Cognitive-behavioral therapy for generalized anxiety disorder is associated with attenuation of limbic activation to threat-related facial emotions.
Cognitive-behavioral therapy for generalized anxiety disorder is associated with attenuation of limbic activation to threat-related facial emotions.
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DOI：
10.1016/j.jad.2014.07.031
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发表时间：
2014-12
影响因子：
6.6
通讯作者：
Stein, Murray B.
中科院分区：
文献类型：
--
作者：
Fonzo, Gregory A.;Ramsawh, Holly J.;Flagan, Taru M.;Sullivan, Sarah G.;Simmons, Alan N.;Paulus, Martin P.;Stein, Murray B.
认知行为治疗（CBT）对广泛性焦虑症（GAD）的益处背后的神经过程尚未得到很好的理解。21名（n=21）主要诊断为广泛性焦虑症的成年人和11名（n=11）非焦虑的健康对照（HC）在完成面部情绪处理任务时进行了功能性磁共振成像。对威胁相关情绪的反应（即，在GAD组中，在预处理时以及在10次CBT治疗后再次评估恐惧和愤怒与快乐面孔的对比，在HC组中，在相当的等待期内再次评估。在治疗前，GAD参与者表现出迟钝的反应，在杏仁核，杏仁核，前扣带回的快乐的脸处理比较条件，和更大的杏仁核岛连接。CBT与衰减的杏仁核和膝下前扣带回激活恐惧/愤怒的脸和提高岛屿的反应，快乐的脸比较条件，但没有明显的影响连接。治疗前异常和治疗相关变化与焦虑症状无关。没有主动控制条件（例如，治疗等待名单）以比较治疗效果。两者合计，这些结果提供了证据的双重过程的神经系统的变化，在广泛性焦虑症的扣带回杏仁核反应的威胁线索减弱，而积极的面部情绪的岛屿反应增强的心理治疗模型。未来的工作需要确定这些变化的临床意义及其对CBT的特异性。
The neural processes underlying the benefits of cognitive behavioral treatment (CBT) for generalized anxiety disorder (GAD) are not well understood. Twenty-one (n=21) adults with a principal diagnosis of GAD and eleven (n=11) non-anxious healthy controls (HC) underwent functional magnetic resonance imaging while completing a facial emotion processing task. Responses to threat-related emotionality (i.e., the contrast of fear and angry vs. happy faces) were assessed at pretreatment and again following 10 sessions of CBT in the GAD group and a comparable waiting period in the HC group. At pretreatment, GAD participants displayed blunted responses in the amygdala, insula, and anterior cingulate to the happy face-processing comparison condition, and greater amygdalo-insular connectivity. CBT was associated with attenuated amygdalar and subgenual anterior cingulate activation to fear/angry faces and heightened insular responses to the happy face comparison condition, but had no apparent effects on connectivity. Pre-treatment abnormalities and treatment-related changes were not associated with symptoms of worry. There was no active control condition (e.g., treatment waitlist) for comparison of treatment effects. Taken together, these results provide evidence for a dual-process psychotherapeutic model of neural systems changes in GAD in which cingulo-amygdalar reactivity to threat cues is attenuated while insular responses to positive facial emotions are potentiated. Future work is needed to determine the clinical implications of these changes and their specificity to CBT.
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影响因子：
2.3
作者：
Hoehn-Saric, R;Schlund, MW;Wong, SHY
通讯作者：
Wong, SHY
DOI：
10.1176/appi.ajp.2009.09070931
发表时间：
2010-05
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Etkin A;Prater KE;Hoeft F;Menon V;Schatzberg AF
通讯作者：
Schatzberg AF
影响因子：
5.7
作者：
Campbell-Sills, Laura;Simmons, Alan N.;Lovero, Kathryn L.;Rochlin, Alexis A.;Paulus, Martin P.;Stein, Murray B.
通讯作者：
Stein, Murray B.
影响因子：
--
作者：
Kessler, RC;Berglund, P;Walters, EE
通讯作者：
Walters, EE
影响因子：
6.6
作者：
Campbell-Sills, Laura;Norman, Sonya B.;Stein, Murray B.
通讯作者：
Stein, Murray B.