Review of Psychodynamic Psychotherapy Neuroimaging Studies

Abstract

The clinical efficacy of psychodynamic psychotherapy (PDT) has undergone extensive study and review. Recently, researchers have studied the effects of this treatment on brain metabolic or synaptic activity, but the collective findings have never been reviewed. The objective of this review was to describe the findings of all neuroimaging studies of any form of PDT treatment. An extensive literature search through databases along with surveying of research groups were undertaken to acquire all available published studies. Eleven series were included in the final sample, consisting of 2 randomized controlled trials, 5 controlled trials and 4 case series, altogether involving 210 people: 94 healthy controls and 116 people with mood disorders, panic disorder, somatoform disorders and borderline personality disorder. A variety of neuroimaging techniques were used to examine regional metabolic activity and synaptic neurotransmission before and after treatment. The common finding was normalization of synaptic or metabolic activity in limbic, midbrain and prefrontal regions, occurring in association with improved clinical outcomes. PDT has demonstrable effects on brain function in diverse clinical populations as evidenced by a modest group of mixed neuroimaging studies.

Neural Predictors of Successful Brief Psychodynamic Psychotherapy for Persistent Depression

“…Although understudied relative to other interventions [5], psychodynamically oriented therapies have been preliminarily associated with synaptic and metabolic changes in limbic, midbrain, and prefrontal regions [6]. However, heterogeneity of treatment (even within-study) and lack of discrimination between responders and nonresponders limit previous studies in the field.…”

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

“…However, the exact mechanisms through which psychotherapy acts are not well understood. An influential model of the mechanism of action of psychotherapy draws on data from the considerable number of studies that have applied clinical neuroscience approaches (primarily functional neuroimaging) to identify the brain-behavior circuits that change during therapy (for reviews, see Abbass, Nowoweiski, Bernier, Tarzwell, & Beutel, 2014;Beauregard, 2007; DeRubeis, Siegle, & Hollon, 2008;Disner, Beevers, Haigh, & Beck, 2011;Frewen, Dozois, & Lanius, 2008;Messina, Sambin, Palmieri, & Viviani, 2013). According to this model, psychotherapy may act by promoting the effectiveness of control processes of executive nature, whose neurobiological substrate may be located in prefrontal areas (see Fig.…”

Treating anxiety disorders by emotion‐focused psychodynamic psychotherapy (EFPP)—An integrative, transdiagnostic approach

“…In their meta-analysis, Diener, Hilsenroth, and Weinberger (2007) concluded that facilitation of affective experience and expression by the therapist contributed consistently to positive treatment outcomes with a magnitude of r = 0.30 which was comparable to the effect of the therapeutic alliance. Indeed, a recent review of neuroimaging studies demonstrated that therapeutic improvement in PP was associated with changes in neuronal networks subserving emotional processes (Abbass, Nowoweiski, Bernier, Tarzwell, & Beutel, 2014). However, patients' emotional experiencing has received relatively little empirical attention in psychodynamic therapy research (Fisher et al, 2016), along with specific therapeutic actions focusing on affect (Subic-Wrana et al, 2016;Whelton, 2004).…”