Journal of Psychiatry

A preliminary test of the low probability, high severity hypothesis: A mechanistic explanation for the regularity of obsessional themes in obsessive-compulsive disorder

Annual Congress on Mental Health

July 09-11, 2018 | Paris, France

Christopher Hunt

University of Minnesota, USA

Posters & Accepted Abstracts: J Psychiatry

Abstract:

Although obsessions in OCD may vary widely in content, almost all involve fear of high severity, low probability consequences. For example, while religious and disease-focused obsessions appear thematically quite different, both involve consequences that are objectively bad but very unlikely (e.g., being damned for an impure thought, contracting HIV from a door knob). One explanation for this commonality may be a failure of emotional-reasoning, wherein the normal anxiety induced by the contemplation of high severity consequences is used maladaptive to motivate avoidance (e.g., compulsions). To test this hypothesis, the current study used an adapted version of a validated fear-conditioning and avoidance paradigm to examine the degree to which scores on the obsessive-compulsive inventory-revised would strengthen the anxiety-avoidance relationship specifically during low probability, high severity trials. More specifically, low and high severity trials were those where 1 vs. 3 shocks were possible, while high probability trials consisted of stimuli most resembling a learned danger cue (CS+: predictive of shock) and low probability consisted of all other, more visually discrepant stimuli. Fear-potentiated startle (FPS)/self-reported anxiety responses were collected for stimuli on half of trials, while choices to avoid stimuli occurred on the other half. Hierarchical regression indicated that OCI-R scores significantly moderated the relationship between FPS/anxiety ratings and avoidance specifically for low probability, high severity trials, such that higher OCI-R scores were associated with a stronger anxiety-avoidance relationship. Such results provide preliminary support for the notion that the ubiquity of high severity/low probability obsessions in OCD may arise from maladaptive emotional reasoning.

Biography :

Christopher Hunt is a 3rd year Clinical Psychology Doctoral Student at the Clinical Science and Psychopathology Research Program at the University of Minnesota, USA. He is currently advised by Dr. Shmuel Lissek of the ANGST Laboratory, where he is researching how the intersection of personality, fear learning and avoidance decision-making can inform understanding of anxiety and related disorders. His work was recently published as part of a special issue on avoidance decision-making in the journal Behaviour Research and Therapy and was discussed in the issue’s Podcast.

E-mail: Huntx305@umn.edu