Neural Correlates of Moral Sensitivity in Obsessive-Compulsive Disorder

Harrison, Ben J; Pujol, Jesús; Soriano‐Mas, Carles; Hernández‐Ribas, Rosa; López‐Solà, Marina; Ortiz, Héctor; Alonso, Pino; Deus, Joan; Menchón, José M.; Real, Eva; Segalás, Cinto; Contreras‐Rodríguez, Oren; Blanco‐Hinojo, Laura; Cardoner, Narcı́s

doi:10.1001/archgenpsychiatry.2011.2165

Cited by 66 publications

(47 citation statements)

References 73 publications

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“…58 Such findings indicate that the vmPFC may be in volved in the regulation of transiently increased limbic activity when individuals experience anxiety symptoms, a hypothesis that seems to concur with our findings. Increased functional connectivity between the amygdala and prefrontal areas has been reported in patients with OCD during executive function ing as well.…”

Section: Discussionsupporting

confidence: 89%

Structural covariance of neostriatal and limbic regions in patients with obsessive–compulsive disorder

Subirà

Cano

Wit

et al. 2016

jpn

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Section: Discussionsupporting

confidence: 89%

Structural covariance of neostriatal and limbic regions in patients with obsessive–compulsive disorder

Subirà

Cano

Wit

et al. 2016

jpn

Self Cite

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“…Ayrıca, yapılan nörobiyolojik çalışmalarda duygu ile ilişkili limbik beyin patolojileri ile daha fazla ilişkili bulunmuşlardır (Besiroglu ve ark. 2011b, Harrison ve ark. 2012, Subira ve ark.…”

Section: Belirti İçeriğiunclassified

Understanding Treatment Response and Resistance in Obsessive Compulsive Disorder in the Context of Cognitive Neuropsyhological Model

Beşiroğlu¹

2016

Turkish Journal of Psychiatry

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ÖZETBilişsel davranışçı terapiler (BDT), antidepresanlar ve nöro-düzenleme teknikleri obsesif kompulsif bozukluğun (OKB) tedavisinde çeşitli aşa-malarda kullanılan güncel tedavi seçenekleridir. Bir psikiyatrik bozuklukta psikolojik yaklaşımlardan cerrahi tekniklere kadar bambaşka yaklaşımları tedavi etkisinde ortak kılan unsurlar ilgili literatürde yeterince tanımlanmamıştır. Bilişsel Nöropsikolojik Model güncel bir yaklaşım olarak farklı psikopatolojiler için psikolojik ve nörobiyolojik modellerin duygusal işlemleme süreçlerinin bozulması aracılığıyla bağdaştığı ortak bir çatı önermektedir. Bu yazıda OKB'de farklı tedavi seçeneklerinin etkinliğini anlamak için yukarıdan-aşağı ve aşağıdan-yukarı bozulmuş duygusal işlemleme süreçlerini bütünleştiren bir yaklaşım tanımlanmış-tır. Bu modele göre bilişsel terapi bilgi işleme yanlılıklarını doğrudan etkilemek yerine, yukarıdan-aşağı duygusal işlemleme süreçleri üzerin-deki etkileri aracılığıyla şemalar üzerinde aşamalı bir kırılma yaratır. Antidepresanlar ve davranışçı terapinin ise beynin duygusal işlemlemesini aşağıdan-yukarı süreçler yoluyla değiştirdiği öne sürülür. OKB'si olan hastalarda BDT ve ilaç tedavisine direnç sık karşılaşılan bir durumdur ve bu tedavi seçeneklerine olumsuz yanıtı yordayan birçok etmen tanımlanmıştır. Belirti şiddeti, bazı özel belirtilerin varlığı, zayıf içgörü, dissosiyasyon eğilimi ve ailesel katılım hem BDT hem ilaç tedavisine direnç ile ilişkili bulunmuş etmenlerdir. Bu farklı etmenlerin varlığını tedavi direnci ile ilişkili kılan altta yatan nedenler Bilişsel Nöropsikolo-jik Model bağlamında tartışılmıştır. In this paper, an integrated approach of disrupted top-down and bottom-up emotional processing has been described to understand the efficacy of the different treatment modalities for OCD. In this model, the cognitive therapy is proposed to contribute to the gradual breakdown of schemata through the effect on top-down emotional processing instead of acting on information processing biases directly. Antidepressant drugs and behavioral therapy are proposed to alter the brain's emotion processing in a bottom-up process. Resistance to pharmacotherapy and CBT is a common problem in the patients with OCD, and a lot of factors have been described as negative predictors of these treatment options. The severity of symptoms, presence of specific symptoms, poorer insight, high level of dissociation and family accommodation are the factors associated with resistance to both pharmacotherapy and CBT. The underlying reasons establishing an association between the presence of these diverse factors and treatment resistance were discussed in the context of CNM.

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“…An error-related negativity test has indicated that a cognitive bias in outcome prediction is associated with obsessive-compulsive symptomatology [15]. Recent advances in social cognitive neuroscience suggest that a compelling relationship exists between this cognitive bias and the functional activity of brain regions implicated in OCD, including orbitofrontal cortex, dorsolateral prefrontal cortex [16], and other error detection and control-relevant fronto-cingulate system [17]. These studies highlight the importance of cognitive responses to mistakes in OCD and point out the need for further investigations of network interactions involved in treatment resistance in OCD.…”

Section: Introductionmentioning

confidence: 99%

Microstructural Abnormality in Left Nucleus Accumbens Predicts Dysfunctional Beliefs in Treatment-Resistant Obsessive-Compulsive Disorder

et al. 2014

Med Sci Monit

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BackgroundThe aim of this study was to determine whether dysfunctional beliefs might predict treatment-resistance and to examine the relationship between fractional anisotropy (FA) in diffusion tensor imaging (DTI) and cognitive biases for optimal treatment choice.Material/MethodsWe recruited 11 non-resistant obsessive-compulsive disorder (OCD) patients, 11 resistant OCD patients, and 11 healthy subjects.ResultsOCD patients had higher Obsessive Beliefs Questionnaire (OBQ-87) subscale scores than subjects in non-resistant and resistant groups. A significant difference was found between non-resistant and resistant OCD patients in R-Scale and I-Scale. A significant decrease in FA was found in left dorsal frontal gyrus and left inferior parietal lobule in the non-resistant group as compared to the control group. FA also decreased significantly in left anterior cingulate cortex, putamen, and nucleus accumbens in the resistant group as compared to the control group. There was a significant decrease in FA in nucleus accumbens in the resistant group as compared to the non-resistant group. Reduced FA in left nucleus accumbens was negatively associated with OBQ-87 factor R and I and the total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).ConclusionsAbnormalities in cortical-striatal white matter networks may contribute to the dysfunctional beliefs in patients with treatment-resistant OCD, and the left nucleus accumbens may be an important and promising target for the treatment of OCD.

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Neural Correlates of Moral Sensitivity in Obsessive-Compulsive Disorder

Cited by 66 publications

References 73 publications

Structural covariance of neostriatal and limbic regions in patients with obsessive–compulsive disorder

Structural covariance of neostriatal and limbic regions in patients with obsessive–compulsive disorder

Understanding Treatment Response and Resistance in Obsessive Compulsive Disorder in the Context of Cognitive Neuropsyhological Model

Microstructural Abnormality in Left Nucleus Accumbens Predicts Dysfunctional Beliefs in Treatment-Resistant Obsessive-Compulsive Disorder

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