The impacts of cognitive-behavioral therapy on the treatment of phobic disorders measured by functional neuroimaging techniques: a systematic review

Almeida, Amanda Cristina Galvão Oliveira de; Filho, Gerardo Maria de Araújo; Berberian, Arthur A.; Trezsniak, Clarissa; Nery-Fernandes, Fabiana; Neto, Cesar Augusto Araujo; Jackowski, Andrea Parolin; Miranda-Scippa, Ângela; Oliveira, Irismar Reis de

doi:10.1590/1516-4446-2012-0922

Cited by 12 publications

(51 citation statements)

References 24 publications

(51 reference statements)

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“…Studies that compared the brain signals obtained before and after treatment have reported changes that are consistent with this model of emotion regulation in depression Dichter, Felder, & Smoski, 2010;Goldapple et al, 2004), phobic disorders (Almeida et al, 2013;Schienle, Schafer, Hermann, Rohrmann, & Vaitl, 2007;Straube, Glauer, Dilger, Mentzel, & Miltner, 2006), panic disorder (Beutel, Stark, Pan, Silbersweig, & Dietrich, 2010;Sakai et al, 2006), posttraumatic stress disorder (Lindauer et al, 2008;Thomaes et al, 2014), personality disorders (Schnell & Herpertz, 2007), and eating disorders (Vocks et al,2010;Vocks et al, 2011). In the treatment of depression, these studies have provided evidence that the neural correlate of psychotherapy may consist in increased activation of prefrontal areas when participants are exposed to emotional stimuli, representing successful recruitment of control processes in the context of emotion regulation (DeRubeis et al, 2008;Disner et al, 2011).…”

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confidence: 74%

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

Messina

Sambin

Beschoner

et al. 2016

Cogn Affect Behav Neurosci

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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.

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“…Some published reviews observe brain CBT markers of efficacy, which usually involve the regulation of the activation of amygdala, insula, thalamus, the medial prefrontal cortex and hippocampus (Almeida et al, 2013;Porto et al, 2009). However, there are few studies that investigate the impact of CBT on cardiovascular parameters in anxiety disorders.…”

Section: Introductionmentioning

confidence: 99%

Listening to the heart: A meta-analysis of cognitive behavior therapy impact on the heart rate of patients with anxiety disorders

Gonçalves

Rodrigues

Novaes

et al. 2015

Journal of Affective Disorders

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“…On the other hand, both intervention techniques showed their efficacy by producing a decrease in the activation of the brain areas associated with fear, although the brain regions activated were not the same, partially supporting the second hypothesis. Neuroimaging techniques provide neurobiological support for the efficacy of CBT in the treatment of phobic disorders [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Neuronal Activity during Exposure to Specific Phobia through fMRI: Comparing Therapeutic Components of Cognitive Behavioral Therapy

Fumero

Marrero²,

Pérez³

et al. 2022

Life

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Cognitive behavioral therapy (CBT) packages for anxiety disorders, such as phobias, usually include gradual exposure to anxious contexts, positive self-verbalizations, and relaxation breathing. The objective of this research was to analyze the specific neural activation produced by the self-verbalizations (S) and breathing (B) included in CBT. Thirty participants with clinical levels of a specific phobia to small animals were randomly assigned to three fMRI conditions in which individuals were exposed to phobic stimuli in real images: a group underwent S as a technique to reduce anxiety; a second group underwent B; and a control group underwent exposure only (E). Simple effects showed higher brain activation comparing E > S, E > B, and S > B. In particular, in the E group, compared to the experimental conditions, an activation was observed in sensory-perceptive and prefrontal and in other regions involved in the triggering of emotion (i.e., amygdala, supplementary motor area, and cingulate gyrus) as well as an activation associated with interoceptive sensitivity (i.e., insula and cingulate cortex). According to the specific tool used, discrepancies in the neural changes of CBT efficacy were observed. We discuss the theoretical implications according to the dual model of CBT as a set of therapeutic tools that activate different processes.

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“…Those researchers expanded the concept suggesting that it would include: (1) the identification of targets and neural mediators of the functional effects of psychotherapy; (2) the determination of new ways of psychotherapeutic interventions using neurotechnology; and (3) planning or designing of those interventions based on available scientific knowledge. The interest to study the neural mechanisms of psychological interventions has mainly focused on anxiety disorders and major depression (Almeida et al, 2013; Linden, 2006). In this paper, we will focus on the research that assessed some kind of neurobiological correlate before and after a psychological or non-pharmacological treatment for insomnia.…”

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confidence: 99%

Neurobiological Correlates of Psychological Treatments for Insomnia

Marques

Gomes

Clemente

et al. 2016

European Psychologist

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Abstract. Sleep disorders and sleep disturbances are considered nowadays a major public health problem. Within sleep problems, insomnia is the most common health complaint. The maintenance of insomnia symptoms may lead to a clinical disorder – Insomnia Disorder (ID). A significant amount of literature has shown the efficacy and effectiveness of psychological treatments for ID. Often, the evaluation of therapeutic processes and outcomes focuses on subjective measures such as sleep diaries. In this work, we review the few published studies that evaluate modifications in neurobiological domain related to evidence-based psychological interventions, namely cognitive-behavioral therapy for insomnia (CBT-I). The search was carried out consulting Scopus, PubMed, and ISI Web of Knowledge databases. Only 12 studies were found. From the reviewed papers it was observed that the results are diverse, perhaps due to significant differences pertaining to the methodologies used. However, one interesting finding emerged: daytime experiments on insomnia comprising mainly cognitive tasks denoted hypofunction in ID patients, whereas nighttime experiments mainly associated with affective/emotional tasks denoted hyperarousal. We suggest that the study of the neural changes prompted by CBT-I is a major topic in the domain of psychotherapy and sleep medicine. Despite the scarce studies on neurobiological mechanisms of CBT-I, the results achieved until now are promising and should be taken into account in the future. Nonetheless, more research on this topic is needed.

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The impacts of cognitive-behavioral therapy on the treatment of phobic disorders measured by functional neuroimaging techniques: a systematic review

Cited by 12 publications

References 24 publications

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

Listening to the heart: A meta-analysis of cognitive behavior therapy impact on the heart rate of patients with anxiety disorders

Neuronal Activity during Exposure to Specific Phobia through fMRI: Comparing Therapeutic Components of Cognitive Behavioral Therapy

Neurobiological Correlates of Psychological Treatments for Insomnia

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