Language
English
Publication Date
10-1-2025
Journal
Psychiatry Research
DOI
10.1016/j.psychres.2025.116664
PMID
40782775
PMCID
PMC12475979
PubMedCentral® Posted Date
9-28-2025
PubMedCentral® Full Text Version
Author MSS
Abstract
Background: While 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.
Methods: Youth 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.
Results: A 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.
Conclusions: Findings 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.
Keywords
Humans, Extinction, Psychological, Fear, Obsessive-Compulsive Disorder, Male, Female, Adolescent, Child, Galvanic Skin Response, Psychiatric Status Rating Scales, OCD, Pediatric, Skin conductance, Fear learning, Fear extinction
Published Open-Access
yes
Recommended Citation
Ingram, Katherine M; Storch, Eric A; Geller, Daniel A; et al., "Using Latent Patient-Centered Fear Extinction Profiles To Guide Treatment in Pediatric OCD" (2025). Faculty, Staff and Students Publications. 7911.
https://digitalcommons.library.tmc.edu/baylor_docs/7911