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fear conditioning, extinction, skin conductance, inhibitory learning, obsessive‐compulsive disorder, children

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BACKGROUND: Fear acquisition and extinction are central constructs in the cognitive-behavioral model of obsessive-compulsive disorder (OCD), which underlies exposure-based cognitive-behavioral therapy (CBT). Youth with OCD may have impairments in fear acquisition and extinction that carry treatment implications. We examined these processes using a differential conditioning procedure.

METHODS: Forty-one youth (19 OCD, 22 community comparisons) completed a battery of clinical interviews, rating scales, and a differential conditioning task that included habituation, acquisition, and extinction phases. Skin conductance response (SCR) served as the primary dependent measure.

RESULTS: During habituation, no difference between groups was observed. During acquisition, differential fear conditioning was observed across participants as evidenced by larger SCRs to the CS+ compared to CS-; there were no between-group differences. Across participants, the number and frequency of OCD symptoms and anxiety severity was associated with greater reactivity to stimuli during acquisition. During extinction, a three-way interaction and follow-up tests revealed that youth with OCD showed a different pattern of SCR extinction compared to the community comparison group.

CONCLUSIONS: Youth with OCD exhibit a different pattern of fear extinction relative to community comparisons. This may be attributed to impaired inhibitory learning and contingency awareness in extinction. Findings suggest the potential benefit of utilizing inhibitory-learning principles in CBT for youth with OCD, and/or augmentative retraining interventions prior to CBT to reduce threat bias and improve contingency detection.

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Citation / Publisher Attribution

Depression and Anxiety, v. 33, issue 3, p. 229-237

This is the peer reviewed version of the following article: McGuire, J. F., Orr, S. P., Wu, M. S., Lewin, A. B., Small, B. J., Phares, V. , Murphy, T. K., Wilhelm, S. , Pine, D. S., Geller, D. and Storch, E. A. (2016), FEAR CONDITIONING AND EXTINCTION IN YOUTH WITH OBSESSIVE‐COMPULSIVE DISORDER. Depress Anxiety, 33: 229-237, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.