通过认知行为疗法对焦虑症患者的未经药物治疗的儿科患者进行前端-关节激活的正常化
Simone P Haller1, Julia O Linke1, Hannah L Grassie1
1Emotion and Development Branch, NIMH, Bethesda, Md. (Haller, Grassie, Jones, Mallidi, Berman, Lewis, Kircanski, Brotman); Department of Psychology, University of Freiburg, Freiburg, Germany (Linke); Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York (Pagliaccio); Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands (Harrewijn); Department of Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (White); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Abend); Department of Human Development and Quantitative Methodology, University of Maryland, College Park (Fox); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Silverman); Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison (Kalin); School of Psychological Sciences (Bar-Heim, Naim) and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel.
认知行为疗法 (CBT) 在焦虑的年轻人中正常化了前额-双脑大脑活动. 然而,边缘反应仍然很高,这表明这些区域可能需要更多的时间来改善症状. 这项研究提供了对儿科焦虑治疗机制的见解.
科学领域:
- 神经科学是一个神经科学.
- 儿童和青少年精神病学 儿童和青少年精神病学
- 临床心理学 临床心理学
背景情况:
- 焦虑障碍是常见的,并在年轻人中造成损害.
- 认知行为疗法 (CBT) 是治疗儿科焦虑的第一线治疗方法.
- 了解CBT的神经机制对于优化治疗至关重要.
研究的目的:
- 在接受CBT的患有焦虑症的青少年中,调查与症状改善相关的大脑活动变化.
- 为了检查焦虑的气质风险的年轻人的神经差异.
主要方法:
- 功能性MRI (fMRI) 用于评估12周CBT前后未接受药物治疗的患有焦虑症的青少年在威胁处理任务期间的大脑激活.
- 为了进行比较,纳入了年龄匹配的健康对照组和风险青少年样本.
- 通过使用血液氧气水平依赖 (BOLD) 响应分析了全脑区域激活变化.
主要成果:
- 与对照人群相比,患有焦虑障碍的青少年在前额-双肩注意力网络和边缘区域的激活发生了变化.
- 在CBT后,前额-双肩过度激活正常化,而边缘反应仍然升高.
- 在风险样本中,随着时间的推移与焦虑相关的神经模式与与治疗相关的变化重叠.
结论:
- 在儿科焦虑患者中,CBT可能会使前额-双肩网络激活正常化.
- 边缘区域可能对急性CBT效应的反应较弱.
- 处于危险的年轻人中与治疗相关的神经变化不仅仅是由于时间的流逝.
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