Kalanthroff Eyal, Seror Yuval, Sagi Noa, Hochman Shachar, Linkovski Omer, Naftalovich Hadar, Simpson Helen Blair
Department of Psychology, The Hebrew University of Jerusalem, Israel.
Department of Psychiatry, Columbia University, New York, NY, United States.
J Mood Anxiety Disord. 2025 Mar 1;10:100113. doi: 10.1016/j.xjmad.2025.100113. eCollection 2025 Jun.
Chronotype, a person's circadian preference, reflects individuals' natural pattern of alertness levels throughout the day. It has been shown that chronotype contributes to within-day symptom fluctuations in obsessive-compulsive disorder (OCD). However, the underlying mechanism of this effect is not yet clear. Inhibitory control, an executive function crucial for suppressing unwanted behaviors and thoughts, is essential for managing OCD symptoms and is highly influenced by alertness levels. Hence, the current study investigated the impact of chronotype and time of day on inhibitory control in OCD patients, particularly in response to individually tailored symptom-provoking images, using a novel version of the stop signal task. Ninety-three treatment-seeking OCD patients completed an individually tailored Symptom-Provocation Stop-Signal Task, every morning and evening for four consecutive days. Chronotype was assessed using the Morningness-Eveningness Questionnaire (MEQ). Stop-signal reaction time (SSRT) was assessed for neutral and individually tailored symptom-provoking images separately. Patients exhibited longer SSRTs (worse inhibition) to symptom-provoking trials compared to neutral trials. Most importantly, chronotype and time of day significantly interacted to affect SSRTs in the symptom-provocation condition: A significant correlation was found between optimal alertness periods and improved inhibitory control in the symptom-provocation condition. Taken together, these results indicate that inhibitory control in OCD varies with chronotype and time of day. These findings suggest that aligning treatment sessions with patients' chronotype may enhance therapeutic outcomes and that heightening alertness-by increasing the chances of successful inhibition-might be a way to mitigate the vicious cycle of OCD.
昼夜节律类型，即一个人的昼夜偏好，反映了个体在一天中警觉水平的自然模式。研究表明，昼夜节律类型会导致强迫症（OCD）患者在一天内症状出现波动。然而，这种影响的潜在机制尚不清楚。抑制控制是一种执行功能，对于抑制不必要的行为和想法至关重要，它对管理强迫症症状至关重要，并且受到警觉水平的高度影响。因此，本研究使用一种新型的停止信号任务，调查了昼夜节律类型和一天中的时间对强迫症患者抑制控制的影响，特别是对针对个体定制的引发症状的图像的反应。93名寻求治疗的强迫症患者连续四天每天早晚完成一项针对个体定制的症状激发停止信号任务。使用晨型-夜型问卷（MEQ）评估昼夜节律类型。分别针对中性图像和针对个体定制的引发症状的图像评估停止信号反应时间（SSRT）。与中性试验相比，患者在症状激发试验中的SSRT更长（抑制能力更差）。最重要的是，昼夜节律类型和一天中的时间在症状激发条件下显著相互作用，影响SSRT：在症状激发条件下，最佳警觉期与改善的抑制控制之间存在显著相关性。综上所述，这些结果表明，强迫症中的抑制控制随昼夜节律类型和一天中的时间而变化。这些发现表明，使治疗疗程与患者的昼夜节律类型相匹配可能会提高治疗效果，并且通过增加成功抑制的机会来提高警觉性可能是减轻强迫症恶性循环的一种方法。
