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Wuebken K, Bermpohl F, Boedeker K, Hindi Attar C, Kluczniok D, Schoofs N, Fuchs A, Neukel C, Herpertz SC, Brunner R, Winter SM, Kaess M, Jaite C, Dittrich K. The mediating role of attachment and anger: exploring the impact of maternal early-life maltreatment on child abuse potential. Front Psychiatry 2023; 14:1267038. [PMID: 37965361 PMCID: PMC10641504 DOI: 10.3389/fpsyt.2023.1267038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/02/2023] [Indexed: 11/16/2023] Open
Abstract
Background Maternal early-life maltreatment (ELM) increases the risk of subsequent child maltreatment, but the underlying mechanisms of these intergenerational effects remain largely unknown. Identifying these mechanisms is crucial for developing preventive interventions that can break the cycle of abuse. Notably, previous research has shown that ELM often results in attachment insecurity and altered anger characteristics. Therefore, this study determines whether these characteristics mediate the relationship between maternal history of ELM and child abuse potential. Methods The study sample included 254 mothers, of whom 149 had experienced ELM to at least a moderate degree. Maternal ELM was assessed using the Childhood Experience of Care and Abuse (CECA) interview. Attachment insecurity, trait anger and anger expression, and maternal abuse potential were assessed using the Vulnerable Attachment Questionnaire (VASQ), State-Trait Anger Expression Inventory (STAXI), and Child Abuse Potential Inventory (CAPI), respectively. Results The severity of maternal ELM predicted higher child abuse potential, with attachment insecurity and anger suppression mediating this effect. Specifically, higher levels of maternal ELM were associated with greater attachment insecurity and increased anger suppression, resulting in a higher child abuse potential. Although higher levels of trait anger were directly associated with higher child abuse potential, this parameter did not mediate the relationship with ELM. In addition, no significant associations were observed between outwardly expressed anger and ELM or child abuse potential. All analyses were adjusted for maternal mental disorders, years of education, and relationship status. Discussion Attachment insecurity and anger suppression may serve as pathways linking the maternal history of ELM to the risk of child abuse, even when considering maternal psychopathology. Overall, our findings indicate that interventions aimed at strengthening attachment and improving anger suppression may be beneficial for all mothers with ELM history and high child abuse potential, not just those who suffer from mental illness.
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Affiliation(s)
- Karolina Wuebken
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Katja Boedeker
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Catherine Hindi Attar
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Dorothea Kluczniok
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Nikola Schoofs
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Mitte, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Anna Fuchs
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine C. Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Romuald Brunner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Sibylle Maria Winter
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Charlotte Jaite
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
- Department of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Hildesheim, Hildesheim, Germany
| | - Katja Dittrich
- Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité—Universitätsmedizin Berlin, Charité Campus Virchow, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
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Bratzu J, Ciscato M, Pisanu A, Talani G, Frau R, Porcu P, Diana M, Fumagalli F, Romualdi P, Rullo L, Trezza V, Ciccocioppo R, Sanna F, Fattore L. Communal nesting differentially attenuates the impact of pre-weaning social isolation on behavior in male and female rats during adolescence and adulthood. Front Behav Neurosci 2023; 17:1257417. [PMID: 37915532 PMCID: PMC10616881 DOI: 10.3389/fnbeh.2023.1257417] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Early social isolation (ESI) disrupts neurodevelopmental processes, potentially leading to long-lasting emotional and cognitive changes in adulthood. Communal nesting (CN), i.e., the sharing of parental responsibilities between multiple individuals in a nest, creates a socially enriching environment known to impact social and anxiety-related behaviors. Methods This study examines the effects of (i) the CN condition and of (ii) ESI during the 3rd week of life (i.e., pre-weaning ESI) on motor, cognitive, and emotional domains during adolescence and adulthood in male and female rats reared in the two different housing conditions, as well as (iii) the potential of CN to mitigate the impact of ESI on offspring. Results We found that in a spontaneous locomotor activity test, females exhibited higher activity levels compared to males. In female groups, adolescents reared in standard housing (SH) condition spent less time in the center of the arena, suggestive of increased anxiety levels, while the CN condition increased the time spent in the center during adolescence, but not adulthood, independently from ESI. The prepulse inhibition (PPI) test showed a reduced PPI in ESI adolescent animals of both sexes and in adult males (but not in adult females), with CN restoring PPI in males, but not in adolescent females. Further, in the marble burying test SH-ESI adolescent males exhibited higher marble burying behavior than all other groups, suggestive of obsessive-compulsive traits. CN completely reversed this stress-induced effect. Interestingly, ESI and CN did not have a significant impact on burying behavior in adult animals of both sexes. Discussion Overall, our findings (i) assess the effects of ESI on locomotion, sensorimotor gating, and compulsive-like behaviors, (ii) reveal distinct vulnerabilities of males and females within these domains, and (iii) show how early-life social enrichment may successfully counteract some of the behavioral alterations induced by early-life social stress in a sex-dependent manner. This study strengthens the notion that social experiences during early-life can shape emotional and cognitive outcomes in adulthood, and points to the importance of social enrichment interventions for mitigating the negative effects of early social stress on neurodevelopment.
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Affiliation(s)
- Jessica Bratzu
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
| | - Maria Ciscato
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
| | - Augusta Pisanu
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
| | - Giuseppe Talani
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
| | - Roberto Frau
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Patrizia Porcu
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
| | - Marco Diana
- G.Minardi’ Cognitive Neuroscience Laboratory, CPMB Science Department, University of Sassari, Sassari, Italy
| | - Fabio Fumagalli
- Department of Pharmacological and Biomolecular Sciences ‘Rodolfo Paoletti’, University of Milan, Milan, Italy
| | - Patrizia Romualdi
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Laura Rullo
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Viviana Trezza
- Department of Science, University “Roma Tre”, Rome, Italy
| | - Roberto Ciccocioppo
- School of Pharmacy, Center for Neuroscience, Pharmacology Unit, University of Camerino, Camerino, Italy
| | - Fabrizio Sanna
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Liana Fattore
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
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Dostal AL, Pilkington PD. Early maladaptive schemas and obsessive-compulsive disorder: A systematic review and meta-analysis. J Affect Disord 2023; 336:42-51. [PMID: 37217101 DOI: 10.1016/j.jad.2023.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a condition with poor treatment outcomes. Improved understanding of the aetiology can inform prevention and treatment approaches; hence several studies have assessed early maladaptive schemas (EMSs) in OCD. This systematic review and meta-analysis aimed to synthesise the evidence on relationships between the 18 EMSs and OCD. METHODS The study was conducted according to PRISMA guidelines and registered on PROSPERO (CRD42022329337). A systematic search of PubMed, PsycINFO, and CINAHL Complete was conducted on 4 June 2022. Studies in peer-reviewed journal articles were included if they assessed EMSs and OCD (diagnosis or symptom severity) in adults with a mean age of 18 years or older. Studies were excluded if they were not in English, did not include original quantitative data, or reported on case studies. Study details were tabulated and the meta-analysis findings were presented using forest plots. Methodological quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS Based on 22 studies (pooled N = 3699), all 18 EMSs were positively correlated with OCD. The largest associations were with the dependence/incompetence (r = 0.40 95 % CI [0.32, 0.47]), vulnerability to harm or illness (r = 0.40 95 % CI [0.32, 0.48]), and negativity/pessimism schemas (r = 0.42 95 % CI [0.22, 0.58]). LIMITATIONS Several meta-analyses showed considerable heterogeneity and publication bias. CONCLUSIONS The findings suggest all EMSs, particularly those relating to disproportionate negative expectations and a perceived inability to cope, are implicated in OCD. Psychological prevention and treatment for OCD may benefit from targeting these schemas.
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Affiliation(s)
- Amy L Dostal
- School of Behavioural and Health Sciences, Australian Catholic University, Australia.
| | - Pamela D Pilkington
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
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Kaçan H, Öztürk A. Parental Attitudes and Childhood Traumas as Predictors of Obsessive-Compulsive Symptoms in University Students. PSYCHIAT CLIN PSYCH 2023; 33:38-47. [PMID: 38764526 PMCID: PMC11082587 DOI: 10.5152/pcp.2023.22508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/17/2023] [Indexed: 05/21/2024] Open
Abstract
Background In this study, we aimed to examine the predictive effects of parental attitudes and childhood traumas on obsessive-compulsive symptoms in university students. Methods This cross-sectional and correlational study was performed with the participation of 780 students. The data collection tools were a "Descriptive Information Form," the "Padua Inventory," the "Childhood Trauma Questionnaire-28," and the "Parental Attitude Scale." Results The results of the regression analysis revealed that perceived protective/demanding (ß = 0.959; P < .001) and authoritarian (ß = 0.439; P < .001) parenting attitudes and childhood traumas (emotional neglect ß = 0.905; P = .049; physical abuse ß = 1.464; P = .002; emotional abuse ß = 2.152; P < .001; sexual abuse ß = 0.812; P = .030) constituted a positive and significant predictor of obsessive-compulsive symptoms. Conclusion Evaluation of parental attitudes and childhood traumas and interventions aimed at predicting the obsessive-compulsive disorder-related consequences of parental attitudes and childhood traumas can help alleviate obsessive-compulsive disorder symptoms. Involving families in treatment approaches such as psychoeducation and psychotherapy for childhood trauma victims with obsessive-compulsive disorder and cooperation with families can positively affect treatment processes. Nurses with the roles of direct care, support, education, and counseling have important standing in running psychoeducation groups. In particular, academic psychiatric nurses can identify risky students and provide counseling and psychoeducation to university students.
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Affiliation(s)
- Havva Kaçan
- Department of Psychiatry Nursing, Faculty of Health Sciences, Kastamonu University, Kastamonu, Turkey
| | - Ayfer Öztürk
- Department of Psychiatry Nursing, Faculty of Health Sciences, Bartın University, Bartın, Turkey
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Gehrt TB, Obermann M, Toth FE, Frostholm L. Adverse childhood experiences in patients with severe health anxiety: No evidence for an increased frequency compared to patients with obsessive-compulsive disorder. Scand J Psychol 2022; 63:565-572. [PMID: 35778854 PMCID: PMC9796245 DOI: 10.1111/sjop.12856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/01/2022] [Accepted: 06/13/2022] [Indexed: 01/01/2023]
Abstract
Theoretical models of health anxiety emphasize adverse childhood experiences in the development of the disorder, but few studies examine such events in patients with severe health anxiety and the results are difficult to compare across studies. The present study examined adult retrospective reports of illness-related and traumatic childhood experiences in 31 patients with severe health anxiety, 32 non-clinical control participants, and a clinical control group of 33 patients with obsessive-compulsive disorder. No evidence of an increased frequency of adverse childhood experiences in patients with severe health anxiety was found. However, patients with severe health anxiety who had experienced the death of a friend or family member or a major upheaval during childhood, perceived these events as having been more traumatic than the control participants. These findings suggest that biases in how adverse childhood experiences are interpreted or remembered might play a role in severe health anxiety. The findings are discussed in relation to the cognitive behavioral model of health anxiety, and some of the processes in interpretation and memory that could explain how adverse childhood experiences might play a role in the development and maintenance of severe health anxiety are outlined.
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Affiliation(s)
- Tine B. Gehrt
- Center on Autobiographical Memory ResearchAarhus UniversityAarhusDenmark
| | - Marie‐Louise Obermann
- Research Clinic for Functional DisordersAarhus University HospitalAarhusDenmark,Clinic for OCD and Anxiety DisordersAarhus University HospitalAarhusDenmark
| | - Fruzsina Eva Toth
- Clinic for OCD and Anxiety DisordersAarhus University HospitalAarhusDenmark,Regional Psychiatry Unit, Silkeborg HospitalCentral Denmark RegionSilkeborgDenmark
| | - Lisbeth Frostholm
- Research Clinic for Functional DisordersAarhus University HospitalAarhusDenmark,Department of Clinical MedicineAarhus UniversityAarhusDenmark
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Jarrar Q, Ayoub R, Alhussine K, Goh KW, Moshawih S, Ardianto C, Goh BH, Ming LC. Prolonged Maternal Separation Reduces Anxiety State and Increases Compulsive Burying Activity in the Offspring of BALB/c Mice. J Pers Med 2022; 12:1921. [PMID: 36422097 PMCID: PMC9699014 DOI: 10.3390/jpm12111921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The elevated plus maze (EPM) and the marble burying (MB) tests are common behavioral tests used for behavioral phenotyping in mouse models for neurodevelopmental disorders. However, the behavioral effects of maternal separation (MS), a standard paradigm for early life stress in animals, in both the EPM and MB tests remain incompletely known. OBJECTIVES This study aimed to investigate the behavioral effects of prolonged MS in the offspring of mice using the EPM and MB tests. METHODS Male BALB/c mice were isolated from their mothers for 4 h each day during the first 30 days after birth. On day 50 postnatal, groups of separated and non-separated mice (n = 18/each group) were subjected to the EPM and MB tests for comparative behavioral evaluations. In addition, the locomotor activity of mice was evaluated using the actophotometer test. RESULTS The findings of the EPM test revealed that separated mice exhibited anxiolytic-like behaviors, as evidenced by a significant increase in the latency to closed arms and the time spent in the open arms compared with non-separated mice. Separated mice also showed compulsive burying activity in the MB test, as determined by a significant increase in the number of buried marbles. The results of the actophotometer test did not show any significant change in locomotor activity. CONCLUSIONS Prolonged MS caused the adult offspring of mice to exhibit a decrease in anxiety state and increased compulsive burying activity, which were not associated with a change in locomotor activity. Further investigations with validated tests are needed to support these findings.
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Affiliation(s)
- Qais Jarrar
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Rami Ayoub
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Kawther Alhussine
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai 71800, Malaysia
| | - Said Moshawih
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE1410, Brunei Darussalam
| | - Chrismawan Ardianto
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Bey Hing Goh
- Biofunctional Molecule Exploratory Research Group, School of Pharmacy, Monash University Malaysia, Petaling Jaya 47500, Malaysia
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Long Chiau Ming
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE1410, Brunei Darussalam
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
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Childhood adversity affects symptomatology via behavioral inhibition in patients with obsessive-compulsive disorder. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02718-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Destrée L, Brierley MEE, Albertella L, Jobson L, Fontenelle LF. The effect of childhood trauma on the severity of obsessive-compulsive symptoms: A systematic review. J Psychiatr Res 2021; 142:345-360. [PMID: 34425487 DOI: 10.1016/j.jpsychires.2021.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/08/2021] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Childhood trauma is associated with a range of psychiatric disorders, including obsessive-compulsive disorder (OCD). However, our understanding of the different types of childhood trauma and its impact on the different types and severity of obsessive-compulsive symptoms (OCS) is still in its infancy. AIMS We conducted a systematic review to synthesise the current knowledge on the possible relationships between childhood trauma and obsessive-compulsive symptoms in clinical and non-clinical populations. METHODS We systematically searched four electronic databases for studies reporting on childhood trauma and OCS severity. Subsequently, we qualitatively synthesised results of eligible studies and effect sizes were also calculated. RESULTS Twenty-four studies were included in this systematic review. Most studies used OCD samples (k = 16), with a few studies using a sample comprising of a range of psychiatric disorders (k = 6) and some studies using a general community sample (k = 2). Overall, there was support for a significant relationship between childhood trauma and OCS severity (8 out of 16 of the studies using OCD clinical samples, both studies using general population samples, and 5 out of 6 studies used mixed psychiatric samples). CONCLUSIONS We found evidence of a significant relationship between exposure to childhood trauma and OCS severity across clinical and non-clinical populations. Our results also suggest that a range rather than a single type of childhood trauma was associated with OCD.
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Affiliation(s)
- Louise Destrée
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia.
| | - Mary-Ellen E Brierley
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Laura Jobson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Leonardo F Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia; Obsessive, Compulsive, And Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
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