Modulating Prefrontal Circuits Underlying Behavioral Flexibility in OCD: A TMS Study

Inclusion Criteria: OCD group * current primary diagnosis of obsessive-compulsive disorder and Yale-Brown Obsessive Compulsive Scale total score ≥ 16; * 18-55 years of age; * ability to speak, read, write, and understand English sufficiently well to complete study procedures and provide informed consent; * either no use of psychiatric medication or stable psychiatric medication use for 6 weeks prior to study entry, limited to use of serotonin reuptake inhibitors and PRN use of benzodiazepines (other psychiatric medication use excluded), and * right-handed. Inclusion Criteria: Healthy Control group * 18-55 years of age; * ability to speak, read, write, and understand English sufficiently well to complete study procedures and provide informed consent; * right-handed. Exclusion Criteria: OCD group * active problematic substance use; * lifetime psychosis or bipolar mood disorder or OCD beliefs of delusional nature; * clinically significant hoarding symptoms; * active suicidal or homicidal ideation; * significant neurological disease or intracranial pathology; * use of medications which increase risk for seizures during TMS; * significant or unstable medical disorders or contraindication to TMS or MRI scan. Exclusion Criteria: Healthy Control group * current psychiatric diagnosis; * lifetime psychosis, bipolar mood disorder, or OCD; * active suicidal or homicidal ideation; * significant neurological disease or intracranial pathology; * use of psychiatric medications; * use of medications which increase risk for seizures during TMS; * significant or unstable medical disorders or contraindication to TMS or MRI scan.