Conceptual‐level disgust conditioning in contamination‐based obsessive‐compulsive disorder.

Pavlovian fear conditioning and extinction represent learning mechanisms underlying exposure‐based interventions. While increasing evidence indicates a pivotal role of disgust in the development of contamination‐based obsessive‐compulsive disorder (C‐OCD), dysregulations in conditioned disgust acquisition and maintenance, in particular driven by higher‐order conceptual processes, have not been examined. Here, we address this gap by exposing individuals with high (HCC, n = 41) or low (LCC, n = 41) contamination concern to a conceptual‐level disgust conditioning and extinction paradigm. Conditioned stimuli (CS+) were images from one conceptual category partially reinforced by unconditioned disgust‐eliciting stimuli (US), while images from another category served as non‐reinforced conditioned stimuli (CS−). Skin conductance responses (SCRs), US expectancy and CS valence ratings served as primary outcomes to quantify conditioned disgust responses. Relative to LCC, HCC individuals exhibited increased US expectancy and CS+ disgust experience, but comparable SCR levels following disgust acquisition. Despite a decrease in conditioned responses from the acquisition phase to the extinction phase, both groups did not fully extinguish the learned disgust. Importantly, the extinction resilience of acquired disgust was more pronounced in HCC individuals. Together, our findings suggest that individuals with high self‐reported contamination concern exhibit increased disgust acquisition and resistance to extinction. The findings provide preliminary evidence on how dysregulated disgust learning mechanism across semantically related concepts may contribute to C‐OCD. Our study is the first to explore abnormalities in higher‐order disgust conditioning in contamination‐based OCD. Our study demonstrates for the first time that conceptual conditioning extends to the domain of disgust and that individual with high contamination concern exhibit a stronger disgust conditioning but resistance to disgust extinction. Alterations were restricted to disgust experience and threat expectation while autonomous responses as assessed by skin conductance responses were normal, suggesting that dysregulations in cognitive appraisal or subjective emotional experience may represent driving factors of dysfunctional learning in OCD. [ABSTRACT FROM AUTHOR]