Changing views of emotion regulation and neurobiological models of the mechanism of action of psychotherapy

Abstract

Influential neurobiological models of the mechanism of action of psychotherapy attribute its success to increases of activity in prefrontal areas and decreases in limbic areas, interpreted as the successful and adaptive recruitment of controlled processes to achieve emotion regulation. In this article, we review the behavioral and neuroscientific evidence in support of this model and its applicability to explain the mechanism of action of psychotherapy. Neuroimaging studies of explicit emotion regulation, evidence on the neurobiological substrates of implicit emotion regulation, and metaanalyses of neuroimaging studies of the effect of psychotherapy consistently suggest that areas implicated in coding semantic representations play an important role in emotion regulation not covered by existing models based on controlled processes. We discuss the findings that implicate these same areas in supporting working memory, in encoding preferences and the prospective outcome of actions taken in rewarding or aversive contingencies, and show how these functions may be integrated into process models of emotion regulation that depend on elaborate semantic representations for their effectiveness. These alternative models also appear to be more consistent with internal accounts in the psychotherapeutic literature of how psychotherapy works.

Intrinsic Brain Activity Responsible for Sex Differences in Shyness and Social Anxiety

“…In addition, research on the cerebral intrinsic function related to shy and socially anxiety has important clinical implications. Since previous study had proved that the brain network observed in the present study would change in activity after psychotherapy (Messina et al, 2016). As expected, we found specific intrinsic brain networks associated with shyness (or social anxiety): shyness was positively related to brain spontaneous activity in the frontoparietal control network and negatively related to the cingulo-insular network, whereas social anxiety was positively associated with regional spontaneous activity in the frontal-limbic network and negatively associated in the frontoparietal network.…”

Neural Correlates of Outcome of the Psychotherapy Compared to Antidepressant Therapy in Anxiety and Depression Disorders: A Meta-Analysis

“…In line with the theoretical aspects of psychotherapies that emphasize the importance of the internal reality, as the representations, and the processes of the meaning attribution and elaboration (Timary et al, 2011), the increase of the right paracingulate activity might be interpreted as psychotherapy conditioned increase of the attention to personal inner states and of the emotions regulation ability (Keune et al, 2012; Messina et al, 2016). …”

Adaptation of the Scrambled-Sentences Task to Assess “Shattered Assumptions:” Construction of the Test and Investigation of Neural Substrates in an fMRI Study

“…Among the areas active during handling trauma-related content, the temporal poles and the perisylvian region, especially the superior temporal gyrus and the parietal operculum/posterior insula, are known to host semantic representations of personal experience [34] and are candidate neural substrates of representations of schematic information [35, 36]. Though not typically active in functional imaging studies of emotion, they strongly correlate with deficits in the categorization and selection of emotion in patients with cortical damage [37].…”