Neural predictors and effects of cognitive behavioral therapy for depression: the role of emotional reactivity and regulation
| Autor: | Maria A. Oquendo, Bruce P. Doré, J. John Mann, Harry Rubin-Falcone, Lauren Delaparte, Bryan T. Denny, Sudha Raman, Ronit Kishon, Jochen Weber, Kevin N. Ochsner, Jeffrey M. Miller |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent medicine.medical_treatment Emotions Precuneus Hippocampus behavioral disciplines and activities Young Adult 03 medical and health sciences 0302 clinical medicine Neural Pathways medicine Humans Reactivity (psychology) Applied Psychology Depressive Disorder Major Neural correlates of consciousness Cognitive Behavioral Therapy medicine.diagnostic_test Autobiographical memory Middle Aged medicine.disease Magnetic Resonance Imaging 030227 psychiatry Oxygen Cognitive behavioral therapy Psychiatry and Mental health Treatment Outcome medicine.anatomical_structure Major depressive disorder Female Psychology Functional magnetic resonance imaging 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Psychological Medicine. 50:146-160 |
| ISSN: | 1469-8978 0033-2917 |
| Popis: | BackgroundCognitive behavioral therapy (CBT) is an effective treatment for many patients suffering from major depressive disorder (MDD), but predictors of treatment outcome are lacking, and little is known about its neural mechanisms. We recently identified longitudinal changes in neural correlates of conscious emotion regulation that scaled with clinical responses to CBT for MDD, using a negative autobiographical memory-based task.MethodsWe now examine the neural correlates of emotional reactivity and emotion regulation during viewing of emotionally salient images as predictors of treatment outcome with CBT for MDD, and the relationship between longitudinal change in functional magnetic resonance imaging (fMRI) responses and clinical outcomes. Thirty-two participants with current MDD underwent baseline MRI scanning followed by 14 sessions of CBT. The fMRI task measured emotional reactivity and emotion regulation on separate trials using standardized images from the International Affective Pictures System. Twenty-one participants completed post-treatment scanning. Last observation carried forward was used to estimate clinical outcome for non-completers.ResultsPre-treatment emotional reactivity Blood Oxygen Level-Dependent (BOLD) signal within hippocampus including CA1 predicted worse treatment outcome. In contrast, better treatment outcome was associated with increased down-regulation of BOLD activity during emotion regulation from time 1 to time 2 in precuneus, occipital cortex, and middle frontal gyrus.ConclusionsCBT may modulate the neural circuitry of emotion regulation. The neural correlates of emotional reactivity may be more strongly predictive of CBT outcome. The finding that treatment outcome was predicted by BOLD signal in CA1 may suggest overgeneralized memory as a negative prognostic factor in CBT outcome. |
| Databáze: | OpenAIRE |
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