title: FEAR CONDITIONING AND EXTINCTION IN YOUTH WITH OBSESSIVE-COMPULSIVE DISORDER.
abstract: BACKGROUND
  Fear acquisition and extinction are central constructs in the cognitive-behavioral model of obsessive-compulsive disorder (OCD), which underlies exposure-based cognitive-behavioral therapy (CBT). Youth with OCD may have impairments in fear acquisition and extinction that carry treatment implications. We examined these processes using a differential conditioning procedure.
  
  
  METHODS
  Forty-one youth (19 OCD, 22 community comparisons) completed a battery of clinical interviews, rating scales, and a differential conditioning task that included habituation, acquisition, and extinction phases. Skin conductance response (SCR) served as the primary dependent measure.
  
  
  RESULTS
  During habituation, no difference between groups was observed. During acquisition, differential fear conditioning was observed across participants as evidenced by larger SCRs to the CS+ compared to CS-; there were no between-group differences. Across participants, the number and frequency of OCD symptoms and anxiety severity was associated with greater reactivity to stimuli during acquisition. During extinction, a three-way interaction and follow-up tests revealed that youth with OCD showed a different pattern of SCR extinction compared to the community comparison group.
  
  
  CONCLUSIONS
  Youth with OCD exhibit a different pattern of fear extinction relative to community comparisons. This may be attributed to impaired inhibitory learning and contingency awareness in extinction. Findings suggest the potential benefit of utilizing inhibitory-learning principles in CBT for youth with OCD, and/or augmentative retraining interventions prior to CBT to reduce threat bias and improve contingency detection.
authors.affiliation: Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: McGuire
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Scott P
authors.initials: SP
authors.lastname: Orr
authors.affiliation: Department of Psychology, University of South Florida, Tampa, Florida.|Department of Pediatrics, University of South Florida, Tampa, Florida.
authors.forename: Monica S
authors.initials: MS
authors.lastname: Wu
authors.affiliation: Department of Psychology, University of South Florida, Tampa, Florida.|Department of Pediatrics, University of South Florida, Tampa, Florida.|Department of Psychiatry and Behavioral Neuroscience, University of South Florida, Tampa, Florida.|All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Lewin
authors.affiliation: School of Aging Studies, University of South Florida, Tampa, Florida.
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
authors.affiliation: Department of Psychology, University of South Florida, Tampa, Florida.
authors.forename: Vicky
authors.initials: V
authors.lastname: Phares
authors.affiliation: Department of Pediatrics, University of South Florida, Tampa, Florida.|Department of Psychiatry and Behavioral Neuroscience, University of South Florida, Tampa, Florida.|All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida.
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Murphy
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sabine
authors.initials: S
authors.lastname: Wilhelm
authors.affiliation: Section on Developmental and Affective Neurosciences, National Institute of Mental Health, Rockville, Maryland.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Daniel
authors.initials: D
authors.lastname: Geller
authors.affiliation: Department of Psychology, University of South Florida, Tampa, Florida.|Department of Pediatrics, University of South Florida, Tampa, Florida.|Department of Psychiatry and Behavioral Neuroscience, University of South Florida, Tampa, Florida.|All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida.|Rogers Behavioral Health - Tampa Bay, Tampa, Florida.|Department of Health Policy and Management, University of South Florida, Tampa, Florida.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
mesh_terms: D000293:Adolescent; D002648:Child; D003213:Conditioning, Psychological / Q000502:physiology*; D005108:Extinction, Psychological / Q000502:physiology*; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology*
keywords: children; extinction; fear conditioning; inhibitory learning; obsessive-compulsive disorder; skin conductance