Symposia
Treatment - CBT
Joseph F. McGuire, Ph.D.
Assistant Professor
Johns Hopkins University School of Medicine
Baltimore, Maryland
Obsessive-Compulsive Disorder (OCD) predominantly onsets in childhood, affects ~3% of the general population, and represents a leading cause of disability worldwide. Although the etiology of OCD is multi-factorial, the processes of fear conditioning and extinction learning are implicated in the development, maintenance, and evidence-based treatment of OCD. Consequently, a better understanding of impairments in these key processes can provide novel insights into therapeutic approaches that optimize treatment outcomes. Indeed, initial evidence suggests that extinction learning impairments predict treatment response to exposure-based CBT. In this presentation, we compare fear conditioning and extinction learning processes in youth with OCD and healthy controls. We then explore the clinical profile of youth with OCD who exhibit impairments in extinction learning. One hundred youth (59 OCD, 41 controls) completed a standard fear conditioning/ extinction task and clinical rating scales. Skin conductance response (SCR) was collected during the conditioning/extinction task, and is the primary outcome measure. Impairments in extinction learning were identified among youth with OCD and corresponded with specific clinical characteristics. While several key associative learning processes remain unexamined in pediatric OCD, initial findings identify impairments in extinction learning and highlight the potential of novel and/or augmentative therapeutic strategies to precisely target and resolve these impairments.