Understanding the habitual properties of compulsivity through experience sampling

Prominent theories of compulsivity disagree quite fundamentally about whether compulsions are goal-oriented behaviours or are urge-driven and habitual. To shed light on this debate, we analysed self-report symptoms and cognition from N=180 individuals with and without diagnoses who performed compulsions. Six weeks of three-times daily timeseries data were gathered from a transdiagnostic sample who checked their phone compulsively, binge ate, or engaged in compulsions commonly seen in OCD (e.g. checking, cleaning). Across compulsions, the within-person association between compulsive behaviour and urges was 3x stronger than with obsessive thoughts and 4x stronger than with anxiety. We found evidence for urges Granger-causing compulsions, while compulsions themselves had a markedly low tendency to predict themselves compared to the other mental health symptoms sampled. Finally, like habits, compulsions occurred more often when executive functioning was low. Findings were remarkably similar across compulsions, supporting the notion that transdiagnostically, a habit-like mechanism may underlie compulsivity.