Error Processing Dysfunctions in OCD

Theories of Obsessive-Compulsive Disorder assert that individuals with OCD have "hyperactive error signals" telling them that there is a conflict between their internal standards and what is happening in the world (Schwartz, 1997). To reduce the error signals, the person engages in repetitive behavior like washing or checking. Anterior cingulate hyperactivity is also implicated in OCD. Based on these ideas, we predicted that individuals with OCD would show more ERN activity than individuals without the disorder. In collaboration with our colleagues in the U of M Psychiatry Department Anxiety Disorders Clinic (see Gehring, Himle, & Nisenson, 2000), we confirmed this prediction: ERN activity was enhanced in the individuals with OCD compared with controls. Furthermore, the magnitude of this enhancement correlated with the severity of OCD symptoms, as assessed by the Yale-Brown Obsessive-Compulsive Scale. The localization of the activity was consistent with an anterior cingulate generator. These data suggest that excessive anterior cingulate action monitoring activity is associated with the symptoms of OCD. We have continued to follow up this line of research, using functional magnetic resonance imaging (fMRI). Like ERP measures, the fMRI measures show a hyperactivity in the anterior cingulate that correlates with symptom severity (Fitzgerald, Welsh, Gehring, Abelson, Himle, Liberzon, & Taylor, 2005). Interestingly, medication for OCD does not appear to reduce the ERN abnormality (Stern, Liu, Gehring, Lister, Yin, Zhang, Fitzgerald, Himle, Abelson & Taylor, 2010). We are currently finishing several studies of the ERN in pediatric OCD and other childhood psychopathology. Most recently, we found that children with OCD show an exaggerated ERN, it is only those who do not have a history of tics. Children with tics do not show the exaggerated ERN (Hanna et al., in press)