Evidence map›Paper›PMID 40782775›Full record

ArticlePsychiatry research2025

Using latent patient-centered fear extinction profiles to guide treatment in pediatric OCD.

Katherine M Ingram, Eric A Storch, Daniel A Geller, Brent J Small, Sabine Wilhelm, Joseph F McGuire

Abstract read
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Article in Psychiatry research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Katherine M IngramDepartment of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; Brown University Health, Providence, RI, USA.
Eric A StorchDepartment of Psychiatry, Baylor College of Medicine, Houston, TX, USA.
Daniel A GellerDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Brent J SmallSchool of Nursing, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
Sabine WilhelmDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Joseph F McGuireDivision of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Developmental Behavioral Health, Kennedy Krieger Institute, Baltimore, Maryland. Electronic address: jfmcguire@jhmi.edu.

Funding

2/2-D-Cycloserine Augmentation of CBT for Pediatric OCDR01MH093402 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI GELLER, DANIEL A · 2011 to 2014
$1.7M
Research Training in Childhood Stress, Trauma, and ResilienceT32HD101392 · NICHD · MIRIAM HOSPITAL · PI PARADE, STEPHANIE HART, STROUD, LAURA R · 2020 to 2024
$1.7M
1/2-D-Cycloserine Augmentation of CBT for Pediatric OCDR01MH093381 · NIMH · UNIVERSITY OF SOUTH FLORIDA · PI STORCH, ERIC A. · 2011 to 2014
$1.2M
NICHD NIH HHS T32 HD101392NIMH NIH HHS R01 MH093381NIMH NIH HHS R01 MH093402
6 · The paper itself

Abstract

backgroundWhile exposure with response prevention (ERP) is the frontline treatment for pediatric obsessive-compulsive disorder (OCD), not all patients benefit. Impairments in extinction learning are implicated in pediatric OCD's etiology and treatment, with impaired pre-treatment extinction learning associated with worse ERP outcomes. However, available methods for assessing patients' difficulties with fear extinction are costly and underdeveloped. In response, we used person-centered profiles to characterize latent fear extinction patterns among youth with OCD, and investigated the degree to which scores on common rating scales correspond to profile membership.

methodsYouth with OCD (n=98) completed a diagnostic clinical battery followed by a differential fear conditioning/extinction task, in which skin conductance response (SCR) to stimuli served as the primary outcome. Parallel process growth mixture modeling (i.e., person-centered trends in concurrent change over time SCR to differential stimuli) was used to illuminate latent profiles of fear conditioning/extinction processes. The Bose-Chaudhuri-Hocquenghem method compared latent classes to identify clinical correlates of impaired extinction.

resultsA 2-profile solution was retained. Profile 1 (85%) was characterized by typical patterns of fear acquisition and extinction learning. Profile 2 (15%) exhibited elevated levels of SCR and impairments in threat discrimination during extinction. Several items on anxiety and OCD rating scales were significantly different between profiles.

conclusionsFindings identified two distinct profiles in how youth with OCD responded to a fear extinction task, with one demonstrating substantial difficulty. Future directions should examine the extent to which impaired fear extinction ability inhibits ERP effectiveness, and consider utilizing patient-centered profiles as an initial prognostic indicator of ERP appropriateness.

Indexed as

Extinction, PsychologicalFearObsessive-Compulsive DisorderAdolescentChildFemaleGalvanic Skin ResponseHumansMalePsychiatric Status Rating ScalesFear extinctionFear learningOCDPediatricSkin conductance

Identifiers

PMID40782775
PMCPMC12475979

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