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Modulation of error monitoring in obsessive–compulsive disorder by individually tailored symptom provocation

Published online by Cambridge University Press:  04 April 2017

D. Roh ,
J.-G. Chang ,
S. W. Yoo ,
J. Shin  and
C.-H. Kim
D. Roh
Affiliation:
Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Republic of Korea
J.-G. Chang
Affiliation:
Department of Psychiatry, Severance Hospital, Seoul, Republic of Korea
S. W. Yoo
Affiliation:
Yoo and Kim Mental Health Clinic, Seoul, Republic of Korea
J. Shin
Affiliation:
Department of Psychiatry, Severance Hospital, Seoul, Republic of Korea
C.-H. Kim*
Affiliation:
Department of Psychiatry, Severance Hospital, Seoul, Republic of Korea Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
*
*Address for correspondence: C.-H. Kim, M.D., Ph.D., Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic ofKorea. (Email: [email protected])
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Abstract

Background

The enhanced error monitoring in patients with obsessive–compulsive disorder (OCD), typically measured with the error-related negativity (ERN), has been found to be temporally stable and independent of symptom expression. Here, we examined whether the error monitoring in patients with OCD could be experimentally modulated by individually tailored symptom provocation.

Method

Twenty patients with OCD and 20 healthy controls performed a flanker task in which OCD-relevant or neutral pictures were presented prior to a flanker stimulus. An individualized stimulus set consisting of the most provoking images in terms of OCD symptoms was selected for each patient with OCD. Response-locked event-related potentials were recorded and used to examine the error-related brain activity.

Results

Patients with OCD showed larger ERN amplitudes than did control subjects in both the OCD-symptom provocation and neutral conditions. Additionally, while patients with OCD exhibited a significant increase in the ERN under the OCD-symptom provocation condition when compared with the neutral condition, control subjects showed no variation in the ERN between the conditions.

Conclusions

Our results strengthen earlier findings of hyperactive error monitoring in OCD, as indexed by higher ERN amplitudes in patients with OCD than in controls. Importantly, we showed that the patients’ overactive error-signals were experimentally enhanced by individually tailored OCD-symptom triggers, thus suggesting convincing evidence between OCD-symptoms and ERN. Such findings imply that therapeutic interventions should target affective regulation in order to alleviate the perceived threatening value of OCD triggers.

Keywords

electroencephalographyemotion regulationerror-related negativityevent-related potentialobsessive–compulsive disordersymptom provocation
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 12 , September 2017 , pp. 2071 - 2080
Copyright
Copyright © Cambridge University Press 2017 

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