{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T01:53:55Z","timestamp":1777427635727,"version":"3.51.4"},"reference-count":64,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/50026\/2020;UIDP\/50026\/2020;PD\/BDE\/127839\/2016"],"award-info":[{"award-number":["UIDB\/50026\/2020;UIDP\/50026\/2020;PD\/BDE\/127839\/2016"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["NORTE-01-0145-FEDER-00001; NORTE-01-0145-FEDER-000023"],"award-info":[{"award-number":["NORTE-01-0145-FEDER-00001; NORTE-01-0145-FEDER-000023"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Obsessive-compulsive disorder (OCD) is characterized by cognitive regulation deficits. However, the current literature has focused on executive functioning and emotional response impairments in this disorder. Herein, we conducted a systematic review of studies assessing the behavioral, physiological, and neurobiological alterations in cognitive regulation in obsessive-compulsive patients using the PubMed database. Most of the studies included explored behavioral (distress, arousal, and frequency of intrusive thoughts) and neurobiological measures (brain activity and functional connectivity) using affective cognitive regulation paradigms. Our results pointed to the advantageous use of reappraisal and acceptance strategies in contrast to suppression to reduce distress and frequency of intrusive thoughts. Moreover, we observed alterations in frontoparietal network activity during cognitive regulation. Our conclusions are limited by the inclusion of underpowered studies with treated patients. Nonetheless, our findings support the OCD impairments in cognitive regulation of emotion and might help to improve current guidelines for cognitive therapy.<\/jats:p>","DOI":"10.3390\/brainsci10110797","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T09:44:53Z","timestamp":1603964693000},"page":"797","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A Systematic Review of Behavioral, Physiological, and Neurobiological Cognitive Regulation Alterations in Obsessive-Compulsive Disorder"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-1623","authenticated-orcid":false,"given":"S\u00f3nia","family":"Ferreira","sequence":"first","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal"},{"name":"ICVS-3B\u2019s PT Government Associate Laboratory, 4710-057 Braga\/Guimar\u00e3es, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9497-6543","authenticated-orcid":false,"given":"Jos\u00e9 Miguel","family":"P\u00eago","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal"},{"name":"ICVS-3B\u2019s PT Government Associate Laboratory, 4710-057 Braga\/Guimar\u00e3es, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3880-3258","authenticated-orcid":false,"given":"Pedro","family":"Morgado","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal"},{"name":"ICVS-3B\u2019s PT Government Associate Laboratory, 4710-057 Braga\/Guimar\u00e3es, Portugal"},{"name":"Clinical Academic Center-Braga (2CA), 4710-243 Braga, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic Statistical Manual of Mental Disorders (DSM-5), American Psychiatric Association Pub. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.biopsycho.2015.10.012","article-title":"A Theoretical Review of Cognitive Biases and Deficits in Obsessive\u2013Compulsive Disorder","volume":"121","author":"Hezel","year":"2016","journal-title":"Biol. Psychol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.eurpsy.2017.08.001","article-title":"Neural correlates of affective and non-affective cognition in obsessive compulsive disorder: A meta-analysis of functional imaging studies","volume":"46","author":"Rasgon","year":"2017","journal-title":"Eur. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.neuroscience.2016.07.030","article-title":"Cognitive inflexibility in Obsessive-Compulsive Disorder","volume":"345","author":"Gruner","year":"2017","journal-title":"Neuroscience"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pic\u00f3-P\u00e9rez, M., Moreira, P.S., Ferreira, V.D.M., Radua, J., Mataix-Cols, D., Sousa, N., Soriano-Mas, C., and Morgado, P. (2020). Modality-specific overlaps in brain structure and function in Obsessive-compulsive disorder: Multimodal meta-analysis of case-control MRI studies. Neurosci. Biobehav. Rev.","DOI":"10.1016\/j.neubiorev.2020.01.033"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.beth.2019.04.002","article-title":"\u201cCold\u201d Cognitive Control and Attentional Symptoms in Anxiety: Perceptions Versus Performance","volume":"50","author":"Hallion","year":"2019","journal-title":"Behav. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.janxdis.2010.12.002","article-title":"Effects of cognitive self-consciousness on visual memory in obsessive-compulsive disorder","volume":"25","author":"Kikul","year":"2011","journal-title":"J. Anxiety Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1080\/02699931.2014.911144","article-title":"Cognitive deficits are a matter of emotional context: Inflexible strategy use mediates context-specific learning impairments in OCD","volume":"29","author":"Zetsche","year":"2015","journal-title":"Cogn. Emot."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/0005-7967(85)90105-6","article-title":"Obsessional-compulsive problems: A cognitive-behavioural analysis","volume":"23","author":"Salkovskis","year":"1985","journal-title":"Behav. Res. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/S0005-7967(97)00040-5","article-title":"A cognitive theory of obsessions","volume":"35","author":"Rachman","year":"1997","journal-title":"Behav. Res. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/S0005-7967(96)00108-8","article-title":"Cognitive assessment of obsessive-compulsive disorder","volume":"35","author":"Frost","year":"1997","journal-title":"Behav. Res. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S1352465809990439","article-title":"Learning the Futility of the Thought Suppression Enterprise in Normal Experience and in Obsessive Compulsive Disorder","volume":"38","author":"Najmi","year":"2010","journal-title":"Behav. Cogn. Psychother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.jbtep.2013.05.005","article-title":"Symptom dimensions in obsessive-compulsive disorder: Differences in distress, interference, appraisals and neutralizing strategies","volume":"44","author":"Belloch","year":"2013","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/j.brat.2006.11.005","article-title":"Clinical obsessions in obsessive\u2013compulsive patients and obsession-relevant intrusive thoughts in non-clinical, depressed and anxious subjects: Where are the differences?","volume":"45","author":"Morillo","year":"2007","journal-title":"Behav. Res. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.brat.2003.11.007","article-title":"Thought suppression and its effects on thought frequency, appraisal and mood state in individuals with obsessive-compulsive disorder","volume":"43","author":"Purdon","year":"2005","journal-title":"Behav. Res. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jbtep.2015.07.008","article-title":"Exposure to unwanted intrusions, neutralizing and their effects on self-worth and obsessive-compulsive phenomena","volume":"49","author":"Ahern","year":"2015","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1037\/0021-843X.112.4.709","article-title":"Neutralizing increases discomfort associated with obsessional thoughts: An experimental study with obsessional patients","volume":"112","author":"Salkovskis","year":"2003","journal-title":"J. Abnorm. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/jcpp.12675","article-title":"Annual Research Review: On the relations among self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition for developmental psychopathology","volume":"58","author":"Nigg","year":"2017","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.tics.2013.08.006","article-title":"Dynamic cooperation and competition between brain systems during cognitive control","volume":"17","author":"Cocchi","year":"2013","journal-title":"Trends Cogn. Sci."},{"key":"ref_20","first-page":"563","article-title":"Emotional Processing in Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis of 25 Functional Neuroimaging Studies","volume":"3","author":"Thorsen","year":"2018","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1037\/a0027600","article-title":"Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation","volume":"138","author":"Webb","year":"2012","journal-title":"Psychol. Bull."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., G\u00f8tzsche, P.C., Ioannidis, J.P.A., Clarke, M., Devereaux, P.J., Kleijnen, J., and Moher, D. (2009). The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration. PLoS Med., 6.","DOI":"10.2427\/5768"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., and Altman, D.G. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3059","DOI":"10.1017\/S0033291715001026","article-title":"Emotion regulation before and after transcranial magnetic stimulation in obsessive compulsive disorder","volume":"45","author":"Trujillo","year":"2015","journal-title":"Psychol. Med."},{"key":"ref_25","first-page":"352","article-title":"Emotion Regulation in Obsessive-Compulsive Disorder, Unaffected Siblings, and Unrelated Healthy Control Participants","volume":"4","author":"Thorsen","year":"2019","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/S0005-7967(01)00095-X","article-title":"Thought suppression in obsessive-compulsive disorder","volume":"40","author":"Tolin","year":"2002","journal-title":"Behav. Res. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1023\/A:1016559117950","article-title":"Attributions for thought suppression failure in obsessive-compulsive disorder","volume":"26","author":"Tolin","year":"2002","journal-title":"Cognit. Ther. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1023\/A:1018720404750","article-title":"Thought suppression in obsessive-compulsive disorder","volume":"23","author":"Janeck","year":"1999","journal-title":"Cognit. Ther. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.brat.2009.02.015","article-title":"Managing unwanted intrusive thoughts in obsessive-compulsive disorder: Relative effectiveness of suppression, focused distraction, and acceptance","volume":"47","author":"Najmi","year":"2009","journal-title":"Behav. Res. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.janxdis.2018.01.002","article-title":"Changing disgust through imagery rescripting and cognitive reappraisal in contamination-based obsessive-compulsive disorder","volume":"54","author":"Fink","year":"2018","journal-title":"J. Anxiety Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1017\/S0033291715001610","article-title":"Altered emotion regulation in obsessive-compulsive disorder as evidenced by the late positive potential","volume":"46","author":"Paul","year":"2016","journal-title":"Psychol. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.nicl.2014.03.011","article-title":"Amygdala hyperactivation during symptom provocation in obsessive-compulsive disorder and its modulation by distraction","volume":"4","author":"Simon","year":"2014","journal-title":"NeuroImage Clin."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.bandc.2011.03.020","article-title":"Cognitive control of a simple mental image in patients with obsessive\u2013compulsive disorder","volume":"76","year":"2011","journal-title":"Brain Cogn."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/da.22845","article-title":"Intrinsic functional and structural connectivity of emotion regulation networks in obsessive-compulsive disorder","volume":"36","author":"Ipser","year":"2019","journal-title":"Depress. Anxiety"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s007370170004","article-title":"Gender in obsessive-compulsive disorder and obsessive-compulsive spectrum disorders","volume":"4","author":"Lochner","year":"2001","journal-title":"Arch. Womens. Ment. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/jebm.12141","article-title":"The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: A systematic review","volume":"8","author":"Zeng","year":"2015","journal-title":"J. Evid. Based. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.pnpbp.2017.06.001","article-title":"Emotion regulation in mood and anxiety disorders: A meta-analysis of fMRI cognitive reappraisal studies","volume":"79","author":"Radua","year":"2017","journal-title":"Prog. Neuro Psychopharmacol. Biol. Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.neuroimage.2016.06.009","article-title":"Neuroimaging cognitive reappraisal in clinical populations to define neural targets for enhancing emotion regulation. A systematic review","volume":"151","author":"Zilverstand","year":"2017","journal-title":"Neuroimage"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.janxdis.2013.01.004","article-title":"Experiential avoidance and emotion regulation difficulties in hoarding disorder","volume":"27","author":"Landau","year":"2013","journal-title":"J. Anxiety Disord."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1080\/08039488.2019.1652341","article-title":"Decreased theory of mind skills, increased emotion dysregulation and insight levels in adolescents diagnosed with obsessive compulsive disorder","volume":"73","author":"Yazici","year":"2019","journal-title":"Nord. J. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jocrd.2016.10.002","article-title":"Inter-individual variability in emotion regulation: Pathways to obsessive-compulsive symptoms","volume":"11","author":"Goldberg","year":"2016","journal-title":"J. Obsessive. Compuls. Relat. Disord."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.neuroimage.2014.06.051","article-title":"Common and differential neural networks of emotion regulation by Detachment, Reinterpretation, Distraction, and Expressive Suppression: A comparative fMRI investigation","volume":"101","author":"Lamke","year":"2014","journal-title":"Neuroimage"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1007\/s11682-017-9762-3","article-title":"Dispositional use of emotion regulation strategies and resting-state cortico-limbic functional connectivity","volume":"12","author":"Alonso","year":"2018","journal-title":"Brain Imaging Behav."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1037\/bul0000093","article-title":"The structure of common emotion regulation strategies: A meta-analytic examination","volume":"143","author":"McMahon","year":"2017","journal-title":"Psychol. Bull."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"387","DOI":"10.3758\/s13415-020-00775-8","article-title":"The neural bases of cognitive emotion regulation: The roles of strategy and intensity","volume":"20","author":"Moodie","year":"2020","journal-title":"Cogn. Affect. Behav. Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.neuroimage.2013.11.001","article-title":"NeuroImage Neural network of cognitive emotion regulation\u2014An ALE meta-analysis and MACM analysis","volume":"87","author":"Kohn","year":"2014","journal-title":"Neuroimage"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s10964-016-0585-0","article-title":"Emotion Regulation Strategies in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review","volume":"46","author":"Naumann","year":"2017","journal-title":"J. Youth Adolesc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1177\/1529100618821893","article-title":"Beyond Willpower: Strategies for Reducing Failures of Self-Control","volume":"19","author":"Duckworth","year":"2018","journal-title":"Psychol. Sci. Public Interes."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.janxdis.2014.06.008","article-title":"Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review","volume":"28","author":"Bluett","year":"2014","journal-title":"J. Anxiety Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.brat.2018.06.005","article-title":"Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial","volume":"108","author":"Twohig","year":"2018","journal-title":"Behav. Res. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.neubiorev.2019.06.029","article-title":"Common and distinct neural correlates of fear extinction and cognitive reappraisal: A meta-analysis of fMRI studies","volume":"104","author":"Dunsmoor","year":"2019","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2981","DOI":"10.1093\/cercor\/bht154","article-title":"Cognitive Reappraisal of Emotion: A Meta-Analysis of Human Neuroimaging Studies","volume":"24","author":"Buhle","year":"2014","journal-title":"Cereb. Cortex"},{"key":"ref_53","first-page":"211","article-title":"Cognitive-behavioral therapy for obsessive\u2013 compulsive disorder: Access to treatment, prediction of long-term outcome with neuroimaging","volume":"8","author":"Feusner","year":"2015","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1038\/s41572-019-0102-3","article-title":"Obsessive\u2013compulsive disorder","volume":"5","author":"Stein","year":"2019","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"261","DOI":"10.31887\/DCNS.2015.17.3\/sbrooks","article-title":"A systematic review of the neural bases of psychotherapy for anxiety and related disorders","volume":"17","author":"Brooks","year":"2015","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Polman, A., Bouman, T.K., van Hout, W.J.P.J., de Jong, P.J., and den Boer, J.A. (2009). Processes of change in cognitive-behavioural treatment of obsessive-compulsive disorder: Current status and some future directions. Clin. Psychol. Psychother., 17.","DOI":"10.1002\/cpp.638"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.pscychresns.2015.05.004","article-title":"Neuroimaging of psychotherapy for obsessive\u2013compulsive disorder: A systematic review","volume":"233","author":"Thorsen","year":"2015","journal-title":"Psychiatry Res. Neuroimaging"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"60","DOI":"10.3109\/08039488.2011.626869","article-title":"Do cognitive functions in obsessive\u2014Compulsive disorder change after treatment? A systematic review and a double case report","volume":"66","author":"Vandborg","year":"2012","journal-title":"Nord. J. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s10578-018-0830-8","article-title":"Mediating Mechanisms in Cognitive Behavioral Therapy for Childhood OCD: The Role of Dysfunctional Beliefs","volume":"50","author":"Wolters","year":"2019","journal-title":"Child Psychiatry Hum. Dev."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1002\/cpp.707","article-title":"Dysfunctional beliefs in the process of change of cognitive treatment in obsessive compulsive checkers","volume":"18","author":"Polman","year":"2011","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1037\/0022-006X.69.2.205","article-title":"Cognitive versus behavior therapy in the group treatment of Obsessive-Compulsive disorder","volume":"69","author":"McLean","year":"2001","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1037\/a0031865","article-title":"Behavioral versus cognitive treatment of obsessive-compulsive disorder: An examination of outcome and mediators of change","volume":"81","author":"Olatunji","year":"2013","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1007\/s11682-016-9585-7","article-title":"Imbalanced functional link between reward circuits and the cognitive control system in patients with obsessive-compulsive disorder","volume":"11","author":"Xie","year":"2017","journal-title":"Brain Imaging Behav."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.neuroimage.2019.07.008","article-title":"Cognitive reward control recruits medial and lateral frontal cortices, which are also involved in cognitive emotion regulation: A coordinate-based meta-analysis of fMRI studies","volume":"200","author":"Brandl","year":"2019","journal-title":"Neuroimage"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/10\/11\/797\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:26:15Z","timestamp":1760178375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/10\/11\/797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,29]]},"references-count":64,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["brainsci10110797"],"URL":"https:\/\/doi.org\/10.3390\/brainsci10110797","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,29]]}}}