Mechanisms of exposure and response prevention in obsessive-compulsive disorder: effects of habituation and expectancy violation on short-term outcome in cognitive behavioral therapy

Background: Exposure and response prevention is effective and recommended as the first choice for treating obsessive-compulsive disorders (OCD). Its mechanisms of action are rarely studied, but two major theories make distinct assumptions: while the emotional processing theory assumes that treatment effects are associated with habituation within and between exposure sessions, the inhibitory learning approach highlights the acquisition of additional associations, implying alternative mechanisms like expectancy violation. The present study aimed to investigate whether process variables derived from both theories predict short-term outcome. Method: In a university outpatient unit, 110 patients (63 female) with OCD received manual-based cognitive-behavioral therapy with high standardization of the first two exposure sessions. Specifically, therapists repeated the first exposure session identically and assessed subjective units of distress as well as expectancy ratings in the course of exposure sessions. Based on these data, individual scores for habituation and distress-related expectancy violation were calculated and used for prediction of both percentage change on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and remission status after 20 therapy sessions. Results: In a multiple regression model for percentage change, within-session habituation during the first exposure was a significant predictor, while in a logistic regression predicting remission status, distress-related expectancy violation during the first exposure revealed significance. A path model further supported these findings. Conclusions: The results represent first evidence for distress-related expectancy violation and confirm preliminary findings for habituation, suggesting that both processes contribute to treatment benefits of exposure in OCD, and both mechanisms appear to be independent

Narrative Sexueller Bildung. Zwischen den Generationen

Die Autorinnen untersuchen exemplarisch zwei populäre Ratgeber, die sich an Mädchen und Frauen aus medizinisch-therapeutischer Perspektive bzw. an Eltern aus einer Erziehungsberatungsperspektive wenden. Diskursanalytisch werden die alltagskulturellen Medien hinsichtlich des vorliegenden Sexualitätsverständnisses und der erziehungswissenschaftlichen Kategorie der Generation in den Blick genommen. Daraus resultiert eine kritische Lesart von Materialien sexueller Bildung im Hinblick auf das Sprechen über Sexualität und die Produktivität dieses Sprechens. Beide Ratgeber verweisen auf spezifische Aushandlungen von Sexualität und des generationalen Verhältnisses: In ihnen werden Fremdheitserfahrungen und Versuche dem (auch über Wissensgenerierung) kontrollierend zu begegnen zum Ausdruck gebracht. Indem sie populäre Ratgeber in den Mittelpunkt rücken, erinnern die Autorinnen daran, dass sich die Erziehungswissenschaft solchem Wissen um Sexualität und zugehörigen pädagogischen Produktionen nicht entziehen kann, die jenseits der wissenschaftlich begründeten Sexuellen Bildung entwickelt werden. (DIPF/Orig.

Mechanisms of exposure and response prevention in obsessive-compulsive disorder: effects of habituation and expectancy violation on short-term outcome in cognitive behavioral therapy

Background Exposure and response prevention is effective and recommended as the first choice for treating obsessive-compulsive disorders (OCD). Its mechanisms of action are rarely studied, but two major theories make distinct assumptions: while the emotional processing theory assumes that treatment effects are associated with habituation within and between exposure sessions, the inhibitory learning approach highlights the acquisition of additional associations, implying alternative mechanisms like expectancy violation. The present study aimed to investigate whether process variables derived from both theories predict short-term outcome. Method In a university outpatient unit, 110 patients (63 female) with OCD received manual-based cognitive-behavioral therapy with high standardization of the first two exposure sessions. Specifically, therapists repeated the first exposure session identically and assessed subjective units of distress as well as expectancy ratings in the course of exposure sessions. Based on these data, individual scores for habituation and distress-related expectancy violation were calculated and used for prediction of both percentage change on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and remission status after 20 therapy sessions. Results In a multiple regression model for percentage change, within-session habituation during the first exposure was a significant predictor, while in a logistic regression predicting remission status, distress-related expectancy violation during the first exposure revealed significance. A path model further supported these findings. Conclusions The results represent first evidence for distress-related expectancy violation and confirm preliminary findings for habituation, suggesting that both processes contribute to treatment benefits of exposure in OCD, and both mechanisms appear to be independent

Greater neural responses to trajectory errors are associated with superior force field adaptation in older adults

Although age-related declines in cognitive, sensory and motor capacities are well documented, current evidence is mixed as to whether or not aging impairs sensorimotor adaptation to a novel dynamic environment. More importantly, the extent to which any deficits in sensorimotor adaptation are due to general impairments in neural plasticity, or impairments in the specific processes that drive adaptation is unclear. Here we investigated whether there are age-related differences in electrophysiological responses to reaching endpoint and trajectory errors caused by a novel force field, and whether markers of error processing relate to the ability of older adults to adapt their movements. Older and young adults (N = 24/group, both sexes) performed 600 reaches to visual targets, and received audio-visual feedback about task success or failure after each trial. A velocity-dependent curl field pushed the hand to one side during each reach. We extracted ERPs time-locked to movement onset [kinematic error-related negativity (kERN)], and the presentation of success/failure feedback [feedback error-related negativity (fERN)]. At a group level, older adults did not differ from young adults in the rate or extent of sensorimotor adaptation, but EEG responses to both trajectory errors and task errors were reduced in the older group. Most interestingly, the amplitude of the kERN correlated with the rate and extent of sensorimotor adaptation in older adults. Thus, older adults with an impaired capacity for encoding kinematic trajectory errors also have compromised abilities to adapt their movements in a novel dynamic environment

Treatment with Helicobacter pylori-derived VacA attenuates allergic airway disease

BACKGROUND: Asthma is an incurable heterogeneous disease with variations in clinical and underlying immunological phenotype. New approaches could help to support existing therapy concepts. Neonatal infection of mice with Helicobacter pylori or administration of H. pylori-derived extracts or molecules after birth have been shown to prevent the development of allergic airway disease later in life. This study evaluated the potential therapeutic efficacy of H. pylori vacuolating cytotoxin A (VacA) in allergic airway inflammation and investigated the underlying immunological mechanisms for its actions. METHODS: Murine models of allergic airway diseases, and murine and human in vitro models were used. RESULTS: In both an acute model and a therapeutic house dust mite model of allergic airway disease, treatment with H. pylori-derived VacA reduced several asthma hallmarks, including airway hyperresponsiveness, inflammation and goblet cell metaplasia. Flow cytometry and ELISA analyses revealed induction of tolerogenic dendritic cells (DC) and FoxP3 positive regulatory T cells (Tregs), and a shift in the composition of allergen-specific immunoglobulins. Depletion of Tregs during treatment with VacA reversed treatment-mediated suppression of allergic airway disease. Human monocyte derived DCs (moDC) that were exposed to VacA induced Tregs in co-cultured naïve autologous T cells, replicating key observations made in vivo. CONCLUSION: H. pylori-derived VacA suppressed allergic airway inflammation via induction of Tregs in both allergic airway disease models. These data suggest that the immunomodulatory activity of VacA could potentially be exploited for the prevention and treatment of allergic airway disease

Jesuit Theologian to Lecture at USD

The 2,2′:6′:2″-terpyridine ligand has literally shaped the coordination chemistry of transition metal complexes in a plethora of fields. Expansion of the ligand bite by amine functionalities between the pyridine units in the tridentate N,N’-dimethyl-N,N’-dipyridine-2-yl-pyridine-2,6-diamine ligand (ddpd) modifies the properties of corresponding transition metal complexes, comprising redox chemistry, molecular dynamics, magnetism and luminescence. The origins of these differences between ddpd and tpy complexes will be elucidated and comprehensively summarized with respect to first row transition metal complexes with d2–d10 electron configurations. Emerging applications of these ddpd complexes complementary to those of the well-known terpyridine ligand will be highlighted

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin