We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Neuroscience and Psychiatry |

Neural Mechanisms of Harm-Avoidance Learning A Model for Obsessive-Compulsive Disorder? ONLINE FIRST

Tobias U. Hauser, PhD1,2; Eran Eldar, PhD1,2; Raymond J. Dolan, FRS, MD1,2
[+] Author Affiliations
1Wellcome Trust Centre for Neuroimaging, University College London (UCL), London, England
2Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London, England
JAMA Psychiatry. Published online September 21, 2016. doi:10.1001/jamapsychiatry.2016.1938
Text Size: A A A
Published online


This article analyzes the mechanisms of harm-avoidance learning as a potential model for obsessive-compulsive disorder.

A middle-aged man with obsessive-compulsive disorder (OCD) had, since early adulthood, a fear of being infected with the human immunodeficiency virus (HIV). In turn, he developed a variety of compulsive behaviors, such as excessive hand washing, to reduce what he perceived as risks for infection. Despite being aware of the irrationality of his behavior, his compulsions dominated his life. This type of scenario raises a question as to why some people with distressing thoughts develop excessive compulsions, while others do not.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Neurocognitive Mechanisms in Harm-Avoidance Learning

A, A potential threat can be prevented by pursuing different strategies. A passive harm-avoidance strategy is characterized by the cessation of a behavior to prevent exposure. In contrast, active harm-avoidance behavior involves an instrumental behavior to prevent harm. B, A novel gambling task4 assesses individual learning strategies and distinguishes active from passive avoidance learners. C, Striatum plays a key role in harm-avoidance habit: its structure predicts avoidance learning style (red/yellow: more gray matter in active avoiders, blue/green: less gray matter); activation predicts avoidance persistence in patients with obsessive-compulsive disorder (OCD)5; and stimulation alleviates habit persistence after an extinction with response prevention (ERP) procedure.6

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles