重新评估期间的大脑活动和社会焦虑和严重抑郁症中心理治疗反应的关联:一个随机试验
Cope Feurer1, Jagan Jimmy2, Melissa Uribe1
1Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
Psychological medicine
|May 22, 2024
概括
在认知重新评估期间的大脑活动预测了社会焦虑障碍和严重抑郁障碍的治疗反应. 较少的腹侧前额叶皮层活动预测了认知行为疗法的更好的结果,而更多的活动预测了支持性治疗的结果.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 心理学 心理学 心理学
背景情况:
- 认知行为疗法 (CBT) 对社会焦虑障碍 (SAD) 和严重抑郁障碍 (MDD) 有效,但治疗反应各不相同.
- 之前的研究将治疗前的脊侧前额皮层 (dlPFC) 在认知重新评估期间的活性与SAD中的CBT反应联系起来.
- 目前尚不清楚这种关联是否扩展到MDD或是特定于CBT.
研究的目的:
- 研究治疗前神经活动在认知重新评估和SAD或MDD患者的临床改善之间的关系.
- 为了比较这些治疗方法之间的关联:CBT和支持性治疗 (ST).
主要方法:
- 75名患有SAD (n=34) 或MDD (n=41) 的患者随机分配到CBT (n=40) 或ST (n=35) 中.
- 参与者在治疗前的认知再评估任务中接受了功能磁共振成像 (fMRI).
- 在整个治疗过程中,症状严重程度和自我报告的重新评估都被反复评估.
主要成果:
- 在重新评估期间,治疗前的神经活动对CBT和ST的不同预测反应.
- 对于CBT,下腹侧前额皮层 (vlPFC) 活动与更大的症状改善相关.
- 对于ST,更高的vlPFC活性与更大的症状改善相关. 较低的基线dlPFC活性预测了自我报告的重新评估中更大的改善,无论治疗.
结论:
- 重新评估期间大脑活动的个体差异可能预测SAD和MDD的治疗特异性症状改善.
- 这些神经模式也可能与心理治疗后主观重新评估技能的更广泛改进有关.
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