Behavioral and Magnetoencephalographic Correlates of Fear Generalization Are Associated With Responses to Later Virtual Reality Exposure Therapy in Spider Phobia.

Autor: Roesmann K; Institute for Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany; Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany. Electronic address: Kati.Roesmann@uni-siegen.de., Leehr EJ; Institute for Translational Psychiatry, University of Münster, Münster, Germany., Böhnlein J; Institute for Translational Psychiatry, University of Münster, Münster, Germany., Steinberg C; Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany., Seeger F; Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany., Schwarzmeier H; Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany., Gathmann B; Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany., Siminski N; Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany., Herrmann MJ; Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany., Dannlowski U; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany; Institute for Translational Psychiatry, University of Münster, Münster, Germany., Lueken U; Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Humboldt, Germany., Klucken T; Institute for Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany., Hilbert K; Department of Psychology, Humboldt-Universität zu Berlin, Humboldt, Germany., Straube T; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany; Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany., Junghöfer M; Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany.
Jazyk: angličtina
Zdroj: Biological psychiatry. Cognitive neuroscience and neuroimaging [Biol Psychiatry Cogn Neurosci Neuroimaging] 2022 Feb; Vol. 7 (2), pp. 221-230. Date of Electronic Publication: 2021 Jul 26.
DOI: 10.1016/j.bpsc.2021.07.006
Abstrakt: Background: Because overgeneralization of fear is a pathogenic marker of anxiety disorders, we investigated whether pretreatment levels of fear generalization in spider-phobic patients are related to their response to exposure-based treatment to identify pretreatment moderators of treatment success.
Methods: A total of 90 patients with spider phobia completed pretreatment clinical and magnetoencephalography assessments, one session of virtual reality exposure therapy, and a posttreatment clinical assessment. Based on the primary outcome (30% symptom reduction in self-reported symptoms), they were categorized as responders or nonresponders. In a pretreatment magnetoencephalography fear generalization paradigm involving fear conditioning with 2 unconditioned stimuli (UCS), we obtained fear ratings, UCS expectancy ratings, and event-related fields to conditioned stimuli (CS: CS-, CS+) and 7 different generalization stimuli on a perceptual continuum from CS- to CS+.
Results: Before treatment, nonresponders showed behavioral overgeneralization indicated by more linear generalization gradients in fear ratings. Analyses of magnetoencephalography source estimations revealed that nonresponders showed a decline of their (inhibitory) frontal activations to safety-signaling CS- and generalization stimuli compared with CS+ over time, while responders maintained these activations at early (<300 ms) and late processing stages.
Conclusions: Results provide initial evidence that pretreatment differences of behavioral and neural markers of fear generalization may act as moderators of later responses to behavioral exposure. Stimulating further research on fear generalization as a potential predictive marker, our findings are an important first step in the attempt to identify patients who may not benefit from exposure therapy and to personalize and optimize treatment strategies for this vulnerable patient group.
(Copyright © 2021 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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