1
|
Seyednezhad Golkhatmi SH, Dolatshahi B, Nosratabadi M, Shakiba S, Sadjadi SA. Identifying emotional components of event-related potentials in the brain functioning of individuals with contamination obsessions and comparison with healthy control group. Front Psychol 2023; 14:1240493. [PMID: 38046120 PMCID: PMC10693420 DOI: 10.3389/fpsyg.2023.1240493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/20/2023] [Indexed: 12/05/2023] Open
Abstract
The present study aimed to examine the emotional components of event-related potentials (ERPs) in individuals with contamination OCD and compare them with a healthy control group. A convenience sample of 45 participants was included, consisting of 30 individuals diagnosed with contamination-type OCD and 15 individuals in a healthy control group. Both groups participated in an ERP study where they encountered a computer-based task presenting both contamination and neutral pictures, while their brain activity was recorded. The data were analyzed using repeated measures analysis of variance (RANOVA) with SPSS-24 and Matlab software. Findings suggest that in P3 amplitude, only individuals with OCD exhibited a larger positive amplitude (p < 0.05) in response to contaminated pictures compared to neutral pictures and in N2 amplitude, only individuals with OCD exhibited a larger negative amplitude (p < 0.05) in response to contaminated pictures compared to neutral pictures in the central vertex (Fz). These findings hold promising implications for the development of more targeted and effective treatments for contamination OCD, emphasizing the importance of emotion-oriented approaches to address the unique neural patterns observed in the frontal vertex.
Collapse
Affiliation(s)
| | - Behrooz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Masoud Nosratabadi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shima Shakiba
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Alireza Sadjadi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
2
|
Ching THW, Rouleau TM, Turner E, Williams MT. Disgust sensitivity mediates the link between homophobia and sexual orientation obsessive-compulsive symptoms. Cogn Behav Ther 2021; 50:452-465. [PMID: 33475018 DOI: 10.1080/16506073.2020.1861083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Previous research has shown that intrusive thoughts in obsessive-compulsive disorder (OCD) often focus on emotionally significant aspects of individuals' lives (e.g., values and beliefs). The current study sought to expand our understanding of OC symptoms related to sexual orientation (SO-OC symptoms) by investigating the roles of homophobia (i.e., negative attitudes, affect, and behaviors toward individuals with a same-gender orientation) and disgust propensity and sensitivity. A total of 592 self-identified heterosexual college students were recruited to complete measures of homophobia, disgust propensity and sensitivity, and SO-OC symptoms. Results of separate parallel mediation analyses indicated that the relationships between homophobic affect/attitudes and avoidance/aggression on one hand, and SO-OC symptoms on the other, were partially mediated specifically by disgust sensitivity, after controlling for gender. Theoretical and clinical implications are discussed, including how homophobia can be conceptualized as a disgust response in the treatment of SO-OC symptoms, as well as how other constructs of potential interest (sexual and moral disgust, religiosity, conservative sexual ideology) can be examined in future research.
Collapse
Affiliation(s)
- Terence H W Ching
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.,Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | - Emma Turner
- Department of Trauma Research, Baylor Scott and White Research Institute, Dallas, TX, USA
| | | |
Collapse
|
3
|
Fink-Lamotte J, Widmann A, Sering K, Schröger E, Exner C. Attentional Processing of Disgust and Fear and Its Relationship With Contamination-Based Obsessive-Compulsive Symptoms: Stronger Response Urgency to Disgusting Stimuli in Disgust-Prone Individuals. Front Psychiatry 2021; 12:596557. [PMID: 34163378 PMCID: PMC8215551 DOI: 10.3389/fpsyt.2021.596557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/22/2021] [Indexed: 12/05/2022] Open
Abstract
Disgust has recently been characterized as a low-urgency emotion, particularly compared to fear. The aim of the present study is to clarify whether behavioral inhibition during disgust engagement is characteristic of a low-urgency emotion and thus indicates self-imposed attentional avoidance in comparison to fear. Therefore, 54 healthy participants performed an emotional go/no-go task with disgust- and fear-relevant as well as neutral pictures. Furthermore, heart rate activity and facial muscle activity on the fear-specific m. corrugator supercilli and the disgust-specific m. levator labii were assessed. The results partially support the temporal urgency hypothesis of disgust. The emotion conditions significantly differed in emotional engagement and in the facial muscle activity of the m. levator labii as expected. However, contrary to our expectations, no differences between the emotion conditions regarding behavioral inhibition as well as heart rate change could be found. Furthermore, individuals with a higher-trait disgust proneness showed faster reactions and higher activity of the m. levator labii in response to disgust stimuli. The results show that different trait levels influence attentional engagement and physiological parameters but have only a small effect on behavioral inhibition.
Collapse
Affiliation(s)
- Jakob Fink-Lamotte
- University of Leipzig, Clinical Psychology and Psychotherapy, Leipzig, Germany
| | - Andreas Widmann
- University of Leipzig, Cognitive and Biological Psychology, Leipzig, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Konstantin Sering
- University of Tuebingen, Quantitative Linguistics, Tübingen, Germany
| | - Erich Schröger
- University of Leipzig, Cognitive and Biological Psychology, Leipzig, Germany
| | - Cornelia Exner
- University of Leipzig, Clinical Psychology and Psychotherapy, Leipzig, Germany
| |
Collapse
|
4
|
Legrand N, Etard O, Vandevelde A, Pierre M, Viader F, Clochon P, Doidy F, Peschanski D, Eustache F, Gagnepain P. Long-term modulation of cardiac activity induced by inhibitory control over emotional memories. Sci Rep 2020; 10:15008. [PMID: 32929105 PMCID: PMC7490349 DOI: 10.1038/s41598-020-71858-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 07/26/2020] [Indexed: 12/15/2022] Open
Abstract
Efforts to exclude past experiences from conscious awareness can lead to forgetting. Memory suppression is central to affective disorders, but we still do not really know whether emotions, including their physiological causes, are also impacted by this process in normal functioning individuals. In two studies, we measured the after-effects of suppressing negative memories on cardiac response in healthy participants. Results of Study 1 revealed that efficient control of memories was associated with long-term inhibition of the cardiac deceleration that is normally induced by disgusting stimuli. Attempts to suppress sad memories, by contrast, aggravated the cardiac response, an effect that was closely related to the inability to forget this specific material. In Study 2, electroencephalography revealed a reduction in power in the theta (3-8 Hz), alpha (8-12 Hz) and low-beta (13-20 Hz) bands during the suppression of unwanted memories, compared with their voluntary recall. Interestingly, however, the reduction of power in the theta frequency band during memory control was related to a subsequent inhibition of the cardiac response. These results provide a neurophysiological basis for the influence of memory control mechanisms on the cardiac system, opening up new avenues and questions for treating intrusive memories using motivated forgetting.
Collapse
Affiliation(s)
- Nicolas Legrand
- Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Caen, France
| | - Olivier Etard
- Service d'Explorations Fonctionnelles du Système Nerveux, CHU de Caen, Caen, France
- Imagerie et Stratégies Thérapeutiques de la Schizophrénie, Normandie Univ, UNICAEN, ISTS EA 7466, GIP Cyceron, Caen, France
| | - Anaïs Vandevelde
- Imagerie et Stratégies Thérapeutiques de la Schizophrénie, Normandie Univ, UNICAEN, ISTS EA 7466, GIP Cyceron, Caen, France
| | - Melissa Pierre
- Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Caen, France
| | - Fausto Viader
- Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Caen, France
| | - Patrice Clochon
- Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Caen, France
| | - Franck Doidy
- Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Caen, France
| | - Denis Peschanski
- European Center for Sociology and Political Science (CESSP), Université Paris I Panthéon Sorbonne, HESAM Université, EHESS, CNRS, UMR8209, Paris, France
| | - Francis Eustache
- Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Caen, France
| | - Pierre Gagnepain
- Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Caen, France.
| |
Collapse
|
5
|
Serrano MÁ, Rosell-Clari V, García-Soriano G. The Role of Perceived Control in the Psychophysiological Responses to Disgust of Subclinical OCD Women. SENSORS 2019; 19:s19194180. [PMID: 31561601 PMCID: PMC6806286 DOI: 10.3390/s19194180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/13/2019] [Accepted: 09/24/2019] [Indexed: 12/27/2022]
Abstract
Obsessive‒compulsive disorder (OCD), and especially contamination obsessions and washing compulsions, has been related to disgust. However, when its cardiovascular correlates have been studied, contradictory results have been found, including heart rate accelerations and decelerations. The aim of this study is to analyze emotional, cognitive, and cardiovascular responses in nonclinical (control) and subclinical participants with obsessive‒compulsive contamination/washing symptoms when confronted with a disgusting stimulus. Twenty-seven participants (14 subclinical OCD) completed a behavioral avoidance task with a contamination-based stimulus while their heart rate and subjective variables were measured. Results showed heart rate reductions in both samples, whereas subjective measures reflected higher disgust, anxiety, dirtiness, and emotional valence in the subclinical sample. However, at the same time, the sense of dominance was lower in the control group. In conclusion, our results support a heart rate deceleration during exposure to a disgusting stimulus dissociated from the subjective experience.
Collapse
Affiliation(s)
- Miguel Ángel Serrano
- Departamento de Psicobiología, Facultad de Psicología, Universitat de València, 46010 Valencia, Spain.
| | - Vicent Rosell-Clari
- Departamento de Psicología Básica, Facultad de Psicología, Universitat de València, 46010 Valencia, Spain.
| | - Gemma García-Soriano
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, 46010 Valencia, Spain.
| |
Collapse
|
6
|
Ching THW, Williams MT, Siev J, Olatunji BO. Responsibility/Threat Overestimation Moderates the Relationship Between Contamination-Based Disgust and Obsessive-Compulsive Concerns About Sexual Orientation. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1109-1117. [PMID: 29476409 DOI: 10.1007/s10508-018-1165-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 06/03/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
Disgust has been shown to perform a "disease-avoidance" function in contamination fears. However, no studies have examined the relevance of disgust to obsessive-compulsive (OC) concerns about sexual orientation (e.g., fear of one's sexual orientation transforming against one's will, and compulsive avoidance of same-sex and/or gay or lesbian individuals to prevent that from happening). Therefore, we investigated whether the specific domain of contamination-based disgust (i.e., evoked by the perceived threat of transmission of essences between individuals) predicted OC concerns about sexual orientation, and whether this effect was moderated/amplified by obsessive beliefs, in evaluation of a "sexual orientation transformation-avoidance" function. We recruited 283 self-identified heterosexual college students (152 females, 131 males; mean age = 20.88 years, SD = 3.19) who completed three measures assessing disgust, obsessive beliefs, and OC concerns about sexual orientation. Results showed that contamination-based disgust (β = .17), responsibility/threat overestimation beliefs (β = .15), and their interaction (β = .17) each uniquely predicted OC concerns about sexual orientation, ts = 2.22, 2.50, and 2.90, ps < .05. Post hoc probing indicated that high contamination-based disgust accompanied by strong responsibility/threat overestimation beliefs predicted more severe OC concerns about sexual orientation, β = .48, t = 3.24, p < .001. The present study, therefore, provided preliminary evidence for a "sexual orientation transformation-avoidance" process underlying OC concerns about sexual orientation in heterosexual college students, which is facilitated by contamination-based disgust, and exacerbated by responsibility/threat overestimation beliefs. Treatment for OC concerns about sexual orientation should target such beliefs.
Collapse
Affiliation(s)
- Terence H W Ching
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Monnica T Williams
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Jedidiah Siev
- Department of Psychology, Swarthmore College, Swarthmore, PA, USA
| | - Bunmi O Olatunji
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
7
|
Leppanen J, Ng KW, Kim YR, Tchanturia K, Treasure J. Meta-analytic review of the effects of a single dose of intranasal oxytocin on threat processing in humans. J Affect Disord 2018; 225:167-179. [PMID: 28837950 DOI: 10.1016/j.jad.2017.08.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/23/2017] [Accepted: 08/14/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Heightened threat sensitivity is a transdiagnostic feature in several psychiatric disorders. The neuropeptide oxytocin has been shown to reduce fear related behaviours and facilitated fear extinction in animals. These findings have led to increasing interest to explore the effects of intranasal oxytocin on threat processing in humans. METHODS The review included 26 studies (N = 1173), nine of which included clinical populations (N = 234). The clinical groups included were people with borderline personality disorder (BPD), anorexia nervosa, bulimia nervosa, depression, anxiety, and alcohol dependence disorder. We examined the effects of a single dose of intranasal oxytocin on startle response, attentional responses, and behavioural responses to threat. RESULTS A single dose of intranasal oxytocin significantly increased the physiological startle response to threat in healthy people with a small effect size. However, oxytocin did not have significant effects on attentional bias towards social or disorder-specific threat, fixation towards threatening stimuli among healthy or clinical populations, or on threat related behavioural approach or avoidance responses. LIMITATIONS No studies investigated the effects of oxytocin on the startle response to threat among clinical populations. Additionally, only one of the reviewed studies had sufficient power to detect at least a moderate effect of oxytocin according to our criterion. DISCUSSION The synthesis of literature suggest that oxytocin may influence the salience of threatening stimuli among healthy individuals, increasing the startle response to threat. It would be of interest to investigate the effects of oxytocin on the startle response to threat among clinical populations.
Collapse
Affiliation(s)
- Jenni Leppanen
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychological Medicine, London, United Kingdom.
| | - Kah Wee Ng
- Singapore General Hospital, 20 College Road, Academia, 169865 Singapore, Singapore
| | - Youl-Ri Kim
- Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, South Korea
| | - Kate Tchanturia
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychological Medicine, London, United Kingdom; Department of Psychology, Illia State University, Tbilisi, Georgia
| | - Janet Treasure
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychological Medicine, London, United Kingdom
| |
Collapse
|
8
|
Saremi AA, Shariat SV, Nazari MA, Dolatshahi B. Neuropsychological Functioning in Obsessive-Compulsive Washers: Drug-Naive Without Depressive Symptoms. Basic Clin Neurosci 2017; 8:233-248. [PMID: 28781731 PMCID: PMC5535329 DOI: 10.18869/nirp.bcn.8.3.233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 11/25/2016] [Accepted: 12/19/2016] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Obsessive-Compulsive Disorder (OCD) is a complex and heterogeneous neuropsychiatric syndrome. Contamination obsessions and washing/cleaning compulsions are the most frequent clinical OCD subtypes. The current study aimed at examining the neuropsychological impairments in drug-naive obsessive-compulsive (OC) washers without depressive symptoms and their association with the severity of symptoms. METHODS In the current causal-comparative study, 35 patients with diagnostic and statistical mental disorders class (DSM)-IV diagnosed with washing-subtype OCD and 35 healthy subjects were selected by the convenience sampling method and evaluated by computerized neuropsychology battery and clinical tests as Stroop Color-Word Test (SCWT), Wisconsin Card Sorting Test (WCST), Go/No-Go Test, Digits Forward (DF), Digits Backward (DB), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and General Health Questionnaire (GHQ)-28. The patients were matched to the comparison group with regard to age, gender, intelligence quotient (IQ), education, and handedness. All the tests were standardized in Iran. SPSS version 20.00 was used for descriptive and analytical data analysis. RESULTS There was no statistically significant different between the OCD washing and the control groups regarding socio-demographic variables or IQ. There were significant differences between the OC washer and the healthy control groups on the neuropsychological functioning. The obtained results suggested that OC washers performed significantly worse on neuropsychological measures than the controls. There was no significant association between the severity of OC symptoms and the neuropsychological functions in the OCD washing group. CONCLUSION It was concluded that executive function impairment, which is a core feature in OC washers was trait-like in nature.
Collapse
Affiliation(s)
- Ali Akbar Saremi
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Seyed Vahid Shariat
- Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioural Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Nazari
- Department of Psychology, Faculty of Education & Psychology, University of Tabriz, Tabriz, Iran
| | - Behrooz Dolatshahi
- Department of Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
9
|
Disgust stimuli reduce heart rate but do not contribute to vasovagal symptoms. J Behav Ther Exp Psychiatry 2016; 51:116-22. [PMID: 26851836 DOI: 10.1016/j.jbtep.2016.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/09/2015] [Accepted: 01/27/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The vasovagal response demonstrates a unique form of stress response, common in medical settings yet provoked by a variety of blood-injury-injection stimuli. This study aimed to better understand the psychophysiological mechanisms of the vasovagal response.. METHODS 16 undergraduates with and 42 without a self-reported history of fainting watched five 3-5 min videos with different emotional content. One documentary clip (Neutral condition) described a campus environmental project while another (Blood/Injury) depicted portions of an open heart surgery. Three additional clips were also used, including Medical, Threat, and Contamination stimuli. Vasovagal symptoms and physiological variables were assessed during each video. RESULTS As predicted, while the disgust-related stimuli (Blood/Injury, Medical, Contamination) were associated with generally lower heart rate, the Blood/Injury video produced the highest symptoms and the only significant difference between previous fainters and non-fainters. The physiological measures also revealed that participants with a fainting history experienced higher stroke volume and lower systolic blood pressure throughout, as well as several main effects of video. LIMITATIONS An additional decrease in systolic blood pressure and respiration produced by watching the Blood/Injury video may have been sufficient to trigger symptoms in some, though results also suggest that systemic variables do not entirely explain susceptibility to symptoms. More careful evaluation of regional blood flow may be required. CONCLUSIONS Participants who had previously experienced strong vasovagal responses displayed what appeared to be an anticipatory response to the Blood/Injury video. Finally, disgust stimuli may reduce heart rate but do not appear to contribute to vasovagal symptoms.
Collapse
|
10
|
Buyukturkoglu K, Roettgers H, Sommer J, Rana M, Dietzsch L, Arikan EB, Veit R, Malekshahi R, Kircher T, Birbaumer N, Sitaram R, Ruiz S. Self-Regulation of Anterior Insula with Real-Time fMRI and Its Behavioral Effects in Obsessive-Compulsive Disorder: A Feasibility Study. PLoS One 2015; 10:e0135872. [PMID: 26301829 PMCID: PMC4547706 DOI: 10.1371/journal.pone.0135872] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 07/27/2015] [Indexed: 11/27/2022] Open
Abstract
Introduction Obsessive-compulsive disorder (OCD) is a common and chronic condition that can have disabling effects throughout the patient's lifespan. Frequent symptoms among OCD patients include fear of contamination and washing compulsions. Several studies have shown a link between contamination fears, disgust over-reactivity, and insula activation in OCD. In concordance with the role of insula in disgust processing, new neural models based on neuroimaging studies suggest that abnormally high activations of insula could be implicated in OCD psychopathology, at least in the subgroup of patients with contamination fears and washing compulsions. Methods In the current study, we used a Brain Computer Interface (BCI) based on real-time functional magnetic resonance imaging (rtfMRI) to aid OCD patients to achieve down-regulation of the Blood Oxygenation Level Dependent (BOLD) signal in anterior insula. Our first aim was to investigate whether patients with contamination obsessions and washing compulsions can learn to volitionally decrease (down-regulate) activity in the insula in the presence of disgust/anxiety provoking stimuli. Our second aim was to evaluate the effect of down-regulation on clinical, behavioural and physiological changes pertaining to OCD symptoms. Hence, several pre- and post-training measures were performed, i.e., confronting the patient with a disgust/anxiety inducing real-world object (Ecological Disgust Test), and subjective rating and physiological responses (heart rate, skin conductance level) of disgust towards provoking pictures. Results Results of this pilot study, performed in 3 patients (2 females), show that OCD patients can gain self-control of the BOLD activity of insula, albeit to different degrees. In two patients positive changes in behaviour in the EDT were observed following the rtfMRI trainings. Behavioural changes were also confirmed by reductions in the negative valence and in the subjective perception of disgust towards symptom provoking images. Conclusion Although preliminary, results of this study confirmed that insula down-regulation is possible in patients suffering from OCD, and that volitional decreases of insula activation could be used for symptom alleviation in this disorder.
Collapse
Affiliation(s)
- Korhan Buyukturkoglu
- Graduate School of Neural & Behavioural Sciences, International Max Planck Research School, University of Tübingen, Tuebingen, Germany
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Tuebingen, Germany
| | - Hans Roettgers
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Jens Sommer
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Mohit Rana
- Graduate School of Neural & Behavioural Sciences, International Max Planck Research School, University of Tübingen, Tuebingen, Germany
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Tuebingen, Germany
- Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
| | - Leonie Dietzsch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Ezgi Belkis Arikan
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Ralf Veit
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Tuebingen, Germany
| | - Rahim Malekshahi
- Graduate School of Neural & Behavioural Sciences, International Max Planck Research School, University of Tübingen, Tuebingen, Germany
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Tuebingen, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Niels Birbaumer
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Tuebingen, Germany
- Ospedale San Camillo, Istituto di Ricovero e Cura a Carattere Scientifico, Venezia, Italy
| | - Ranganatha Sitaram
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Tuebingen, Germany
- Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
- * E-mail: (SR); (RS)
| | - Sergio Ruiz
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Tuebingen, Germany
- Departamento de Psiquiatría, Escuela de Medicina, Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail: (SR); (RS)
| |
Collapse
|
11
|
Ludvik D, Boschen MJ, Neumann DL. Effective behavioural strategies for reducing disgust in contamination-related OCD: A review. Clin Psychol Rev 2015; 42:116-29. [PMID: 26190372 DOI: 10.1016/j.cpr.2015.07.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/19/2015] [Accepted: 07/01/2015] [Indexed: 11/29/2022]
Abstract
Disgust is an understudied but important emotion in various psychological disorders. Over the last decade, increasing evidence suggests that disgust is also present in various subtypes of obsessive-compulsive disorder (OCD), especially in contamination-related OCD (C-OCD). The treatment of choice for C-OCD is exposure with response prevention, originally designed to reduce fear-associated emotions thought to be acquired through Pavlovian conditioning (PC). However, disgust has been proposed to be acquired through evaluative conditioning (EC) and according to the referential model of this form of learning, there are functional differences between PC and EC that need to be considered in the treatment of disgust-related responses. Alternative strategies suggested by EC-based models include counterconditioning (contingent presentation of the CS with a US of opposite valence) and US revaluation (contingent presentation of the US with US of opposite valence). Drawing on the referential model, this paper reviews evidence for the effectiveness of each strategy to identify the most theoretically sound and empirically valid intervention to reduce disgust in C-OCD.
Collapse
Affiliation(s)
- Dominika Ludvik
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia.
| | - Mark J Boschen
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia.
| | - David L Neumann
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast 4222, Australia.
| |
Collapse
|
12
|
Bottini G, Brugger P, Sedda A. Is the desire for amputation related to disturbed emotion processing? A multiple case study analysis in BIID. Neurocase 2015; 21:394-402. [PMID: 24679146 DOI: 10.1080/13554794.2014.902969] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Body integrity identity disorder (BIID) is characterized by the overwhelming desire to amputate one or more healthy limbs or to be paraplegic. Recently, a neurological explanation of this condition has been proposed, in part on the basis of findings that the insular cortex might present structural anomalies in these individuals. While these studies focused on body representation, much less is known about emotional processing. Importantly, emotional impairments have been found in psychiatric disorders, and a psychiatric etiology is still a valid alternative to purely neurological accounts of BIID. In this study, we explored, by means of a computerized experiment, facial emotion recognition and emotional responses to disgusting images in seven individuals with BIID, taking into account their clinical features and investigating in detail disgust processing, strongly linked to insular functioning. We demonstrate that BIID is not characterized by a general emotional impairment; rather, there is a selectively reduced disgust response to violations of the body envelope. Taken together, our results support the need to explore this condition under an interdisciplinary perspective, taking into account also emotional connotations and the social modulation of body representation.
Collapse
Affiliation(s)
- Gabriella Bottini
- a Department of Brain and Behavioral Science , University of Pavia , Pavia , Italy
| | | | | |
Collapse
|