Emotional processing theory (EPT; Foa, Huppert, & Cahill, 2006; Foa & Kozak, 1986; Foa & McNally, 1996) has traditionally been the domi- nant model for explaining improvement during ERP (Abramowitz, Deacon, & Whiteside, 2011); although see Hyman and Pedrick (2010) for an exception. This theory proposes that therapeutic exposure must activate a “ fear structure ” that is contained in memory, and then provide information that is incompatible with the fear structure. This incompat- ible information is thought to become integrated via “ corrective learn- ing, ” such that non-fear based elements replace (Foa & Kozak, 1986), or compete with (Foa & McNally, 1996; Foa et al., 2006), fear based associations. Fear reduction during exposure (i.e., habituation, Groves & Thompson, 1970; Lader & Mathews, 1968; Watts, 1979) is considered a critical index of change in ERP and evidence that learning is taking place. Habituation is a short-term sensory effect resulting in one's “ decreased response to repeated stimulation ” (Groves & Thompson, 1970, pp. 419) such that one's “ original reaction towards the stimulus diminishes in intensity or even disappears ” (Eelen, Hermans, & Baeyens, 2001, pp. 251). Thus, patients who experience habituation are expected to respond less fearfully to anxiety-related stimuli over time. Lang (1971) suggests that fear reactions are comprised of three re- sponse symptoms: verbal (i.e., self-report quanti ﬁ cation of anxiety level using the Subjective Units of Distress scale, SUDS; Wolpe, 1973), behav- ioral (e.g., observable escape and avoidance behaviors that function to reduce anxiety and fear, such as compulsive rituals), and physiological (e.g., heart rate [HR] and skin conductance [SC]). In the present review, therefore, we also quantify fear reactions along these lines. Foa and colleagues proposed three indicators of emotional processing that pre- dict successful outcomes in exposure therapy: (1) initial fear activation (IFA; peak fear level during an exposure minus baseline fear level before exposure began), (2) within-session habituation (WSH; peak fear level during an exposure minus ending fear level), and (3) between-session habituation (BSH; peak fear level during an exposure minus peak fear level during the subsequent exposure). These authors further suggest that between-session habituation is dependent on within-session habitation, and thus is the basis for longer-term learning.
Abstract: The current literature provides substantial evidence of brain alterations associated with obsessive-compulsive disorder (OCD) symptoms (eg, checking, cleaning/decontamination, counting compulsions; harm or sexual, symmetry/exactness obsessions), and emotional problems (eg, defensive/appetitive emotional imbalance, disgust, guilt, shame, and fear learning/extinction) and cognitive impairments associated with this disorder (eg, inhibitory control, working memory, cognitive flexibility). Building on this evidence, new clinical trials can now target specific brain regions/networks. Real-time functional magnetic resonance imaging (rtfMRI) was introduced as a new therapeutic tool for the self-regulation of brain–mind. In this review, we describe initial trials testing the use of rtfMRI to target brain regions associated with specific OCD symptoms (eg, contamination), and other mind–brain processes (eg, cognitive – working memory, inhibitory control, emotional – defensive, appetitive systems, fear reduction through counter-conditioning) found impaired in OCD patients. While this is a novel topic of research, initial evidence shows the promise of using rtfMRI in training the self-regulation of brain regions and mental processes associated with OCD. Additionally, studies with healthy populations have shown that individuals can regulate brain regions associated with cognitive and emotional processes found impaired in OCD. After the initial “proof-of-concept” stage, there is a need to follow up with controlled clinical trials that could test rtfMRI innovative treatments targeting brain regions and networks associated with different OCD symptoms and cognitive-emotional impairments.
Impairments in EF are frequently observed in OCD (see  for a review). But if EF impairments have been linked to prefrontal and frontosubcortical dysfunc- tions in OCD, the specific nature and pattern of EF impairments remain unclear: is it general or is there specific impairments on more specific EF components? In a group of patients with OCD and in a control group of patients with anxiety disorder, Bannon et al.  studied inhibition, set shifting, planning, verbal flu- ency and working memory; they found that only some aspects of EF (set shifting and inhibition) are specifically impaired in OCD. Olley, Malhi and Sachdev  reviewed memory and EF in OCD. They evidenced a neuropsychological profile in OCD with a primary impairment in EF. The memory impairment in OCD seemed to result from a strategic deficit in organization during encoding (see also ). In a meta-analysis, Snyder et al.  concluded that OCD patients showed EF deficits in tasks measuring inhibition (e.g. the Stroop test and the stop signal task), shifting (e.g. the Wisconsin Card Sorting Test), working mem- ory and updating (e.g. the digitspan backward, Corsi block span and n-back tasks), and planning. These findings suggest that OCD is associated with broad impairments in EF and not just the selective impairments in shifting or inhibi- tion hypothesized by Bannon et al. . However, the nature of EF impairment in patients with OCD had not been unambiguously demonstrated as the abilities of OCD patients to shift set, organize, plan, and quickly solve problems have yielded contradictory results ; those contradictory results might reflect the impact of psychotropic medication, taken by some participants, on cognition; the effect of OC symptoms severity on cognitive performance; the potential im- pact of educational level on neuropsychological functioning; the effect of possi- ble comorbidities (such as depression and anxiety); specific OCD symptom pres- entations (e.g., checking, contamination/cleaning or sexual/religious obsessions)
Additional support for a neurological basis for OCD is that obsessive-compulsive symptoms can present in adults as a consequence of certain neurological conditions such as a brain tumour, Sydenham’s chorea, Huntington’s disease, fronto-temporal dementia, or as a complication of brain injury to the frontal lobe (Veale & Roberts, 2014). Also there is evidence that some people with OCD, when compared with control participants, have deficits on a range of inductive reasoning, executive functioning (e.g. planning) and some learning and memory tasks (Greisberg & McKay, 2003). However, this is not universal and when deficits do exist they tend to be mild (Taylor, Abramowitz & McKay, 2007). It is thought that people with OCD have a malfunctioning of the so called “orbitofrontal loop” or “OCD circuit”. This consists of a pathway in the brain from the basal ganglia (which is involved in voluntary motor control, procedural learning relating to routine behaviours or "habits”, and cognitive and emotional functions) to the orbitofrontal cortex (responsible for social adjustment and the control of mood, drive and responsibility). This neurological mechanism in OCD is supported by evidence from neuroimaging studies that indicate abnormal activity in the cortico-basal ganglia circuits and other volumetric differences in parts of the brains of OCD sufferers (Lagemann et al., 2012). However, it is not yet clear how these contribute to the expression of OCD symptoms. In addition, there is the question of the direction of the correlation as it is not been shown that brain abnormalities precede the development of OCD; instead they may be due to an adaption to over-activity caused by long practiced behaviours
Collective Memory: Maurice Halbwachs has established himself as an important sociologist and is responsible for the inauguration of the field of memory studies in sociology. Therefore, it points out as fundamental the understanding that social contexts should be considered in the exercise of collective memory reconstruction. The author considers that the individual is always inserted in society and in a given space and, therefore, belongs to one or more reference groups. Therefore, the memories are derived from a collective process and inserted in a distinct social context. This contextualization includes time and space as essential dimensions of each individual's experience and constitution. Due to the stability of space, one has the perception of its immutability and this provides the illusion of no apparent changes in space and this phenomenon helps people and groups to cling to the place where they live (HALBWACHS, 2006). To this end, Los marcos sociales de la memoria, launched in the 1920s, is a valuable study for understanding that social frameworks are relevant references for collective memories to be recalled and transmitted over time. The social frameworks anchor the reconstruction of memory, since:
The French sociologist, Maurice Halbwachs (1877-1945), is usually credited with introducing the concept of collective memory into contemporary usage (Misztal, 2003; Olick, 2008; Olick & Robbins, 1998: 106; Zerubavel, 2003). Aside from a few notable exceptions such as Andrea Casey, Halbwachs is ritually cited but rarely read in organizational memory studies. This means that Boje’s detailed reading of Halbwachs’s Collective Memory (1980 ) is valuable. He emphasizes Halbwachs’s point that ‘when we have a remembrance we do so, 99 per cent of the time, with the thoughts, ideas, and feelings of various groups, of which we are a part’ (p. 81). However, Boje characterizes Halbwachs’s theory of collective memory as ‘a bridge between Bergson’s sensemaking of individuals and Durkheim’s social solidarity of social construction by groups. It therefore falls in between the scope of phenomenologist and social psychologist’ (p. 82). By contrast, the sociologists Olick and Robbins (1998) maintain that ‘Halbwachs developed his concept of collective memory not only beyond philosophy but against psychology’. Ricoeur places Halbwachs firmly in the Durkheimian school which opposed its own ‘a methodological holism’ against methodological individualism, and made individual memory problematic, even threatening to dismiss the then emerging phenomenology ‘under the more or less infamous label of psychologism’ (Ricoeur, 2004: 95). Social memory studies derived from Halbwachs is therefore partly defined by a rejection of ‘an individual- psychological approach to memory’ (Olick & Robbins, 1998: 109). This has serious implications for the prevailing methodological individualism in organizational memory studies, which Boje does not consider.
Accommodation, criticism, and communication patterns all play important roles in how OCD impacts relationship functioning. These three factors are closely intertwined in how individuals with OCD and their partners perceive their relationships, and how couples rate their relationship satisfaction. These factors are also crucial in how they impact OCD treatment, often preventing successful treatment outcome (Chambless & Steketee, 1999). It is also important to recognize that OCD is a diverse disorder in terms of severity levels as well as symptom themes. Obsession severity is negatively correlated with relationship satisfaction (Abbey, 2007). However, research has not been done to investigate how relationship functioning is impacted across the four theme-based symptom dimensions of OCD. Due to the diverse nature of these four dimensions, it is important to investigate how each is associated with relationship functioning. By developing a better understanding of relationship functioning within each dimension, couple therapy strategies can be tailored to produce better outcomes for their patients. For example, an individual with a contamination obsession may be more likely to have a partner that engages in frequent accommodation, compared to an individual with unacceptable obsessions of a sexual nature. This same OCD patient may also struggle with effective communication with his or her partner, whereas the individual with the “unacceptable thought” obsession communicates well with his or her partner. Therapy for these two couples would need to target different aspects of relationship functioning in order to be most effective for both couples.
(Goodman et al.1989a). This scale rates obsessive compulsive symptoms in patients diagnosed as having OCD. This scale has two components (1) a symptom checklist and (2) severity rating scale., Insight scale-The insight scale has 32 items to be answered yes, no or do not know. The scale each can be administered by one observer but can also be self-rated. Questions pertaining to following areas are included in the scale: Hospitalization, Mental illness in general, Perception of being ill, Changes in the self, Control over the situation, Perception of the environment, Wanting to understand one’s situation
Throughout most wars that targeted memory and identity, systemic demolition of some buildings, architectural heritage, and landmarks occurred and sometimes urban areas were removed completely. This happened in cases of obliterating a certain civilization and replacing it with another. “The first step in liquidating a people is to erase its memory. Destroy its books, its culture, its history” (Kundera, 1999). In history we have a lot of examples such as: the destruction of the Library of Alexandria by the Romans in 48 B.C, the demolition of lots of cities and countries during World War I and II, conflicts between Muslims and Hindus in India over 1947-1991, and the destruction of the Tibet heritage by China during 1949- 1950. In addition to lots of violent acts against symbolic buildings such as libraries, mosques and bridges in Yugoslavia over 1991-1999, the destruction of Buddha statues in Bamiyan (in Afghanistan) by Taliban in 2001, the attack on World Trade Center on the ninth of September 2001, and finally the demolition of the Shrines in Mali in July 2012. Those buildings are targeted and destroyed due to their moral value and what they represent of cultural memory at the community or people’s level. According to Bevan Robert, the author of “The Destruction of Memory”: “This is the active and often systemic destruction of particular building types or architectural traditions that happens in conflicts where the erasure of the memories, history, and identity attached to architecture and place-enforced forgetting-is the goal itself. These buildings are attacked not because they are in the path of a military objective: to their destroyers that are the objective" (Bevan, 2004).
the ability to extrapolate the direct and immediate experience of an individual., contributing to the process of incorporating certain learnings that affect the whole group of people to which he belongs. Hence, the reason for choosing to analyze the proposed object through the field of memory, affiliating the perspective of observing the long-term learning processes present in social practices as a whole. At this moment, going back in time also provided the possibility of observing the link between the “Bahia Film Club” and the holding of the “Bahia Film Festival”, glimpsing a web of people whose knowledge generated and enhanced by these environments, through knowledge and experiences shared, even if only by observation and indirectly, extended over time, in a continuous flow and open to new thoughts, therefore, to transformations. The conception of movie clubs as the genesis of film and audiovisual festivals and exhibitions came in this wake, as the space that proposed the exhibition of films alternative to the circuit of the commercial halls linked to the large exhibition companies, which provided, in many moments, the conditions
in the World. It is not funded by industry and tries in the short and long-term to answer the question whether further CBT or SSRI is better in CBT-non-responders. Knowledge of real world effectiveness is needed for the plans of health organizations, for therapists and doctors who consider choice of treatment, and for the informed patient or parent who wants to participate in treatment planning. Expert clinical guidelines need to be tested empirically to be the basis of these health decisions. The units in the NordLOTS ranges from university based specialized OCD-clinics to unspecialized child and ado- lescent psychiatric outpatient units. This will make it possible to study the contribution of the type of clinic to treatments success as well.
Obsessions are intermittent and decided musing, driving forces, or picture that reason upsetting feelings, for example, anxiety. Numerous individuals with "OCD" perceive that the considerations, Obsession are a result of their psyche and are intemperate or outlandish. however, nosy thoughts can't be solve by rationale or thinking. A great many people with OCD endeavour to disregard or smother like obsession them with some different musings or activity. Run of the mill Obsessions incorporate inordinate worries about defilement or damage, the requirement for precision, symmetry, prohibited sexual or religious thoughts.
Repetitive transcranial magnetic stimulation (rTMS) is a novel and non-invasive treatment option for numerous psy- chiatric disorders. 12–15 Several randomized controlled trials using rTMS in treatment-resistant patients with OCD have been published, but the results from meta-analyses have been inconclusive. 15–18 However, the ﬁ ndings of a recent meta- analysis demonstrated that stimulation, speci ﬁ cally of the supplementary motor area (SMA), yielded the greatest reduc- tion in the Yale-Brown obsessive-compulsive scale (Y-BOCS) scores, relative to that of other cortical regions. 19 These reports regarding the effectiveness of rTMS involved patients who were unresponsive to earlier OCD treatments; the effec- tiveness of this approach when applied to previously untreated patients with OCD remains unknown.
with studies that have shown the positive impact of per- ceived social support on individuals’ ability to cope with the difficulties of OCD [55, 56]. Similar to our findings, some studies show that most family members of indi- viduals living with OCD accommodate them in most respects—e.g. actively assisting the OC individual by participating in their rituals or doing chores for them in order to save time or reduce frustration [16, 57]. How- ever, there also is strong evidence to suggest that family support and involvement may exacerbate dysfunctional behaviours [58, 59]. Whereas participants in our study explicitly stated an appreciation of this type of accom- modation, and perceived it as a means of social sup- port—studies show that this type of accommodation seems to interfere with a positive response to treatment [16, 60]. Furthermore, while participants were mostly positive about the support they received from their sig- nificant others, there were concerns about their illness as being burdensome and traumatic for the families [61, 62]. Arguably, these concerns may lead to avoidance of shar- ing and ultimately, to feeling isolated. This hypothesis is consistent with findings from a recent qualitative study where participants reported feeling disconnected from family and friends . As such, emotional responses towards family and friends may range from positive and appreciative to fears of being burdensome and with- drawal—highlighting that it is an important avenue for further research. Indeed, some literature suggests that involving family in treatment (e.g. partners, in couple- based therapy) may not be suitable for everyone . Furthermore, other studies have also demonstrated that familial responses to OCD vary, and in some instances may become a source of conflict that can contribute to even poorer relationship functioning, marital discord, and divorce [63–65]. The inability to maintain a mean- ingful connection with others limits patients’ access to emotional support and is likely to perpetuate feelings of hopelessness and helplessness [10, 11, 13, 14, 17].
A significant endpoint of general anesthesia is the loss of memory, indeed a terrible complication of narcosis is the anesthesia awareness (AA), a rare condition that occurs when surgical patients can recall their surroundings or an event related to their surgery while they are under general anesthesia (GA). During GA the amnesia is mostly achieved with general anesthetic drugs (endovenous and inhaled), nevertheless different classes of drugs administered can impact the memory. Starting from a brief description of the recent knowledge on the AA phenomenon, this work focuses on the relationship between GA and memory, the pharmacodynamic mechanisms of amnesia induced by anesthetic drugs, as well as the possibility of memory modulation during GA. Benzodiazepines (BDZs) are a complex class of drugs with significant effects on anterograde memory, however in this paper we also discuss on a their hypothetical effect on retrograde memory, even in anesthetized patients.
The shifting of hisidentification space –The Foster House - and facing the reality in a new space - a new residence - made certain concerns of the respondent come back, like the feeling of rootlessness and abandonment. At the transition moment, not just exiting the place, but entering the adult world, when herequired affective and emotional support; At other moment, when he returned to his interaction place, his safety spot was not comprised any more by the people who one day took part on his experiences. This way, the new reality can be displayed as lacking protection and with props that are not linked anywhere, leaving open areas as pieces of an affective and episodic memory. All the same, recalling the past surrounded by adversities, our respondent talks about of current memory rooted in personal and professional accomplishments like the service of baker's assistant, after signing the work permit, the home ownership and the possible conclusion of the third year of high school, which happen at the end of 2016. Past memory, articulated and upgraded with the present memory and, why not saying with the future. As a life project, he means to be linked to childhood and adolescence areas, as he intends to join the selection to be a tutor counselor. He said that he really likes children and that he wants to use the twenty years’ experience to help other boys. Our third respondent was not detached from the Childhood Municipal Policy. He went from a resident to an arts instructor at Conquista Criança. He is 31 years old, He told that his first job was in the senior group and that it was the coordinator of the “Conquista Criança” that got him the spot, later a new opportunity appeared for him to return and he is there until today, but is looking for assurance, because he is hired:
It is possible to hypothesize that a polymorphism in the transcriptional control region upstream of the 5-hydrox- ytryptamine (serotonin) transporter (5-HTT) coding sequence could be an important factor in conferring sus- ceptibility to OCD [8, 11, 12]. The 5-HTTLPR consists of a 44-bp deletion/insertion yielding a 14-repeat allele (short; S) and a 16-repeat allele (long; L). The S allele reduces the transcriptional efficiency of the 5-HTT gene promotor, resulting in decreased 5-HTT expression and availability. Bloch et al. . suggested the possibility that the L allele is associated with specific OCD subgroups such as childhood-onset OCD. In contrast, Lin et al.  found that OCD was associated with the SS homozygous genotype. Some researchers suggested that this L allele could be subdivided further to L A and L G alleles . The
Participants’ favoured naive explanations demonstrated greatest change post-manipulation. This suggests that even relatively strongly held concepts of OCD are amenable to change during childhood. Research in the developmental psychology literature supports this finding, with children capable of abrupt change dependent upon the source of information (Robinson and Whitcombe, 2003) and the initial level of variability in the child’s conceptualizations (Alibali, 1999). Typically periods of conceptual transition are marked by increased variability but this was not found in this study. Causal factors other than biomedical/cognitive behavioural remained fairly stable post-manipulation. This highlights both the potential strength and weakness of clinicians providing children with explanations for their difficulties; they are both receptive and amenable to psychoeducation, but they are likely to assimilate explanations, regardless of their utility and potentially to the exclusion of other plausible explanations. This places an increased burden of responsibility on the clinician.
to psychiatric illness, researchers have identified how ill- ness, associated treatments and social context disrupt life and shape identity . Consequently, the concept is not solely tied to curative experiences, after a long illness ex- perience. The burden of normality (defined as difficulty in adjusting to being free of significant symptomatology) has been evaluated in neurological conditions such as epilepsy. The burden of normality following DBS for neurological disorders [11, 12] highlights the importance of taking into account personality and illness duration to address the period post DBS. Literature amplifying consumer voices in regard to health, illness and treatment has grown stea- dily in recent decades, with recognition of the centrality of consumer views to development of evidence-based prac- tice. But, the implications of DBS for the lived experience of the individual, including sometimes dramatic reduction in symptoms, have only recently been appreciated [13, 14]. A study of 18 participants aged 26–65 years following DBS for severe and treatment-refractory OCD explored their broader post-operative experience via semi-structured in- terviews, beyond that of changes in obsessive-compulsive symptomatology alone . The study found that over- all, participants reported experiencing increased trust, self-reliance and confidence, as well as being more carefree and impulsive, less preoccupied about their cir- cumstances, and improvement in mood and the extent of anxiety. However, the interviews were conducted 6 to 91 months following DBS, with an increased pos- sibility of recall bias, including that of some nuances of subjective experience. Also, the study did not include participants with extremes of therapeutic response, with none of those being interviewed having almost complete response in their obsessive-compulsive symptoms; the latter reportedly declined participation in further research, opting to just get on in regard to their lives.
This study investigated the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms and their relationship with pregnancy- related anxiety, perinatal depression and clinical anger among pregnant black African women in South Africa. The sample consisted of 206 women attending their antenatal check-ups at the Mankweng, Nobody, and Rethabile Clinics, and the Mankweng hospital in the Capricorn District, Limpopo Province. Quantitative data was collected from a convenience sample, within a cross-sectional survey design. First, the prevalence of OCD among the women was established. Then Pearson‘s correlation analysis was used to establish if there was a linear relationship between the variables of the study. Variables that were related were then subjected to regression analysis, seeking to establish if the independent variables, pregnancy-related anxiety, perinatal depression and clinical anger, together with other pregnancy-related variables, would predict OCD symptoms. When correlational analysis was conducted, the patient characteristics of having undergone a medical check-up, and having previously delivered a live baby generally did not correlate with any of the main scales measuring OCD symptoms, perinatal depression, pregnancy-related anxiety and clinical anger (p > 0.05). Almost 39.5% of the pregnant women could be classified as obsessive-compulsive disordered, when using the cut-off score of 36. Furthermore, findings from regression analyses indicated that higher age, the number of gestation weeks, having previously experienced pregnancy-related complications, perinatal depression, pregnancy-related anxiety and clinical anger were variably positive predictors of the Revised version of the Obsessive-Compulsive Inventory (OCI-R) measured OCD symptoms. The predictors were specific to each of the symptoms. It can be concluded from the study that there is a relationship between OCD symptoms and all the independent variables used. (Afr J Reprod Health 2019; 23: 44-55).