Mechanisms of Change in Exposure Therapy for Anxiety and Related Disorders: A Research Agenda

Clinical Psychological Science, Journal Year: 2024, Volume and Issue: unknown

Published: May 25, 2024

Anxiety and related disorders are a significant public-health burden with rising prevalence in the wake of COVID-19 pandemic. As demand for effective anxiety treatment increases, so too does need strategies to bolster outcomes. Research on mechanisms exposure therapy, frontline behavioral treatment, will be critically important optimizing clinical We outline an initial agenda future research change developed collaboration large international team researchers through Exposure Therapy Consortium. Key questions recommendations focus four priority areas: conceptualization, measurement, study design/analysis, individual/contextual differences. Rising challenge addressing these require coordinated action availability centralized tools that can used across trials, settings, groups.

Language: Английский

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Invasive and Non-invasive Neurostimulation for OCD

Current topics in behavioral neurosciences, Journal Year: 2021, Volume and Issue: unknown, P. 399 - 436

Published: Jan. 1, 2021

Language: Английский

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Comparable roles for serotonin in rats and humans for computations underlying flexible decision-making

Neuropsychopharmacology, Journal Year: 2023, Volume and Issue: 49(3), P. 600 - 608

Published: Nov. 1, 2023

Serotonin is critical for adapting behavior flexibly to meet changing environmental demands. Cognitive flexibility important successful attainment of goals, as well social interactions, and frequently impaired in neuropsychiatric disorders, including obsessive-compulsive disorder. However, a unifying mechanistic framework accounting the role serotonin behavioral has remained elusive. Here, we demonstrate common effects manipulating function across two species (rats humans) on latent processes supporting choice during probabilistic reversal learning, using computational modelling. The findings support plasticity, indicated, respectively, by increases or decreases repetition ('stickiness') reinforcement learning rates following manipulations intended increase decrease function. More specifically, rate at which expected value increased reward decreased punishment (reward 'learning rates') was greatest after sub-chronic administration selective reuptake inhibitor (SSRI) citalopram (5 mg/kg 7 days followed 10 twice day 5 days) rats. Conversely, humans given single dose an SSRI (20 mg escitalopram), can post-synaptic signalling, rats that received neurotoxin 5,7-dihydroxytryptamine (5,7-DHT), destroys forebrain serotonergic neurons, exhibited rates. A basic perseverative tendency ('stickiness'), irrespective outcome produced, likewise 12-day regimen 5,7-DHT These humans-identified via modelling-suggest evolutionarily conserved plasticity have clinical relevance transdiagnostically disorders.

Language: Английский

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An Active-Inference Approach to Second-Person Neuroscience

Perspectives on Psychological Science, Journal Year: 2023, Volume and Issue: 19(6), P. 931 - 951

Published: Aug. 11, 2023

Social neuroscience has often been criticized for approaching the investigation of neural processes that enable social interaction and cognition from a passive, detached, third-person perspective, without involving any real-time interaction. With emergence second-person neuroscience, investigators have uncovered unique complexity neural-activation patterns in actual, occurs during is fundamentally different unfolding observation. However, it remains unclear how correlates are to be interpreted. Here, we leverage active-inference framework shed light on mechanisms at play studies. Specifically, show counterfactually rich mutual predictions, bodily adaptation, policy selection explain activation components default mode, salience, frontoparietal networks brain, as well basal ganglia. We further argue these constitute crucial underwrite bona fide By placing experimental approach theoretical foundation framework, inform field about real-life interactions. thereby contribute foundations empirical neuroscience.

Language: Английский

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Beliefs, compulsive behavior and reduced confidence in control

PLoS Computational Biology, Journal Year: 2024, Volume and Issue: 20(6), P. e1012207 - e1012207

Published: June 20, 2024

OCD has been conceptualized as a disorder arising from dysfunctional beliefs, such overestimating threats or pathological doubts. Yet, how these beliefs lead to compulsions and obsessions remains unclear. Here, we develop computational model examine the specific that trigger sustain compulsive behavior in simple symptom-provoking scenario. Our results demonstrate single belief disturbance–a lack of confidence effectiveness one’s preventive (harm-avoiding) actions–can maintain is directly linked compulsion severity. This distrust can further explain number seemingly unrelated phenomena OCD, including role not-just-right feelings, link intolerance uncertainty, perfectionism, overestimation threat, deficits reversal state learning. simulations shed new light on which underlying drive highlight important perceived ability exert control for OCD.

Language: Английский

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Disrupted state transition learning as a computational marker of compulsivity

Psychological Medicine, Journal Year: 2021, Volume and Issue: 53(5), P. 2095 - 2105

Published: Sept. 24, 2021

Disorders involving compulsivity, fear, and anxiety are linked to beliefs that the world is less predictable. We lack a mechanistic explanation for how such arise. Here, we test hypothesis in people with anxiety, learning probabilistic mapping between actions environmental states compromised.In Study 1 (n = 174), designed novel online task isolated state transition from other facets of planning. To determine whether this impairment due too fast or slow, estimated rates by fitting computational models two independent datasets, which tested environments transitions were either stable (Study 2: n 1413) changing 3: 192).Study established individuals higher levels compulsivity more likely demonstrate an learning. Preliminary evidence here common factor comprising fear. Studies 2 3 showed associated when it should be slow (i.e. stable) change).Together, these findings indicate dysregulation learning, wherein rate not well adapted environment. Thus, dysregulated might provide key target therapeutic intervention compulsivity.

Language: Английский

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Learned uncertainty: The free energy principle in anxiety

Frontiers in Psychology, Journal Year: 2022, Volume and Issue: 13

Published: Sept. 6, 2022

Generalized anxiety disorder is among the world's most prevalent psychiatric disorders and often manifests as persistent difficult to control apprehension. Despite its prevalence, there no integrative, formal model of how arise. Here, we offer a perspective derived from free energy principle; one that shares similarities with established constructs such

Language: Английский

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OCD patients show lower confidence and higher error sensitivity while learning under volatility compared to healthy and highly compulsive samples from the general population

Published: July 20, 2023

BackgroundOur sense of confidence guides our actions. A decoupling between and action could relate to compulsive behaviour as seen in obsessive-compulsive disorder (OCD). The link OCD has been investigated clinical case-control studies the general population with discrepant findings. generalizability findings from highly-compulsive samples questioned. Here, we address discrepancies by investigating relationship patients compared healthy controls (HC) a sample matched subjects (HComp).Methods38 medication comorbid diagnosis free patients, 37 HC 76 HComp participants performed predictive inference task investigate while learning under volatility. Action-updating, their coupling group were groups. Moreover, computational modeling was compare groups on error sensitivity, parameters reflecting environmental changes.ResultsOCD showed lower higher rates reaction (particularly small) prediction errors than both groups, signaling hyperactive negative bias. No evidence found for differences action-confidence groups.ConclusionsDifferent behavioral profiles are related symptoms different samples, sensitivity samples. Overall, underlying mechanisms might differ resulting (meta)cognitive profiles.

Language: Английский

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The different mediation role of habit features between intolerance of uncertainty and psychopathological symptom dimensions: A transdiagnostic perspective

Journal of Affective Disorders, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

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An active inference account of stuttering behavior

Frontiers in Human Neuroscience, Journal Year: 2025, Volume and Issue: 19

Published: April 3, 2025

This paper presents an interpretation of stuttering behavior, based on the principles active inference framework. Stuttering is a neurodevelopmental disorder characterized by speech disfluencies such as repetitions, prolongations, and blocks. The inference, theory predictive processing sentient can be used to conceptualize disruption in perception-action cycling underlying production. proposed here posits that arises from aberrant sensory precision prediction error dynamics, inhibiting syllable initiation. Relevant this theory, two hypothesized mechanisms are proposed: (1) mistiming (2) excessive attentional focus. Both highlight role neural oscillations, error, hierarchical integration framework also explains contextual variability behaviors, including adaptation effects fluency-inducing conditions. Reframing synaptopathy integrates neurobiological, psychological, behavioral dimensions, suggesting disruptions precision-weighting mediated neuromodulatory systems. perspective provides unified account sets stage for innovative research therapeutic approaches.

Language: Английский

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