Changes in functional connectivity of the amygdala during cognitive reappraisal predict symptom reduction during trauma-focused cognitive–behavioral therapy among adolescent girls with post-traumatic stress disorder
| Autor: | Clinton D. Kilts, Sonet Smitherman, Josh M. Cisler, Benjamin A. Sigel, J. S. Steele, Teresa L. Kramer, Karin L. Vanderzee, Joy R. Pemberton |
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| Rok vydání: | 2016 |
| Předmět: |
Child abuse
medicine.medical_specialty Adolescent Trauma focused cognitive behavioral therapy medicine.medical_treatment Poison control behavioral disciplines and activities Stress Disorders Post-Traumatic Cognitive reappraisal 03 medical and health sciences 0302 clinical medicine Functional neuroimaging Outcome Assessment Health Care mental disorders medicine Humans Child Abuse Child Psychiatry Applied Psychology Cerebral Cortex Cognitive Behavioral Therapy medicine.diagnostic_test Functional Neuroimaging Traumatic stress Amygdala Prognosis Magnetic Resonance Imaging 030227 psychiatry Cognitive behavioral therapy Psychiatry and Mental health Female Functional magnetic resonance imaging Psychology 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Psychological Medicine. 46:3013-3023 |
| ISSN: | 1469-8978 0033-2917 |
| DOI: | 10.1017/s0033291716001847 |
| Popis: | BackgroundWhile trauma-focused cognitive–behavioral therapy (TF-CBT) is the ‘gold standard’ treatment for pediatric post-traumatic stress disorder (PTSD), little is known about the neural mechanisms by which TF-CBT produces clinical benefit. Here, we test the hypothesis that PTSD symptom reduction during TF-CBT among adolescent girls with PTSD is associated with changes in patterns of brain functional connectivity (FC) with the amygdala during cognitive reappraisal.MethodAdolescent girls with PTSD related to physical or sexual assault (n = 34) were enrolled in TF-CBT, delivered in an approximately 12-session format, in an open trial. Before and after treatment, they were engaged in a cognitive reappraisal task, probing neural mechanisms of explicit emotion regulation, during 3 T functional magnetic resonance imaging.ResultsAmong adolescent girls completing TF-CBT with usable pre- and post-treatment scans (n = 20), improvements in self-reported emotion from pre- to post-treatment were positively related to improvements in PTSD symptoms. Adolescent girls with greater post-treatment symptom reduction were also able to suppress amygdala–insula FC while re-appraising, which was not evident in girls with less symptom reduction. Pre- to post-treatment changes in right amygdala to left insula FC that scaled with PTSD symptom reduction also scaled with improvements in emotion regulation.ConclusionsThese preliminary results suggest the neurocircuitry mechanisms through which TF-CBT produces clinical outcomes, providing putative brain targets for augmenting TF-CBT response. |
| Databáze: | OpenAIRE |
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