Fear Extinction Learning as a Predictor of Response to Cognitive Behavioral Therapy for Pediatric Obsessive Compulsive Disorder
| Autor: | Rachel Porth, Daniel A. Geller, Brent J. Small, Joseph F. McGuire, Kathleen Trainor, Scott P. Orr, Eric A. Storch, Sabine Wilhelm, Tanya K. Murphy |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
050103 clinical psychology Obsessive-Compulsive Disorder Adolescent medicine.medical_treatment Conditioning Classical Stimulus (physiology) behavioral disciplines and activities Article Extinction Psychological 03 medical and health sciences 0302 clinical medicine Obsessive compulsive mental disorders medicine Humans 0501 psychology and cognitive sciences Fear conditioning Child Cognitive Behavioral Therapy 05 social sciences Classical conditioning Cognition Extinction (psychology) Fear Combined Modality Therapy humanities 030227 psychiatry Cognitive behavioral therapy Psychiatry and Mental health Clinical Psychology Treatment Outcome Phobic Disorders Cycloserine Female Skin conductance Psychology Clinical psychology |
| Zdroj: | J Anxiety Disord |
| Popis: | Background While cognitive behavior therapy (CBT) is an effective treatment for many children and adolescents with Obsessive Compulsive Disorder (OCD), therapeutic response is variable. Fear conditioning and extinction are central constructs underlying exposure-based CBT. Fear extinction learning assessed prior to CBT may be a useful predictor of CBT response for guiding treatment decisions. Methods Sixty-four youth who participated in a randomized placebo-controlled trial of CBT with and without d-cycloserine (DCS) completed a fear conditioning task. Skin conductance response (SCR) scores were used to measure fear acquisition and extinction to determine whether extinction learning could predict CBT response. Results CBT responders and non-responders appeared to acquire conditioned fear SCRs in a similar manner. However, differences between treatment responders and non-responders emerged during the extinction phase. A responder (responder, non-responder) by conditioned stimulus type (CS+, CS−) interaction showed that CBT responders differentiated the stimulus paired with (CS+) and without (CS−) the unconditioned stimulus correctly during early and late extinction, whereas the CBT non-responders did not (p = .004). Conclusions While the small sample size makes conclusions tentative, this study supports an emerging literature that differential fear extinction may be an important factor underlying clinical correlates of pediatric OCD, including CBT response. |
| Databáze: | OpenAIRE |
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