scholarly journals Acquisition and maintenance of disgust reactions in an OCD analogue sample: Efficiency of extinction strategies through a counter-conditioning procedure

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254592
Author(s):  
Caroline Novara ◽  
Cindy Lebrun ◽  
Alexandra Macgregor ◽  
Bruno Vivet ◽  
Pierre Thérouanne ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Conditioned Stimulus ◽  
Associative Learning ◽  
Unconditional Stimulus ◽  
Emotional Responses ◽  
Learning Task ◽  
Conditioning Procedure ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Highly Correlated

Background Obsessive-compulsive disorder (OCD) has long been considered as an anxiety disorder, disgust is the dominant emotion in contamination-based OCD. However, disgust seems resistant to exposure with response prevention partly due to the fact that disgust is acquired through evaluative conditioning. Aims The present research investigates a counter-conditioning intervention in treating disgust-related emotional responses in two groups of individuals with high (High contamination concerns, HCC, n = 24) and low (Low contamination concerns LCC, n = 23) contamination concerns. Methods The two groups completed a differential associative learning task in which neutral images were followed by disgusting images (conditioned stimulus; CS+), or not (CS-). Following this acquisition phase, there was a counter-conditioning procedure in which CS+ was followed by a very pleasant unconditional stimulus while CS- remained unreinforced. Results Following counter-conditioning, both groups reported significant reduction in their expectancy of US occurrence and reported less disgust with CS+. For both expectancy and disgust, reduction was lower in the HCC group than in the LCC group. Disgust sensitivity was highly correlated with both acquisition and maintenance of the response acquired, while US expectation was predicted by anxiety. Conclusion Counter-conditioning procedure reduces both expectations and conditioned disgust.

Acquisition and maintenance of disgust reactions in an OCD analogue sample: efficiency of extinction strategies through a counter conditioning procedure

2020 ◽  
Author(s):  
caroline Novara ◽  
Cindy Lebrun ◽  
Alexandra MacGregor ◽  
Bruno Vivet ◽  
Pierre Therouanne ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Conditioned Stimulus ◽  
Associative Learning ◽  
Obsessive Compulsive Disorder ◽  
Emotional Responses ◽  
Learning Task ◽  
Conditioning Procedure ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Highly Correlated

Abstract Background If obsessive-compulsive disorder (OCD) has long been considered as an anxiety disorder, disgust is the dominant emotion in contamination-based OCD. However, disgust seems resistant to exposure with response prevention partly due to the fact that disgust is acquired through evaluative conditioning. The present research investigates a counter-conditioning intervention in treating disgust-related emotional responses in two groups of individuals with high (HDCC, n = 25) and low (LDCC, n = 23) contamination concerns. Methods The two groups completed a differential associative learning task in which neutral images were followed by disgusting images (conditioned stimulus; CS+), or not (CS-). Following this acquisition phase, there was a counterconditioning procedure in which CS + was followed by a very pleasant US, while CS- remained unreinforced. Results Following counterconditioning, both groups reported significant reduction in their expectancy of US occurrence and reported less disgust with CS+. For both expectancy and valence, reduction was lower in the HDCC group than in the LDCC group. Disgust sensitivity was highly correlated with both acquisition and maintenance of the response acquired, while US expectation was predicted by anxiety. Conclusion Desensitization to disgust handled by counter-conditioning procedure reduces both expectations and conditioned valence.

Patients with obsessive–compulsive disorder are impaired in associative learning based on external feedback

2009 ◽  
Vol 39 (9) ◽  
pp. 1519-1526 ◽  
Author(s):  
M. M. Nielen ◽  
J. A. den Boer ◽  
H. G. O. M. Smid
Keyword(s):  
Associative Learning ◽  
Obsessive Compulsive Disorder ◽  
Response Selection ◽  
Learning Task ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
External Feedback ◽  
Selection Processes ◽  
Initial Learning ◽  
Gains And Losses

BackgroundPatients with obsessive–compulsive disorder (OCD) have to repeat their actions before feeling satisfied that the action reached its intended goal. Learning theory predicts that this may be due to a failure in the processing of external feedback.MethodWe examined the performance of 29 OCD patients and 28 healthy volunteers on an associative learning task, in which initial learning is based solely on external feedback signals. Feedback valence was manipulated with monetary gains and losses.ResultsAs predicted, OCD patients were impaired during initial, external feedback-driven learning but not during later learning stages. The emotional salience of the feedback modulated learning during the initial stage in patients and controls alike. During later learning stages, however, patients approached near-normal performance with rewarding feedback but continued to produce deficient learning with punishing feedback.ConclusionOCD patients have a fundamental impairment in updating behavior based on the external outcome of their actions, possibly mediated by faulty error signals in response selection processes.

Sex Differences in Anxiety Disorders

2019 ◽  
pp. 404-432
Author(s):  
Teresa A. Piggott ◽  
Alexandra N. Duran ◽  
Isha Jalnapurkar ◽  
Tyler Kimm ◽  
Stephanie Linscheid ◽  
...  
Keyword(s):  
Sex Differences ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Stress Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Considerable Research ◽  
Psychosocial Influences ◽  
Psychiatric Conditions ◽  
The Impact

Women are more likely than men to meet lifetime criteria for an anxiety disorder. Moreover, anxiety is a risk factor for the development of other psychiatric conditions, including major depression. Numerous studies have identified evidence of sex differences in anxiety disorders, and there is considerable research concerning factors that may contribute to vulnerability for anxiety in females. In addition to psychosocial influences, biological components such as the female reproductive hormone cycle have also been implicated. Although psychotropic medication is more likely to be prescribed to women, there is little controlled data available concerning sex differences in the efficacy and/or tolerability of pharmacotherapy in anxiety disorders. This chapter provides an overview of the impact of gender in the epidemiology, phenomenology, course, and treatment response in generalized anxiety disorder (GAD), social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), panic disorder (PD), and obsessive-compulsive disorder (OCD).

scholarly journals Long-Term Effectiveness and Cost-Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder, Panic Disorder, and Social Anxiety Disorder in Japan: One-Year Follow-Up of a Single-Arm Trial (Preprint)

2019 ◽  
Author(s):  
Kazuki Matsumoto ◽  
Sayo Hamatani ◽  
Kazue Nagai ◽  
Chihiro Sutoh ◽  
Akiko Nakagawa ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

BACKGROUND Face-to-face individual cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) without videoconferencing are known to have long-term effectiveness for obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD). However, videoconference-delivered CBT (VCBT) has not been investigated regarding its long-term effectiveness and cost-effectiveness. OBJECTIVE The purpose of this study was to investigate the long-term effectiveness and cost-effectiveness of VCBT for patients with OCD, PD, or SAD in Japan via a 1-year follow-up to our previous 16-week single-arm study. METHODS Written informed consent was obtained from 25 of 29 eligible patients with OCD, PD, and SAD who had completed VCBT in our clinical trial. Participants were assessed at baseline, end of treatment, and at the follow-up end points of 3, 6, and 12 months. Outcomes were the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Panic Disorder Severity Scale (PDSS), Liebowitz Social Anxiety Scale (LSAS), Patient Health Questionnaire–9 (PHQ-9), General Anxiety Disorder–7 (GAD-7), and EuroQol-5D-5L (EQ-5D-5L). To analyze long-term effectiveness, we used mixed-model analysis of variance. To analyze cost-effectiveness, we employed relevant public data and derived data on VCBT implementation costs from Japanese national health insurance data. RESULTS Four males and 21 females with an average age of 35.1 (SD 8.6) years participated in the 1-year follow-up study. Principal diagnoses were OCD (n=10), PD (n=7), and SAD (n=8). The change at 12 months on the Y-BOCS was −4.1 (<i>F</i><sub>1</sub>=4.45, <i>P</i>=.04), the change in PDSS was −4.4 (<i>F</i><sub>1</sub>=6.83, <i>P</i>=.001), and the change in LSAS was −30.9 (<i>F</i><sub>1</sub>=6.73, <i>P</i>=.01). The change in the PHQ-9 at 12 months was −2.7 (<i>F</i><sub>1</sub>=7.72, <i>P</i>=.007), and the change in the GAD-7 was −3.0 (<i>F</i><sub>1</sub>=7.09, <i>P</i>=.009). QALY at 12 months was 0.7469 (SE 0.0353, 95% Cl 0.6728-0.821), and the change was a significant increase of 0.0379 (<i>P</i>=.01). Total costs to provide the VCBT were ¥60,800 to ¥81,960 per patient. The set threshold was ¥189,500 ($1723, €1579, and £1354) calculated based on willingness to pay in Japan. CONCLUSIONS VCBT was a cost-effective way to effectively treat Japanese patients with OCD, PD, or SAD. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000026609; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000030495

Pharmacotherapy of anxiety and related disorders

2020 ◽  
pp. 147-164
Author(s):  
Dan J. Stein
Keyword(s):  
Clinical Trials ◽  
Anxiety Disorder ◽  
Mental Disorders ◽  
Randomized Clinical Trials ◽  
Generalized Anxiety ◽  
Obsessive Compulsive ◽  
Future Directions ◽  
Compulsive Disorder ◽  
Translational Models ◽  
Shed Light

Anxiety disorders are the most prevalent of the mental disorders, and good translational models of these conditions encourage pharmacotherapy studies. This chapter discusses six randomized clinical trials that have contributed significantly to the pharmacotherapy of anxiety and related disorders, including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and social anxiety disorder. Although any such list is necessarily incomplete, these selections may shed light on early and ongoing challenges in the field and on key advances to date. After reviewing these foundational papers, the advances they represent, and the work that they have given impetus to, the chapter closes by considering future directions in work on the pharmacotherapy of anxiety and related disorders.

scholarly journals Obsessive–compulsive disorder: subclassification based on co-morbidity

2008 ◽  
Vol 39 (9) ◽  
pp. 1491-1501 ◽  
Author(s):  
G. Nestadt ◽  
C. Z. Di ◽  
M. A. Riddle ◽  
M. A. Grados ◽  
B. D. Greenberg ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Obsessive Compulsive Disorder ◽  
Clinical Characteristics ◽  
Latent Class ◽  
Age At Onset ◽  
Separation Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Co Morbidity ◽  
The Relationship

BackgroundObsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes.MethodSeven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated.ResultsTwo and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness.ConclusionsOCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.

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