Randomized controlled trial of mindfulness-based stress reduction versus aerobic exercise: effects on the self-referential brain network in social anxiety disorder.
Randomized controlled trial of mindfulness-based stress reduction versus aerobic exercise: effects on the self-referential brain network in social anxiety disorder.
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DOI：
10.3389/fnhum.2012.00295
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发表时间：
2012
影响因子：
2.9
通讯作者：
Gross JJ
中科院分区：
文献类型：
--
作者：
Goldin P;Ziv M;Jazaieri H;Gross JJ
背景：社交焦虑障碍（SAD）是一种以扭曲的自我观为特征的障碍。这项研究的目的是检验基于正念的减压（MBSR）是否会改变消极和积极自我观的行为和大脑测量。方法：将五十六例成人泛发性SAD患者随机分为正念减压治疗组和有氧运动对照组。在基线和干预后进行自我参照编码任务，以检查功能性磁共振成像期间自我参照脑网络中行为和神经反应的变化。患者被提示决定积极和消极的社会特质形容词是自我描述的还是大写字体。结果：在行为上，正念减压疗法较之主动积极疗法，能更大程度地降低消极自我观，而同等程度地提高积极自我观。在神经方面，与AE相比，在负性自我与病例的过程中，正念减压导致后扣带回皮层（PCC）的脑反应增加。积极自我与病例之间没有差异性变化。二次分析表明，对消极和积极自我观点的认可的变化与MBSR的社交焦虑症状严重程度降低相关，但与AE无关。此外，与病例相比，在消极自我观期间，MBSR相关的背内侧前额叶皮层（DMPFC）活动增加与社交焦虑相关的残疾减少和正念增加有关。神经时间动力学的分析显示，MBSR相关的变化，在DMPFC和PCC的神经反应的时间为负的自我观与情况。结论：这些发现表明，正念减压疗法通过促进自动（即，未受指导的）认知和注意力调节神经网络的募集。这突出了自我参照和认知注意力调节系统之间潜在的重要联系，并表明正念减压疗法可能会增强SAD患者更适应性的社会自我参照过程。
Background: Social anxiety disorder (SAD) is characterized by distorted self-views. The goal of this study was to examine whether mindfulness-based stress reduction (MBSR) alters behavioral and brain measures of negative and positive self-views. Methods: Fifty-six adult patients with generalized SAD were randomly assigned to MBSR or a comparison aerobic exercise (AE) program. A self-referential encoding task was administered at baseline and post-intervention to examine changes in behavioral and neural responses in the self-referential brain network during functional magnetic resonance imaging. Patients were cued to decide whether positive and negative social trait adjectives were self-descriptive or in upper case font. Results: Behaviorally, compared to AE, MBSR produced greater decreases in negative self-views, and equivalent increases in positive self-views. Neurally, during negative self versus case, compared to AE, MBSR led to increased brain responses in the posterior cingulate cortex (PCC). There were no differential changes for positive self versus case. Secondary analyses showed that changes in endorsement of negative and positive self-views were associated with decreased social anxiety symptom severity for MBSR, but not AE. Additionally, MBSR-related increases in dorsomedial prefrontal cortex (DMPFC) activity during negative self-view versus case were associated with decreased social anxiety related disability and increased mindfulness. Analysis of neural temporal dynamics revealed MBSR-related changes in the timing of neural responses in the DMPFC and PCC for negative self-view versus case. Conclusion: These findings suggest that MBSR attenuates maladaptive habitual self-views by facilitating automatic (i.e., uninstructed) recruitment of cognitive and attention regulation neural networks. This highlights potentially important links between self-referential and cognitive-attention regulation systems and suggests that MBSR may enhance more adaptive social self-referential processes in patients with SAD.
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