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Amygdala and ventral anterior cingulate activation predicts treatment response to cognitive behaviour therapy for post-traumatic stress disorder

Citation

Bryant, RA and Felmingham, KL and Kemp, A and Das, P and Hughes, G and Peduto, A and Williams, L, Amygdala and ventral anterior cingulate activation predicts treatment response to cognitive behaviour therapy for post-traumatic stress disorder, Psychological Medicine, 2008, (38) pp. 555-561. ISSN 0033-2917 (2008) [Refereed Article]


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Copyright Statement

Copyright 2007 Cambridge University Press

DOI: doi:10.1017/S0033291707002231

Abstract

Background. Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), approximately half of patients do not respond to CBT. No studies have investigated the capacity for neural responses during fear processing to predict treatment response in PTSD. Method. Functional magnetic resonance imaging (fMRI) responses of the brain were examined in individuals with PTSD (n=14). fMRI was examined in response to fearful and neutral facial expressions presented rapidly in a backwards masking paradigm adapted for a 1.5 T scanner. Patients then received eight sessions of CBT that comprised education, imaginal and in vivo exposure, and cognitive therapy. Treatment response was assessed 6 months after therapy completion. Results. Seven patients were treatment responders (defined as a reduction of 50% of pretreatment scores) and seven were non-responders. Poor improvement after treatment was associated with greater bilateral amygdala and ventral anterior cingulate activation in response to masked fearful faces. Conclusions. Excessive fear responses in response to fear-eliciting stimuli may be a key factor in limiting responses to CBT for PTSD. This excessive amygdala response to fear may reflect difficulty in managing anxiety reactions elicited during CBT, and this factor may limit optimal response to therapy.

Item Details

Item Type:Refereed Article
Keywords:Cognitive behaviour therapy, fMRI, post-traumatic stress disorder, treatment prediction
Research Division:Psychology and Cognitive Sciences
Research Group:Psychology
Research Field:Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
Author:Felmingham, KL (Professor Kim Felmingham)
ID Code:72075
Year Published:2008
Web of Science® Times Cited:153
Deposited By:Psychology
Deposited On:2011-08-19
Last Modified:2015-02-11
Downloads:316 View Download Statistics

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