 335338.
Chamberlain, SR, Menzies, L, Hampshire, A, Suckling, J, Fineberg, NA, del Campo, N, Aitken, M, Craig, K, Owen, AM, Bullmore, ET, Robbins, TW, Sahakian, BJ (2008). Orbitofrontal dysfunction in patients with obsessive-compulsive disorder and their unaffected relatives. Science 321, 421422.
Cools, R, Roberts, AC, Robbins, TW (2008). Serotoninergic regulation of emotional and behavioural control processes. Trends in Cognitive Science 12, 3140.
Crockett, MJ, Clark, L, Robbins, TW (2009). Reconciling the role of serotonin in behavioral inhibition and aversion: acute tryptophan depletion abolishes punishment-induced inhibition in humans. Journal of Neuroscience 29, 1199311999.
Cyders, MA, Smith, GT (2008). Emotion-based dispositions to rash action: positive and negative urgency. Psychological Bulletin 134, 807828.
Endrass, T, Kloft, L, Kaufmann, C, Kathmann, N (2011). Approach and avoidance learning in obsessive-compulsive disorder. Depression and Anxiety 28, 166172.
Endrass, T, Schuermann, B, Kaufmann, C, Spielberg, R, Kniesche, R, Kathmann, N (2010). Performance monitoring and error significance in patients with obsessive-compulsive disorder. Biological Psychology 84, 257263.
Ersche, KD, Roiser, JP, Abbott, S, Craig, KJ, Muller, U, Suckling, J, Ooi, C, Shabbir, SS, Clark, L, Sahakian, BJ, Fineberg, NA, Merlo-Pich, EV, Robbins, TW, Bullmore, ET (2011). Response perseveration in stimulant dependence is associated with striatal dysfunction and can be ameliorated by a d(2/3) receptor agonist. Biological Psychiatry 70, 754762.
Evers, EA, van der Veen, FM, van Deursen, JA, Schmitt, JA, Deutz, NE, Jolles, J (2006). The effect of acute tryptophan depletion on the BOLD response during performance monitoring and response inhibition in healthy male volunteers. Psychopharmacology (Berlin) 187, 200208.
Figee, M, Vink, M, de Geus, F, Vulink, N, Veltman, DJ, Westenberg, H, Denys, D (2011). Dysfunctional reward circuitry in obsessive-compulsive disorder. Biological Psychiatry 69, 867874.
Foa, EB, Huppert, JD, Leiberg, S, Langner, R, Kichic, R, Hajcak, G, Salkovskis, PM (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment 14, 485496.
Gehring, WJ, Himle, J, Nisenson, LG (2000). Action-monitoring dysfunction in obsessive-compulsive disorder. Psychological Science 11, 16.
Gillan, CM, Papmeyer, M, Morein-Zamir, S, Sahakian, BJ, Fineberg, NA, Robbins, TW, de Wit, S (2011). Disruption in the balance between goal-directed behavior and habit learning in obsessive-compulsive disorder. American Journal of Psychiatry 168, 718726.
Goodman, WK, Price, LH, Rasmussen, SA, Mazure, C, Fleischmann, RL, Hill, CL, Heninger, GR, Charney, DS (1989). The Yale–Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Archives of General Psychiatry 46, 10061011.
Graybiel, AM, Rauch, SL (2000). Toward a neurobiology of obsessive-compulsive disorder. Neuron 28, 343347.
Gu, BM, Park, JY, Kang, DH, Lee, SJ, Yoo, SY, Jo, HJ, Choi, CH, Lee, JM, Kwon, JS (2008). Neural correlates of cognitive inflexibility during task-switching in obsessive-compulsive disorder. Brain 131, 155164.
Henseler, I, Gruber, O, Kraft, S, Krick, C, Reith, W, Falkai, P (2008). Compensatory hyperactivations as markers of latent working memory dysfunctions in patients with obsessive-compulsive disorder: an fMRI study. Journal of Psychiatry and Neuroscience 33, 209215.
Jung, WH, Kang, DH, Han, JY, Jang, JH, Gu, BM, Choi, JS, Jung, MH, Choi, CH, Kwon, JS (2011). Aberrant ventral striatal responses during incentive processing in unmedicated patients with obsessive-compulsive disorder. Acta Psychiatrica Scandinavica 123, 376386.
Kehagia, A, Murray, GK, Robbins, TW (2010). Learning and cognitive flexibility: frontostriatal function and monoaminergic modulation. Current Opinion in Neurobiology 20, 199204.
Koran, LM, Hanna, GL, Hollander, E, Nestadt, G, Simpson, HB (2007). Practice guideline for the treatment of patients with obsessive-compulsive disorder. American Journal of Psychiatry 164 (Suppl. 7), 553.
Kuelz, AK, Hohagen, F, Voderholzer, U (2004). Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biological Psychology 65, 185236.
Lipszyc, J, Schachar, R (2010). Inhibitory control and psychopathology: a meta-analysis of studies using the stop signal task. Journal of the International Neuropsychological Society 16, 10641076.
Maltby, N, Tolin, DF, Worhunsky, P, O'Keefe, TM, Kiehl, KA (2005). Dysfunctional action monitoring hyperactivates frontal-striatal circuits in obsessive-compulsive disorder: an event-related fMRI study. Neuroimage 24, 495503.
Menzies, L, Achard, S, Chamberlain, SR, Fineberg, N, Chen, CH, del Campo, N, Sahakian, BJ, Robbins, TW, Bullmore, E (2007). Neurocognitive endophenotypes of obsessive-compulsive disorder. Brain 130, 32233236.
Menzies, L, Chamberlain, SR, Laird, AR, Thelen, SM, Sahakian, BJ, Bullmore, ET (2008). Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neurosciecne and Biobehavioural Reviews 32, 525549.
Monterosso, JR, Aron, AR, Cordova, X, Xu, J, London, ED (2005). Deficits in response inhibition associated with chronic methamphetamine abuse. Drug and Alcohol Dependence 79, 273277.
Montgomery, SA, Asberg, M (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382389.
Morein-Zamir, S, Fineberg, NA, Robbins, TW, Sahakian, BJ (2010). Inhibition of thoughts and actions in obsessive-compulsive disorder: extending the endophenotype? Psychological Medicine 40, 263272.
Moritz, S, Hubner, M, Kluwe, R (2004). Task switching and backward inhibition in obsessive-compulsive disorder. Journal of Clinical and Experimental Neuropsychology 26, 677683.
Nelson, HE (1982). The National Adult Reading Test Manual. NFER-Nelson: Windsor.
Nielen, MM, den Boer, JA, Smid, HG (2009). Patients with obsessive-compulsive disorder are impaired in associative learning based on external feedback. Psychological Medicine 39, 15191526.
O'Doherty, JP (2007). Lights, camembert, action! The role of human orbitofrontal cortex in encoding stimuli, rewards, and choices. Annals of the New York Academy of Sciences 1121, 254272.
Olley, A, Malhi, G, Sachdev, P (2007). Memory and executive functioning in obsessive-compulsive disorder: a selective review. Journal of Affective Disorders 104, 1523.
Page, LA, Rubia, K, Deeley, Q, Daly, E, Toal, F, Mataix-Cols, D, Giampietro, V, Schmitz, N, Murphy, DG (2009). A functional magnetic resonance imaging study of inhibitory control in obsessive-compulsive disorder. Psychiatry Research 174, 202209.
Penades, R, Catalan, R, Rubia, K, Andres, S, Salamero, M, Gasto, C (2007). Impaired response inhibition in obsessive compulsive disorder. European Psychiatry 22, 404410.
Rauch, SL, Wedig, MM, Wright, CI, Martis, B, McMullin, KG, Shin, LM, Cannistraro, PA, Wilhelm, S (2007). Functional magnetic resonance imaging study of regional brain activation during implicit sequence learning in obsessive-compulsive disorder. Biological Psychiatry 61, 330336.
Remijnse, PL, Nielen, MM, van Balkom, AJ, Cath, DC, van Oppen, P, Uylings, HB, Veltman, DJ (2006). Reduced orbitofrontal-striatal activity on a reversal learning task in obsessive-compulsive disorder. Archives of General Psychiatry 63, 12251236.
Roth, RM, Saykin, AJ, Flashman, LA, Pixley, HS, West, JD, Mamourian, AC (2007). Event-related functional magnetic resonance imaging of response inhibition in obsessive-compulsive disorder. Biological Psychiatry 62, 901909.
Sahakian, BJ, Morein-Zamir, S (2011). Depression and resilience: insights from cognitive, neuroimaging and psychopharmacological studies. In Decision Making, Affect, and Learning: Attention and Performance XXIII (ed. Delgado, M., Phelps, E. and Robbins, T. W.), pp. 505532. Oxford University Press: Oxford
Spielberger, CD, Gorsuch, RL, Lushene, R, Vagg, PR, Jacobs, GA (1983). Manual for the State-Trait Anxiety Inventory (Form Y). Consulting Psychologists Press: Palo Alto, CA.
Stahl, SM (2008). Stahl's Essential Psychopharmacology: Neruoscientific Basis and Practical Applications. Cambridge University Press: New York.
Stern, ER, Welsh, RC, Fitzgerald, KD, Gehring, WJ, Lister, JJ, Himle, JA, Abelson, JL, Taylor, SF (2011). Hyperactive error responses and altered connectivity in ventromedial and frontoinsular cortices in obsessive-compulsive disorder. Biological Psychiatry 69, 583591.
van den Heuvel, OA, Veltman, DJ, Groenewegen, HJ, Cath, DC, van Balkom, AJ, van Hartskamp, J, Barkhof, F, van Dyck, R (2005). Frontal-striatal dysfunction during planning in obsessive-compulsive disorder. Archives of General Psychiatry 62, 301309.
Watkins, LH, Sahakian, BJ, Robertson, MM, Veale, DM, Rogers, RD, Pickard, KM, Aitken, MR, Robbins, TW (2005). Executive function in Tourette's syndrome and obsessive-compulsive disorder. Psychological Medicine 35, 571582.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed