Negative reinforcement in OCD — MRCPsych Paper A MCQ

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EasyPsychologyNegative reinforcement in OCDMRCPsych Paper A

A 34-year-old woman with obsessive-compulsive disorder washes her hands whenever contamination-related anxiety rises. Immediately after washing, her anxiety falls briefly; over time, she washes her hands more often. Which learning process best explains the increased frequency of handwashing?

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Correct answer: B — Negative reinforcement

Negative reinforcement occurs when a behaviour becomes more frequent because it removes or reduces an aversive state. Here, handwashing briefly reduces contamination-related anxiety, making future washing more likely and maintaining the obsessive-compulsive cycle. “Negative” means that something aversive is removed, not that the consequence is harmful. Positive reinforcement would require adding a rewarding stimulus after washing. Positive punishment would add an aversive consequence to reduce the behaviour, while negative punishment would remove something desirable to reduce it. Habituation is a gradual reduction in response after repeated exposure and does not explain why the washing itself increases.

Reference: Swisher VS, Newman MG. Why compulsions persist: An ecological momentary assessment study of the reinforcement of compulsions. Journal of Affective Disorders. 2026;394(Pt A):120530. https://pubmed.ncbi.nlm.nih.gov/41283928/