Figure 3.

Proposed model of the relationship between core quantifiable traits and symptomatology in OCD. Biases towards habit formation and trait anxiety (although may not be necessary for diagnosis) act in concert to foster compulsive urges, probably supported by the putamen, where action control is transferred from a misfiring (putatively hyperactive) caudate and OFC. Obsessions may be a cognitive interpretation of compulsive urge, which ultimately interacts with anxiety and reinforces the desire to perform compulsions through cognitive dissonance. Brain schematic illustrates important nodes in the fronto-striatal circuits implicated in OCD, of which the mOFC and the caudate are most consistently implicated. Disruption in these regions may be necessary and sufficient for OCD diagnosis, but probably contribute to a range of disorders along the anxious and compulsive spectrums.