Extinction retention and fear renewal in a lifetime obsessive-compulsive disorder sample

Abstract

Obsessive-compulsive disorder (OCD), like other illnesses with prominent anxiety, may involve abnormal fear regulation and consolidation of safety memories. Impaired fear extinction memory (extinction recall, ER) has been shown in individuals with current symptoms of OCD [1]. However, contrary to expectations, the only previous study investigating this phenomenon showed a positive correlation between extinction recall abilities and OCD symptomology (i.e., as OCD symptoms worsened, extinction memory improved). The purpose of the current study was to determine if patients with a lifetime diagnosis of OCD (not necessarily currently symptomatic) also demonstrate impairments in extinction memory, and the relationship between OCD symptomology and extinction memory in this type of sample. In addition, we also examined fear renewal, which has never been investigated in an OCD sample. We enrolled 37 patients with OCD, the majority of whom were on serotonin reuptake inhibitors, and 18 healthy control participants in a 2-day paradigm assessing fear conditioning and extinction (Day 1) and extinction retention and renewal (Day 2). Skin conductance responses (SCRs) were the dependent measure. Results, as in the prior study, indicated that the only between-group difference was impaired ER in OCD patients relative to controls. Contrary to our prediction, OCD symptom severity was not correlated with the magnitude of extinction recall. There were no differences in fear renewal between OCD patients and controls.

Keywords: Anxiety/anxiety disorders; Biological markers; CBT/cognitive behavior therapy; Cognition; OCD/obsessive–compulsive disorder.

Fig. 1

Schematic of experimental protocol. Pictures showing the visual contexts used in the experiment within which conditioned stimuli (CS) were presented. In this example, pictures of an office and a conference room represent conditioning and extinction (E) contexts, respectively, whereas the blue light represents the CS+ that was paired with the shock and later extinguished. Extinction recall and fear renewal were conducted on Day 2.

Fig. 2

Trial by trial skin conductance responses to CS+ and CS− for healthy control and OCD patient groups during each phase.

Fig. 3

Extinction retention index (ERI) for OCD and healthy controls.

Fig. 4

Relationship between extinction recall index and level of OCD symptom severity among patients with OCD.