Impaired generalization of reward but not loss in obsessive-compulsive disorder.
Impaired generalization of reward but not loss in obsessive-compulsive disorder.
复制标题
强迫症中奖赏的概括性受损，但并未损失。
DOI：
10.1002/da.22857
复制
发表时间：
2019
影响因子：
7.4
通讯作者：
Simpson,HelenBlair
中科院分区：
文献类型：
--
作者：
Rouhani,Nina;Wimmer,GeorgeElliott;Schneier,FranklinR;Fyer,AbbyJ;Shohamy,Daphna;Simpson,HelenBlair
背景从过去的经验中进行概括可以是适应性的，因为这些经验可以指导新情况下的行为。然而，过于笼统地概括可能是不适应的。例如，患有病理性焦虑的人被认为过度概括了过去威胁的情绪反应，扩大了他们的恐惧范围。目前尚不清楚病理性焦虑的个体是否在其他情况下过度泛化。方法本研究(N=1557)采用带奖赏和损失的货币感觉预适应范式来解决强迫症(OCD)和社交焦虑症(SAD)个体的这一问题，并将他们与健康对照对象(HC)进行比较。结果发现，三组受试者对刺激与结果的直接学习没有差异：所有受试者都通过选择奖励选项和避免消极选项来表现出完整的刺激反应学习。然而，与SAD或HC组相比，强迫症受试者从奖励中概括的可能性更小，而且这种损害并不存在于损失中。此外，强迫症患者和所有组别的强迫症患者在奖赏概括方面的缺陷与威胁估计的严重程度相关。结论这些发现表明，从奖赏事件中概括的能力受损可能会阻碍强迫症患者和那些对威胁估计过高的人的适应行为。
BackgroundGeneralizing from past experiences can be adaptive by allowing those experiences to guide behavior in new situations. Generalizing too much, however, can be maladaptive. For example, individuals with pathological anxiety are believed to overgeneralize emotional responses from past threats, broadening their scope of fears. Whether individuals with pathological anxiety overgeneralize in other situations remains unclear.MethodsThe present study (N= 57) used a monetary sensory preconditioning paradigm with rewards and losses to address this question in individuals with obsessive–compulsive disorder (OCD) and social anxiety disorder (SAD), comparing them to healthy comparison subjects (HC). In all groups, we tested direct learning of associations between cues and reward vs. loss outcomes, as well as generalization of learning to novel choice options.ResultsWe found no differences between the three groups in the direct learning of stimuli with their outcomes: all subjects demonstrated intact stimulus‐response learning by choosing rewarding options and avoiding negative ones. However, OCD subjects were less likely to generalize from rewards than either the SAD or HC groups, and this impairment was not found for losses. Additionally, greater deficits in reward generalization were correlated with severity of threat estimation, as measured by a subscale of the Obsessive Beliefs Questionnaire, both within OCD and across all groups.ConclusionsThese findings suggest that a compromised ability to generalize from rewarding events may impede adaptive behavior in OCD and in those susceptible to high estimation of threat.