A new study now shows that OCD sufferers Scientists linked How to Simulate Softness. By exploring this Commit a Crime?
The pattern isn't unique to However, a new study casts doubt on the value of sleep time suggesting that women who experience night sweats are more vulnerable to Uncovering Hidden Intelligence of Collectives Sep. New research by psychologists suggests this sort of crash may often be the The answer is yes, according to new Most Popular Stories. Ditch the Cheat Day. Because patients with OCD scored significantly higher on the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale compared with controls, we repeated the previous group analyses after covarying for these rating scores.
Results shown in eFigure 3 illustrate that the brain regions identified as significantly increased in activation in patients with OCD remained when specifically controlling for group differences in comorbid affective symptoms. Across groups, the likelihood that participants endorsed moral violations was found to be negatively associated with activation of the dorsal medial and lateral prefrontal cortices, rostral anterior cingulate cortex and posterior cingulate cortex, inferior parietal and posterior temporal cortices, caudate nucleus, medial dorsal thalamus, and globus pallidus eTable 2 and eFigure 4.
No significant differences in the strength of these associations were found to discriminate patients with OCD from controls.
No significant positive associations with this behavioral measure were observed. We observed only significant positive associations between patients' DY-BOCS ratings of total symptom severity and activation of the right caudate nucleus, mid-orbitofrontal cortex, hypothalamus, left posterior temporal cortex, and dorsal medial frontal cortex eFigure 5 and eTable 3. Although there was considerable overlap in the brain response to moral dilemma between patients with OCD and controls, there were also significant differences between the 2 groups.
Overall, the nature of these differences seems to support the moral sensitivity hypothesis of OCD and suggests an intriguing putative connection between neurobiological processes and certain maladaptive cognitions in this disorder. Consistent with predictions, the moral dilemma task provoked greater activation of the ventromedial prefrontal and orbitofrontal cortex regions in patients with OCD. Despite rating the moral dilemmas as significantly more emotionally provocative than the nondilemma condition, patients did not rate them as more provocative than did healthy participants.
Thus, although this assessment was not specific to particular moral emotions or sentiments, it nevertheless suggests some distinction between patients' increased ventral frontal cortex response and their perceived experience of emotion during moral dilemma. With reference to the additional regions that distinguished patients with OCD from healthy participants, it is possible that the moral dilemma task provoked other disorder-relevant processes consistent with the moral sensitivity hypothesis. Recent studies 50 - 52 in healthy participants have shown that the explicit cognitive appraisal of emotional stimuli, including negative appraisals, consistently leads to increased activation of the left dorsolateral prefrontal cortex and posterior middle temporal gyrus, the same regions implicated in patients with OCD.
For example, in one study, 52 activation of these regions was prominent when healthy participants were instructed to upregulate negative emotions by consciously reappraising visual emotional images to be more personally salient in terms of their subjective relevance. The left hemispheric predominance of this finding was attributed to the idea that such appraisals draw heavily on affective descriptors and verbal narratives to regulate emotion. In patients with OCD, it is plausible that disorder-relevant cognitive biases engaged during moral decision making, such as greater perceived responsibility, might evoke heightened activation of these same left frontotemporal regions.
If true, the neural correlates of moral sensitivity in OCD would, therefore, seem to equally implicate brain regions associated with the conscious cognitive appraisal of emotional stimuli and those more directly associated with the subjective experience of moral emotions. The extent to which such processes might interact or be dissociable in patients with OCD is not presently clear.titokehighkelb.ga
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The 2 groups were not different in their activation of other task-relevant cortical regions, including the dorsal medial frontal, inferior parietal, posterior cingulate, and rostral anterior cingulate cortices. Irrespective of group membership, individual differences in the willingness to endorse moral violations were found to be negatively correlated with activation of these regions. Greater difficulty in endorsing moral violations may, therefore, have been experienced as generally more self-engaging.
We recruited a large group of patients with OCD for this work, which afforded the possibility to assess relationships between brain activations and clinical symptoms. To this end, greater overall symptom severity was found to predict the activation of several task-related and task-unrelated regions as defined at the group imaging level. In the former case, this included the dorsal medial frontal cortex and left posterior temporal sulcus, and in the latter case, this included the hypothalamus, ventral caudate nucleus, and mid-orbitofrontal cortex.
In previous functional imaging studies, 22 , 23 , 56 , 57 OCD symptom severity has been most consistently associated with elevated activity of the orbitofrontal cortex and striatum, which is, therefore, relevant to observe herein. Moreover, both of these regions remain centrally implicated in pathophysiologic models that implicate primary disturbances of orbitofrontal-striatal circuits to this disorder.
Of these regions, the amygdala was not robustly activated by the task at the group imaging level. Considering the anatomy of these limbic-paralimbic regions and their link to emotional-autonomic states, 58 it is conceivable that patients scoring high on this symptom dimension felt more challenged or provoked by the moral dilemmas. Indeed, it is generally assumed that a strong link exists between moral sensitivity in OCD and the experience of sexual and religious obsessions.
Moreover, on the basis of cognitive bias models of OCD, it may be suspected that these associations were specifically mediated or modulated by common dysfunctional belief domains, such as inflated responsibility.
There are limitations to this study. First, we attempted to maximize the emotionally provocative nature of the moral dilemmas by using a simple mode of decision making during task performance; for discussion, see the study by Harrison et al. However, based on accumulated evidence in other clinical cohorts and a recent behavioral study of moral reasoning in OCD, it was generally not anticipated that patients with OCD would exhibit pronounced deficits in moral decision making per se.
Such a measure would have permitted direct exploration of the influence of inflated responsibility vs other belief domains on the imaging findings.
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Third, since all but 2 patients in this study were receiving medication at the time of assessment primarily selective serotonin reuptake inhibitor—based antidepressant treatment , we could not compare medicated and unmedicated subgroups. Although on the basis of several previous studies, 22 , 25 , 56 , 64 - 66 it can be argued that the influence of such treatments on brain activation in OCD may have been to attenuate rather than inflate this study's results; this account is not definitive.
Such evidence does not address the fact that patients with OCD receiving a selective serotonin reuptake inhibitor often receive other adjunct treatments, as was the case in the present sample, and that the combined effect of such treatment on brain functional activity is mostly unexplored.
The issue of medication use, therefore, represents a caveat to this study that will need to be addressed in future work. Fourth, despite the large patient cohort and evaluation of OCD symptom dimensions, comparisons with another psychiatric cohort would have enhanced the specificity of these findings. The previous limitations considered, this study provided a novel characterization of brain regions that potentially represent an important link between neurobiological processes and certain maladaptive cognitions in patients with OCD.
One broader implication of this work may be to inform more advanced models of the etiology of obsessions and compulsions with the capacity to integrate distinct measurements across cognitive and biological domains. Such research may take the form of longitudinal studies 68 , 69 or specific experimental manipulations 70 capable of prospectively testing causal predictions between cognitive and neurobiological factors and the emergence of obsessive-compulsive symptoms and behaviors. Correspondence: Ben J. Submitted for Publication: June 19, ; final revision received November 7, ; accepted November 8, Author Contributions: Dr Harrison had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Role of the Sponsors: The funding bodies had no specific role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript. All Rights Reserved. View Large Download. Table 1. Table 2.
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