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. 2021 Oct 1:12:730742.
doi: 10.3389/fpsyt.2021.730742. eCollection 2021.

Examining Differences in Fear Learning in Patients With Obsessive-Compulsive Disorder With Pupillometry, Startle Electromyography and Skin Conductance Responses

Dorothee Pöhlchen  1   2 , Marthe Priouret  1 , Miriam S Kraft  1 , Florian P Binder  1   2 , Deniz A Gürsel  3   4 , Götz Berberich  5 ; BeCOME working group; Kathrin Koch  3   4 , Victor I Spoormaker  1
Collaborators, Affiliations

Examining Differences in Fear Learning in Patients With Obsessive-Compulsive Disorder With Pupillometry, Startle Electromyography and Skin Conductance Responses

Dorothee Pöhlchen et al. Front Psychiatry. .

Abstract

Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent thoughts and repetitive behaviors causing stress and anxiety. In the associative learning model of OCD, mechanisms of fear extinction are supposed to partly underlie symptom development, maintenance and treatment of OCD, proposing that OCD patients suffer from rigid memory associations and inhibitory learning deficits. To test these assumptions, previous studies have used skin conductance and subjective ratings as readouts in fear conditioning paradigms, finding impaired fear extinction learning, impaired fear extinction recall or no differences between individuals with OCD and healthy controls. Against this heterogeneous background, we tested fear acquisition and extinction in 37 OCD patients and 56 healthy controls, employing skin conductance as well as pupillometry and startle electromyography. Extinction recall was also included in a subsample. We did not observe differences between groups in any of the task phases, except a trend toward higher startle amplitudes during extinction for OCD. Overall, sensitive readouts such as pupillometry and startle responses did not provide evidence for moderate-to-large inhibitory learning deficits using classical fear conditioning, challenging the assumption of generically impaired extinction learning and memory in OCD.

Keywords: anxiety; extinction; fear conditioning; inhibitory learning; obsessive compulsive disorder.

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Conflict of interest statement

VS has received income from consultations and advisory services for Roche. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Experimental procedure of the fear-conditioning task. Sample (A) underwent a habituation phase, three blocks of fear acquisition (FA) and two blocks of extinction (EXT) on day 1. Sample (B) additionally underwent a two-block fear recall (REC) and two-block reinstatement (REI) procedure on day 2. All blocks were separated by US-expectancy ratings.
Figure 2
Figure 2
SCR across fear acquisition and extinction. Error bars are standard errors of the mean.
Figure 3
Figure 3
Pupil dilations across fear acquisition and extinction. Error bars are standard errors of the mean.
Figure 4
Figure 4
Startle EMG across fear acquisition and extinction. Error bars are standard errors of the mean.
Figure 5
Figure 5
Subjective US expectancy across fear acquisition and extinction. Error bars are standard errors of the mean.
See this image and copyright information in PMC

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