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Block 2.6. Anxiety & Stress: Problem 6 OCD (Obsessive Compulsive disorder), English summary

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Block 2.6. Anxiety & Stress: Problem 6 OCD(Obsessive Compulsive Disorder) English Summary Summary of everything discussed in the tutorials and the literature, The grade obtained for the course was 8.1

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Voorbeeld van de inhoud

PROBLEM 6. OCD 1



Pavlovian disgust conditioning as a model for
contamination-based OCD: Evidence from an
analogue study (Thomas Armstrong, Bunmi O. Olatunji)
Introductory Terminology
OCD: disorder characterized by intrusive, unwanted thoughts (obsessions) that motivate rigid,
ritualistic behaviors (compulsions)
 Fear > targets urgent threats because of potential damage to the body
 Disgust > targets less urgent threats e.g. spoiled food, bodily secretions that can potentially
defile the body.
Contamination: cognitive appraisal that the defiling essence of one stimulus is transferred to another
stimulus via contact
Disgust: emotional response to contamination
 Contamination and disgust are distinct yet inseparable
Disgust sensitivity: how easily, intensely one experiences disgust
 Can predict symptom severity in contamination-based OCD, stronger relation to the disorder
than trait/state anxiety.
Distaste: food rejection reflex-precursor to disgust
 Hedonic shift/evaluative conditioning: transfer of negative valence from US to CS > CS
develops an aversive quality independent of US
 Taste aversion resistant to extinction (no modification of the valence)
st
1 : Excessive contamination concern, would lead to facilitation of conditioned disgust response which
would lead to more frequent contamination perceptions

2nd : Excessive contamination concern is characterized by impaired extinction of conditioned disgust
which lead to more enduring perceptions of contamination

3rd: Disgust learning relation to disgust sensitivity

4th : Trait anxiety relation to disgust sensitivity and learning
Methods
Sample Characteristics: fairly equal demographics, 32 participants in the High contamination
concerned group (HCC) and 30 in the Low Contamination Concerned group (LCC).
25 item questionnaire for sensitivity to disgust elicitors.
Disgust Scale Revised (DS-R)
Total score > proneness to disgust
18-item questionnaire assessing how much distress is cause by
Obsessive Compulsive Inventory
OCD symptoms.
Revised (OCI-R)
Focus on Washing subscale (3 items)
Padua Inventory 10-item measure of contamination concerns that reflects how
Contamination much disturbance the OCD symptoms have created in one’s
Obsessions and Washing life.
Compulsions Subscale (PI-COWC)
State Train Anxiety Inventory 20-item scale that measures enduring/chronic experience of
(Trait version) (STAI-T) anxiety. General experience of anxiety symptoms

, PROBLEM 6. OCD 2


Rating subjective experiences (0-100)
Empirical Valence Scale (EVS) In this study participants rated their disgust response to the CS
and their expectancy of the US
Procedure: Habituation, Acquisition, Extinction
Results
Habituation
 US expectancy: not significant difference in CS’s ability to elicit anticipation of US, no group
difference
 Disgust ratings: not significant difference in Cs’s ability to elicit disgust, no group difference
Acquisition
 US expectancy: participants anticipated US more during the CS+ (learned contingency), no
group difference
 Disgust ratings: more disgust in response to CS+ and group difference with HCC reporting
more disgust.
Extinction
 US expectancy: participants continued anticipating US more during CS+ after extinction. HSS
showed reduced extinction of US expectancy. Partial extinction achieved (reduced expectancy
from post-acquisition to post-extinction)
 Disgust ratings: more disgust of CS+ after extinction, HCC more disgust in response to CS+
not to CS-, Disgust decreased from post-acquisition to post-extinction.(partial extinction)
Extra findings
o Disgust sensitivity and contamination concern correlated with disgust to CS+ in acquisition and
extinction, not correlated with US expectancy.
o Greater UR > grater CR in CS+ and greater disgust with CS- in acquisition only and greater
expectancy of US when CS- in extinction only.
o Disgust sensitivity mediated group differences for disgust response but not for US expectancy
o Group differences in disgust response to CS+ after extinction were explained partially by group
differences in the change in US expectancy.
Conclusions & Limitations
 HCC and LCC showed similar acquisition of disgust responding.
 They showed differences in disgust responding after extinction
o HCC did not show higher expectancy of US for CS+ after extinction
o HCC showed more resistance to extinction regarding Us expectancy during CS+ (small
reduction between acquisition and extinction)
→ Because of greater disgust, extinction was harder or because they failed to modify the
contingency of US-CS
 Disgust sensitivity strongly correlated with disgust to CS+ at acquisition and extinction
o Group differences were mediated by disgust sensitivity
o Could contribute to contamination based PCD by causing stronger and long-lasting
responses
o Persistent disgust could lead to more avoidance behaviors and safety behaviors like
washing hands
o It could also interfere with treatment > new goal to target the affective value acquired by

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