Four-Week Mentalizing Imagery Therapy for Family Dementia Caregivers: A Randomized Controlled Trial with Neural Circuit Changes.
Four-Week Mentalizing Imagery Therapy for Family Dementia Caregivers: A Randomized Controlled Trial with Neural Circuit Changes.
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DOI：
10.1159/000521950
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发表时间：
2022
影响因子：
22.8
通讯作者：
Yeung, Albert
中科院分区：
文献类型：
--
作者：
Jain, Felipe A.;Chernyak, Sergey V.;Nickerson, Lisa D.;Morgan, Stefana;Schafer, Rhiana;Mischoulon, David;Bernard-Negron, Richard;Nyer, Maren;Cusin, Cristina;Gomez, Liliana Ramireza;Yeung, Albert
痴呆症患者的家庭照顾者承受着沉重的抑郁负担，积极情绪减少。心理意象疗法（MIT）提供正念和引导意象技能培训，以改善平衡的心理和情绪调节。为了验证以下假设，即家庭照顾者的MIT比支持小组（SG）更能减少抑郁症状和改善积极心理特质，并增加背外侧前额叶皮层（DLPFC）连接和减少膝下前扣带皮层（sgACC）连接。46名护理人员参加了一项随机对照试验，比较了为期4周的MIT组（n=24）与SG组（n=22）。在基线和治疗后对28名照顾者进行静息状态神经影像学检查，并对所有参与者进行问卷调查。主要结果是抑郁症的变化;次要指标包括焦虑，正念，自我同情和幸福感。确定了DLPFC和sgACC参与的脑网络。DLPFC和sgACC与各自网络的连接强度用二元回归确定。DLPFC-网络连接与抑郁结局相关。MIT在改善抑郁、焦虑、正念、自我同情和幸福感方面的表现明显优于SG，其效果大小为中等至大。相对于SG，MIT的参与者显示DLPFC连接性显着增加-完全复制了试点研究结果-但sgACC没有变化。DLPFC连接变化与正念呈正相关，与抑郁变化呈负相关。在本试验中，MIT在减轻抑郁和焦虑症状以及改善积极心理特质方面优于SG上级。神经影像学结果表明，加强DLPFC与情绪调节网络的连接可能与MIT效应有关。
Family caregivers of patients with dementia suffer a high burden of depression and reduced positive emotions. Mentalizing Imagery Therapy (MIT) provides mindfulness and guided imagery skills training to improve balanced mentalizing and emotion regulation. To test the hypotheses that MIT for family caregivers would reduce depression symptoms and improve positive psychological traits more than a support group (SG), and would increase dorsolateral prefrontal cortex (DLPFC) connectivity and reduce subgenual anterior cingulate cortex (sgACC) connectivity. 46 caregivers participated in a randomized controlled trial comparing a 4-week MIT group (n=24) versus SG (n=22). Resting state neuroimaging was obtained at baseline and post group in 28 caregivers, and questionnaires completed by all participants. Primary outcome was change in depression; secondary measures included anxiety, mindfulness, self-compassion and well-being. Brain networks with participation of DLPFC and sgACC were identified. Connectivity strengths of DLPFC and sgACC with respective networks were determined with dual regression. DLPFC-network connectivity was correlated with depression outcome. MIT significantly outperformed SG in improving depression, anxiety, mindfulness, self-compassion, and well-being, with moderate to large effect sizes. Relative to SG, participants in MIT showed significant increases in DLPFC connectivity – exactly replicating pilot study results – but no change in sgACC. DLPFC connectivity change correlated positively with mindfulness and negatively with depression change. In this trial, MIT was superior to SG for reducing depression and anxiety symptoms and improving positive psychological traits. Neuroimaging results suggested that strengthening DLPFC connectivity with an emotion regulation network might be mechanistically related to MIT effects.
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DOI：
10.1098/rstb.2005.1634
发表时间：
2005-05-29
影响因子：
6.3
作者：
Beckmann, CF;DeLuca, M;Smith, SM
通讯作者：
Smith, SM
影响因子：
48
作者：
Esteban, Oscar;Markiewicz, Christopher J.;Gorgolewski, Krzysztof J.
通讯作者：
Gorgolewski, Krzysztof J.
影响因子：
22.8
作者：
Guidi, Jenny;Brakemeier, Eva-Lotta;Fava, Giovanni A.
通讯作者：
Fava, Giovanni A.
影响因子：
10.6
作者：
Greicius, Michael D.;Flores, Benjamin H.;Schatzberg, Alan F.
通讯作者：
Schatzberg, Alan F.
影响因子：
5.7
作者：
O'Rourke, N;Tuokko, HA
通讯作者：
Tuokko, HA