Fear conditioning and extinction are central in the cognitive behavioral model of obsessive-compulsive disorder (OCD), which underlies exposure-based cognitive behavioral therapy (CBT). Youth with OCD may have impairments in conditioning and extinction that carries treatment implications. The present study examined these processes using a differential conditioning paradigm. Forty-one youth (19 OCD, 22 community controls) and their parents completed a battery of clinical interviews, rating scales, and a differential conditioning task. Skin conductance response (SCR) served as the primary dependent measure across all three phases of the conditioning procedure (habituation, acquisition, and extinction). During habituation, no meaningful differences were observed between groups. During acquisition, differential fear conditioning was identified across groups evidenced by larger SCRs to the CS+ compared to CS-, with no significant group differences. During extinction, a three-way interaction and follow-up tests revealed youth with OCD failed to exhibit differential fear conditioning during early fear extinction; whereas community controls consistently exhibited differential fear conditioning throughout extinction. Across participants, the number and frequency of OCD symptoms was positively associated with fear acquisition and negatively associated with fear extinction to the conditioned stimulus. OCD symptom severity was negatively associated with differential SCR in early extinction. Youth with OCD exhibit a different pattern of fear extinction relative to community controls that may be accounted for by impaired inhibitory learning in early fear extinction. Findings suggest the potential benefit of augmentative retraining interventions prior to CBT. Therapeutic approaches to utilize inhibitory-learning principles and/or engage developmentally appropriate brain regions during exposures may serve to maximize CBT outcomes.

Children have not historically been the subject of research focusing on internalizing disorders (i.e., childhood depression), even though childhood depression continues to be viewed as one of the most prevalent affective problem within this population. Over the past two decades, a small portion of that literature describes prevention efforts in public schools. There has been a growing body of literature centered on childhood depression. However, there are only three studies that report on longitudinal findings that have taken a primary prevention approach. The present study was a follow-up investigation to delineate the effects of a school-based primary prevention program. The original study utilized a social/ interpersonal and cognitive-behavioral model incorporated into the health education curriculum of the school. The results of the study suggest that the students continued to report normal to low levels of depressive symptoms at one-year follow-up . The results also suggest that students maintained the social skills gained during the intervention at the one-year followup. In addition, reports of depressive symptomatology slightly declined from posttest to one-year follow-up.