The impact of therapists' words on the adolescent brain: In the context of addiction treatment.
The impact of therapists' words on the adolescent brain: In the context of addiction treatment.
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DOI：
10.1016/j.bbr.2015.09.041
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发表时间：
2016-01-15
影响因子：
2.7
通讯作者：
Filbey FM
中科院分区：
文献类型：
--
作者：
Feldstein Ewing SW;Houck JM;Yezhuvath U;Shokri-Kojori E;Truitt D;Filbey FM
尽管有基础性的工作，我们仍然不知道治疗师的行为如何影响酗酒青少年的大脑反应和相关的治疗结果。因此，我们调查了17名酗酒青年(平均年龄=16.62岁；64.3%女性；42.9%西班牙裔；28.6%混血/多种族)。在这项受试者内部设计中，所有的年轻人都完成了基线评估，两次治疗，一次功能磁共振扫描，并在治疗后一个月重新评估行为变化。在功能磁共振成像课程中，向年轻人展示了他们的治疗治疗师的两种类型的治疗反应：经验支持的成瘾治疗中开出的更高技能的治疗性陈述(复杂反思)与更广泛的成瘾治疗中的语言标准(封闭式问题)。在行为改变方面，在一个月的随访中，青少年在治疗后饮酒天数和酗酒天数明显减少。此外，我们发现复杂反思和闭合性问题的主效应横跨颞中上回和中回(Fwe-校正，p<；0.05)。在双侧扣带回前部，复杂问题比闭合性问题表现出相对较强的反应。此外，在封闭式提问中，顶叶的大胆反应越大，与治疗后饮酒的减少显著相关。最后，在复杂的反思和楔形前期的封闭性问题中，较低的大胆回答与治疗后对改变饮酒重要性的更高评级有关。这项研究是了解某些治疗师的行为如何影响发育中的青少年大脑，以及在成瘾治疗的背景下，这种神经反应可能如何与青少年治疗结果相关的第一步。
Despite foundational work, we still do not know how therapist behaviors influence brain response and related treatment outcomes for alcohol-using adolescents. Therefore, we examined this question with 17 binge drinking youth (mean age = 16.62 years; 64.3% female; 42.9% Hispanic; 28.6% bi-/multi-racial). In this within-subjects design, all youth completed a baseline assessment, two therapy sessions, an fMRI scan, and were re-evaluated for behavior change at one-month post-treatment. During the fMRI session, youth were presented with two types of therapist responses from their treating therapist: higher-skill therapeutic statements prescribed in an empirically-supported addiction treatment (complex reflections) versus language standard within addiction treatment more broadly (closed questions). In terms of behavior change, at the one-month follow-up, youth showed significant reductions in their number of drinking days and binge drinking days post-treatment. Further, we found main effects for complex reflections and closed questions across the superior middle temporal gyrus and middle temporal gyrus (FWE-corrected, p<.05). Complex questions showed a relatively stronger response than closed questions within the bilateral anterior cingulate gyrus. Additionally, greater BOLD response in the parietal lobe during closed questions was significantly associated with less post-treatment drinking. Finally, lower BOLD responses during both complex reflections and closed questions in the precuneus were associated with greater post-treatment ratings of importance of changing drinking. This study represents a first step in understanding how certain therapist behaviors influence the developing adolescent brain and how that neural response may be associated with youth treatment outcomes in the context of addiction treatment.