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Levi E, Peysachov G, Admon R, Zilcha-Mano S. Cortisol interdependence during psychotherapy in major depressive disorder. Psychoneuroendocrinology 2024; 163:106983. [PMID: 38367530 DOI: 10.1016/j.psyneuen.2024.106983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 02/19/2024]
Abstract
The current study explored cortisol interdependence between patients and therapists during psychotherapy, the possible moderating effect of patient alliance ratings on this interdependence, and the associations between cortisol interdependence and treatment outcome. While cortisol interdependence was explored in other interpersonal contexts, its presence in psychotherapy has remained unexplored. We hypothesized that (a) patients' and therapists' cortisol levels at pre-session will predict their own and their partner's subsequent cortisol levels at post-session, (b) patient ratings of their relationship with their therapists will moderate these partner effects, and (c) cortisol interdependence will be associated with better treatment outcome. Fifty dyads undergoing 16 weeks of psychodynamic treatment for major depressive disorder participated in this study. Patient-therapist salivary cortisol samples were collected at eight time points, alongside a post-session patient-rated alliance questionnaire and a symptom severity interview. For analyses we employed the actor-partner interdependence model. Results revealed that (a) patients' and therapists' cortisol levels before sessions predicted their own post-session cortisol changes. However, significant cortisol interdependence was observed in patients' pre-session cortisol levels predicting therapists' post-session cortisol levels. Furthermore, (b) poorer alliance ratings associated with more pronounced cortisol interdependence, and (c) in dyads where patient pre-session cortisol predicted therapist's post-session cortisol, a better treatment outcome was found. This study found novel evidence of cortisol interdependence in psychotherapy and is partially in line with other studies inspecting cortisol interdependence in adjacent research fields. These findings emphasize the intricate psychophysiological interactions within therapeutic relationships and their associations with treatment outcome.
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Affiliation(s)
- Eyal Levi
- Department of Psychology, University of Haifa, Israel
| | | | - Roee Admon
- Department of Psychology, University of Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Israel
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2
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Stefana A, Fusar-Poli P, Vieta E, Youngstrom EA. Assessing the patient's affective perception of their psychotherapist: validation of the in-Session Patient Affective Reactions Questionnaire. Front Psychiatry 2024; 15:1346760. [PMID: 38757138 PMCID: PMC11096799 DOI: 10.3389/fpsyt.2024.1346760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
Background Psychotherapists need effective tools to monitor changes in the patient's affective perception of the therapist and the therapeutic relationship during sessions to tailor therapeutic interventions and improve treatment outcomes. This study aims to evaluate the factor structure, reliability, and validity of the in-Session Patient Affective Reactions Questionnaire (SPARQ), a concise self-report measure designed for practical application in real-world psychotherapy settings. Methods Validation data was gathered from (N = 700) adult patients in individual psychotherapy. These patients completed the SPARQ in conjunction with additional measures capturing sociodemographic details, characteristics of therapeutic interventions, individual personality traits, mental health symptom severity, elements of the therapeutic relationship, and session outcomes. This comprehensive approach was employed to assess the construct and criterion-related validity of the SPARQ. Results The SPARQ has a two-factor structure: Positive Affect (k = 4, ω total = .87) and Negative Affect (k = 4, ω total = .75). Bifactor confirmatory factor analysis (CFA) yielded the following fit indices: X2[df] = 2.53, CFI = .99; TLI = .98; RMSEA = .05; and SRMR = .02. Multi-group CFAs demonstrated measurement invariance (i) across patients who attended psychotherapy sessions in person versus in remote mode, and (ii) across patients with and without psychiatric diagnoses confirmed metric invariance. Furthermore, the SPARQ showed meaningful correlations with concurrently administered measures. Discussion The SPARQ proves to be a valuable instrument in clinical, training, and research contexts, adept at capturing patients' session-level affective responses towards their therapist and perceptions of the therapeutic alliance. Comprehensive descriptive statistics and a range of score precision indices have been reported, intended to serve as benchmarks for future research.
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Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Centro de Investigacio Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Barcelona, Spain
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Institute for Mental and Behavioral Health Research, Nationwide Children’s Hospital, Division of Child and Family Psychiatry, The Ohio State University, Columbus, OH, United States
- Helping Give Away Psychological Science, Chapel Hill, NC, United States
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3
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Zangri RM, Blanco I, Pascual T, Vázquez C. Unlocking the past: efficacy of guided self-compassion and benefit-focused online interventions for managing negative personal memories. Cogn Emot 2024:1-15. [PMID: 38635402 DOI: 10.1080/02699931.2024.2337132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
Positive reappraisal strategies have been found to reduce negative affect following the recall of negative personal events. This study examined the restorative effect of two mood-repair instructions (self-compassion vs benefit-focused reappraisal) and a control condition with no instructions following a negative Mood Induction Procedure by using the guided recall of a negative autobiographical event. A total of 112 university students participated in the online study (81% women, Mage: 21.0 years). Immediately following the negative memory recall, participants were randomised to each condition [(self-compassion: n = 36, benefit-focused: n = 39) or a control condition (n = 37)]. Repeated measures ANOVAs 3 (Repair condition) × 3 (Time of mood assessment: pre-recall, post-recall, post-regulation) showed that, as expected, negative mood (sadness, shame, and guilt) worsened significantly after the guided recall in all groups (p < .001). After the mood-repair intervention, participants in the self-compassion and benefit-focused conditions showed a significant reduction in negative mood (p < .019), while such improvement was not observed in the control group. Self-compassion and benefit-focused reappraisal functioned similarly as mood repair strategies after experiencing negative affect induced by the recall of negative personal memories. Implications in the context of autobiographical memory biases are discussed.
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Affiliation(s)
- Rosaria Maria Zangri
- Department of Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Ivan Blanco
- Department of Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Teodoro Pascual
- Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain
| | - Carmelo Vázquez
- Department of Clinical Psychology, Complutense University of Madrid, Madrid, Spain
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4
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Lu J, Yang Y, Chen H, Ma H, Tan Y. Effects of different psychosocial interventions on death anxiety in patients: a network meta-analysis of randomized controlled trials. Front Psychol 2024; 15:1362127. [PMID: 38562234 PMCID: PMC10982502 DOI: 10.3389/fpsyg.2024.1362127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This research intended to assess and compare influence of psychosocial interventions in death anxiety in patients, providing evidence-based guidance for both patients and healthcare providers. Design The present study exclusively gathered randomized controlled trials by comprehensively searching across multiple databases, comprising of PubMed, Embase, Cochrane Library, Web of Science, and Scopus. The methodological quality of the enrolled studies involved in the analysis was assessed using the Cochrane bias risk assessment tool, and data analysis was performed utilizing appropriate software. Results This research, encompassing 15 randomized controlled trials with a cumulative sample size of 926 patients, spanned from the earliest possible date to December 2023. The findings of network meta-analysis unveiled that the Rational-Emotive Hospice Care Therapy significantly reduced death anxiety among patients (Sequentially Updated Cumulative Ranking Analysis: 100%). Conclusion The ranking plot of the network suggested that the rational-emotive hospice care therapy exhibited superior efficacy as a psychological treatment for reducing the death anxiety of patients.Systematic review registration: [https://clinicaltrials.gov/], identifier: [CRD42023484767].
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Affiliation(s)
- Jinhong Lu
- Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Kabrel M, Tulver K, Aru J. The journey within: mental navigation as a novel framework for understanding psychotherapeutic transformation. BMC Psychiatry 2024; 24:91. [PMID: 38302927 PMCID: PMC10835954 DOI: 10.1186/s12888-024-05522-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Despite the demonstrated efficacy of psychotherapy, the precise mechanisms that drive therapeutic transformations have posed a challenge and still remain unresolved. Here, we suggest a potential solution to this problem by introducing a framework based on the concept of mental navigation. It refers to our ability to navigate our cognitive space of thoughts, ideas, concepts, and memories, similar to how we navigate physical space. We start by analyzing the neural, cognitive, and experiential constituents intrinsic to mental navigation. Subsequently, we posit that the metaphoric spatial language we employ to articulate introspective experiences (e.g., "unexplored territory" or "going in circles") serves as a robust marker of mental navigation. METHODS Using large text corpora, we compared the utilization of spatial language between transcripts of psychotherapy sessions (≈ 12 M. words), casual everyday conversations (≈ 12 M. words), and fictional dialogues in movies (≈ 14 M. words). We also examined 110 psychotherapy transcripts qualitatively to discern patterns and dynamics associated with mental navigation. RESULTS We found a notable increase in the utilization of spatial metaphors during psychotherapy compared to casual everyday dialogues (U = 192.0, p = .001, d = 0.549) and fictional conversations (U = 211, p < .001, d = 0.792). In turn, analyzing the usage of non-spatial metaphors, we did not find significant differences between the three datasets (H = 0.682, p = 0.710). The qualitative analysis highlighted specific examples of mental navigation at play. CONCLUSION Mental navigation might underlie the psychotherapy process and serve as a robust framework for understanding the transformative changes it brings about.
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Affiliation(s)
- Mykyta Kabrel
- Institute of Philosophy and Semiotics, University of Tartu, Tartu, Estonia.
| | - Kadi Tulver
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | - Jaan Aru
- Institute of Computer Science, University of Tartu, Tartu, Estonia
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Markowitz JC, Milrod BL. Affect-Focused and Exposure-Focused Psychotherapies. Am J Psychother 2024:appipsychotherapy20230012. [PMID: 38247343 DOI: 10.1176/appi.psychotherapy.20230012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
The authors discuss the two broad domains of affect-focused and exposure-focused psychotherapies, defining the characteristics and potential advantages and disadvantages of each. The two domains differ in their theoretical approaches, structures, and techniques. Exposure-focused therapies have come to dominate research and practice, leading to the relative neglect of affect-focused therapies. When the two approaches have been examined in well-conducted clinical trials, they generally appear to be equally beneficial for treating common mood, anxiety, and trauma disorders, although further research may better define differential therapeutics. The authors argue for better training in affect awareness and tolerance across psychotherapies and use a brief case vignette to illustrate several aspects of these different approaches.
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Affiliation(s)
- John C Markowitz
- Columbia University Vagelos College of Physicians and Surgeons and New York State Psychiatric Institute, New York City (Markowitz); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Milrod)
| | - Barbara L Milrod
- Columbia University Vagelos College of Physicians and Surgeons and New York State Psychiatric Institute, New York City (Markowitz); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Milrod)
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Liu R, Chao Y, Ma X, Sha X, Sun L, Li S, Chang S. ERTNet: an interpretable transformer-based framework for EEG emotion recognition. Front Neurosci 2024; 18:1320645. [PMID: 38298914 PMCID: PMC10827927 DOI: 10.3389/fnins.2024.1320645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024] Open
Abstract
Background Emotion recognition using EEG signals enables clinicians to assess patients' emotional states with precision and immediacy. However, the complexity of EEG signal data poses challenges for traditional recognition methods. Deep learning techniques effectively capture the nuanced emotional cues within these signals by leveraging extensive data. Nonetheless, most deep learning techniques lack interpretability while maintaining accuracy. Methods We developed an interpretable end-to-end EEG emotion recognition framework rooted in the hybrid CNN and transformer architecture. Specifically, temporal convolution isolates salient information from EEG signals while filtering out potential high-frequency noise. Spatial convolution discerns the topological connections between channels. Subsequently, the transformer module processes the feature maps to integrate high-level spatiotemporal features, enabling the identification of the prevailing emotional state. Results Experiments' results demonstrated that our model excels in diverse emotion classification, achieving an accuracy of 74.23% ± 2.59% on the dimensional model (DEAP) and 67.17% ± 1.70% on the discrete model (SEED-V). These results surpass the performances of both CNN and LSTM-based counterparts. Through interpretive analysis, we ascertained that the beta and gamma bands in the EEG signals exert the most significant impact on emotion recognition performance. Notably, our model can independently tailor a Gaussian-like convolution kernel, effectively filtering high-frequency noise from the input EEG data. Discussion Given its robust performance and interpretative capabilities, our proposed framework is a promising tool for EEG-driven emotion brain-computer interface.
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Affiliation(s)
- Ruixiang Liu
- School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Yihu Chao
- School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Xuerui Ma
- School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Xianzheng Sha
- School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
| | - Limin Sun
- Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, China
| | - Shuo Li
- School of Life Sciences, China Medical University, Shenyang, Liaoning, China
| | - Shijie Chang
- School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, China
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Rahimi-Danesh M, Samizadeh MA, Sajadi AE, Rezvankhah T, Vaseghi S. Sex difference affects fear extinction but not lithium efficacy in rats following fear-conditioning with respect to the hippocampal level of BDNF. Pharmacol Biochem Behav 2024; 234:173675. [PMID: 37972713 DOI: 10.1016/j.pbb.2023.173675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
In rodents, exposure to electrical shock and creating a strong fear memory using fear-conditioning model can induce PTSD-like behavior. In this study, we induced a fear-conditioning model in rats and investigated freezing (PTSD-like) behavior, 21 days after three shocks exposure (0.6 mA, 3 s, 30 seconds interval) in both male and female rats. Lithium was injected intraperitoneally (100 mg/kg) in three protocols: (1) 1 h after fear-conditioning (2) 1 h, 24 h, and 48 h after fear-conditioning (3), 1 h, 24 h, 48 h, 72 h, and 96 h after fear-conditioning. Extinction training (20 sounds without shocks, 75 dB, 3 s, 30 seconds interval) was performed in three protocols: (1) 1 h after fear-conditioning (one session), (2) 1 h, 24 h, and 48 h after fear-conditioning (three sessions), (3), 1 h, 24 h, 48 h, 72 h, and 96 h after fear-conditioning (five sessions). Forced swim test (FST) and hot plate were used to assess behavior. Results showed that lithium in all protocols had no effect on freezing behavior, FST, and pain subthreshold in all rats. Extinction training decreased freezing behavior, with more efficacy in females. In males, only 5-session training was effective, while in females all protocols were effective. Extinction training also altered pain perception and the results of FST, depending on the sessions and was different in males and females. Brain-derived neurotrophic factor (BDNF) mRNA level was increased in females following 3 and 5 sessions, and in males following 5 sessions extinction training. In conclusion, we suggested that there is a sex difference for the effect of extinction training on freezing behavior and BDNF mRNA level in a rat model of fear-conditioning.
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Affiliation(s)
- Mehrsa Rahimi-Danesh
- Cognitive Neuroscience Lab, Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
| | - Mohammad-Ali Samizadeh
- Cognitive Neuroscience Lab, Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
| | - Amir-Ehsan Sajadi
- Cognitive Neuroscience Lab, Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
| | - Tara Rezvankhah
- Cognitive Neuroscience Lab, Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
| | - Salar Vaseghi
- Cognitive Neuroscience Lab, Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran; Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.
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Krohner S, Town J, Cannoy CN, Schubiner H, Rapport LJ, Grekin E, Lumley MA. Emotion-Focused Psychodynamic Interview for People with Chronic Musculoskeletal Pain and Childhood Adversity: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2024; 25:39-52. [PMID: 37479050 DOI: 10.1016/j.jpain.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/25/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
Childhood adversity and emotional conflicts are associated with the presence and severity of chronic musculoskeletal pain (CMP), yet common treatments for CMP do not address such risk factors. We developed a single session, emotion-focused psychodynamic interview, based on Emotional Awareness and Expression Therapy and Intensive Short-term Psychodynamic Therapy, and we tested the interview's effects on pain-related outcomes and potential psychological mediators in a randomized, controlled trial. Adults (N = 91; ages 21-70, M = 44.64; 87.9% women) reporting CMP and at least 3 adverse childhood experiences completed measures at baseline and 6-week follow-up. Participants were randomized to immediate interview or waitlist control conditions. The 90-minute interview was conducted via videoconference, and the interviewer elicited disclosure of adversities and conflicts, linked these with pain, and encouraged the experience and expression of adaptive emotions. Analyses indicated that conditions did not differ significantly on change in pain severity; however, compared to control, the interview led to a significantly greater reduction in pain interference (P = .016, ηp2 = .05) and a similar trend for anxiety (P = .058, ηp2 = .04). The interview also significantly changed several potential mediators: pain-related anxiety (P = .008, ηp2 = .06), pain controllability (P = .016, ηp2 = .06), and psychological (P < .001, ηp2 = .15) and brain attributions (P = .022, ηp2 = .05) for pain. Participants viewed the interview as very valuable. We conclude that addressing childhood adversities and conflicts in a psychodynamic interview is beneficial for people with CMP. PERSPECTIVE: This study found that, compared to waitlist control, a 90-minute, remotely-administered, emotion-focused, psychodynamic interview improved pain interference, and anxiety among adults with chronic musculoskeletal pain and childhood adversity. Intensive emotional work can be done in a single session to the benefit of patients with chronic musculoskeletal pain.
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Affiliation(s)
- Shoshana Krohner
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Joel Town
- Centre for Emotions & Health, Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Ciara N Cannoy
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Howard Schubiner
- Department of Internal Medicine, Ascension Health / Providence Park Hospital, Michigan State University, Southfield, Michigan
| | - Lisa J Rapport
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Emily Grekin
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, Michigan
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10
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Milton AL. Drug memory reconsolidation: from molecular mechanisms to the clinical context. Transl Psychiatry 2023; 13:370. [PMID: 38040677 PMCID: PMC10692359 DOI: 10.1038/s41398-023-02666-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 12/03/2023] Open
Abstract
Since its rediscovery at the beginning of the 21st Century, memory reconsolidation has been proposed to be a therapeutic target for reducing the impact of emotional memories that can go awry in mental health disorders such as drug addiction (substance use disorder, SUD). Addiction can be conceptualised as a disorder of learning and memory, in which both pavlovian and instrumental learning systems become hijacked into supporting drug-seeking and drug-taking behaviours. The past two decades of research have characterised the details of the molecular pathways supporting the reconsolidation of pavlovian cue-drug memories, with more recent work indicating that the reconsolidation of instrumental drug-seeking memories also relies upon similar mechanisms. This narrative review considers what is known about the mechanisms underlying the reconsolidation of pavlovian and instrumental memories associated with drug use, how these approaches have translated to experimental medicine studies, and the challenges and opportunities for the clinical use of reconsolidation-based therapies.
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Affiliation(s)
- Amy L Milton
- Department of Psychology, University of Cambridge, Cambridge, UK.
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11
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Begemann S, Willutzki U, Lutz G. Perception, experience and use of moments of change - a qualitative investigation. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2023; 69:331-344. [PMID: 37830881 DOI: 10.13109/zptm.2023.69.oa5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Objectives: In psychotherapeutic change processes, in addition to gradual changes, specific single special moments are described as a starting point for change. We investigated the perception of these moments of change (CMs) from the patient's perspective: What does each patient perceive and experience in a CM? Methods: A qualitative, explorative study of CMs was conducted by means of semi-structured questionnaires as well as qualitative interviews with patients (n = 12). Grounded theory was used for the analysis. Results: CMs were noticed by an "explicit mode of perception" based on physical, emotional and cognitive aspects. In addition, we found a "transcending mode of experience" that involved changes in consciousness and self-experience. CMs showed a "specific transformative pattern" and were preserved as "experience anchors". Conclusions: The intensification of consciousness, transformation of self-experience, and intense prototypical experience of a change process appeared particularly impressive. With the help of CMs, access could be gained to an embodied and implicit experience, which could subsequently be symbolised and used as an "experience anchor". This could be useful especially for the treatment of psychosomatic patients.
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Affiliation(s)
- Simone Begemann
- Abteilung für Psychosomatische Medizin und Psychotherapie Gemeinschaftskrankenhaus Herdecke Gerhard-Kienle-Weg 4 D-58313 Herdecke Deutschland
| | - Ulrike Willutzki
- Department of Clinical Psychology and Psychotherapy I, Faculty of Health, University of Witten/Herdecke Deutschland
| | - Gabriele Lutz
- Abteilung für Psychosomatische Medizin und Psychotherapie Gemeinschaftskrankenhaus Herdecke Gerhard-Kienle-Weg 4 D-58313 Herdecke Deutschland
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Health, University ofWitten/Herdecke, Germany Deutschland
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12
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Vilaro MJ, Bryan E, Palani T, Cooks EJ, Mertens G, Zalake M, Lok BC, Krieger JL. Rural adults' perceptions of nutrition recommendations for cancer prevention: Contradictory and conflicting messages. PREVENTIVE ONCOLOGY & EPIDEMIOLOGY 2023; 1:2237680. [PMID: 38390218 PMCID: PMC10883477 DOI: 10.1080/28322134.2023.2237680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Despite robust evidence linking alcohol, processed meat, and red meat to colorectal cancer (CRC), public awareness of nutrition recommendations for CRC prevention is low. Marginalized populations, including those in rural areas, experience high CRC burden and may benefit from culturally tailored health information technologies. This study explored perceptions of web-based health messages iteratively in focus groups and interviews with 48 adults as part of a CRC prevention intervention. We analyzed transcripts for message perceptions and identified three main themes with subthemes: (1) Contradictory recommendations, between the intervention's nutrition risk messages and recommendations for other health conditions, from other sources, or based on cultural or personal diets; (2) reactions to nutrition risk messages, ranging from aversion (e.g., "avoid alcohol" considered "preachy") to appreciation, with suggestions for improving messages; and (3) information gaps. We discuss these themes, translational impact, and considerations for future research and communication strategies for delivering web-based cancer prevention messages.
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Affiliation(s)
| | - Emma Bryan
- STEM Translational Communication Center, University of Florida
| | - Te Palani
- STEM Translational Communication Center, University of Florida
| | - Eric J Cooks
- STEM Translational Communication Center, University of Florida
| | - Gillian Mertens
- STEM Translational Communication Center, University of Florida
- Literacy Department, SUNY Cortland
| | - Mohan Zalake
- Computer and Information Sciences and Engineering, University of Florida
| | - Benjamin C Lok
- Computer and Information Sciences and Engineering, University of Florida
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13
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Huang Q, Luo M, Mi Y, Luo H. "Leader-Follower" Dynamic Perturbation Manipulates Multi-Item Working Memory in Humans. eNeuro 2023; 10:ENEURO.0472-22.2023. [PMID: 37914409 PMCID: PMC10668215 DOI: 10.1523/eneuro.0472-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023] Open
Abstract
Manipulating working memory (WM) is a central yet challenging notion. Previous studies suggest that WM items with varied memory strengths reactivate at different latencies, supporting a time-based mechanism. Motivated by this view, here we developed a purely bottom-up "Leader-Follower" behavioral approach to manipulate WM in humans. Specifically, task-irrelevant flickering color disks that are bound to each of the memorized items are presented during the delay period, and the ongoing luminance sequences of the color disks follow a Leader-Follower relationship, that is, a hundreds of milliseconds temporal lag. We show that this dynamic behavioral approach leads to better memory performance for the item associated with the temporally advanced luminance sequence (Leader) than the item with the temporally lagged luminance sequence (Follower), yet with limited effectiveness. Together, our findings constitute evidence for the essential role of temporal dynamics in WM operation and offer a promising, noninvasive WM manipulation approach.
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Affiliation(s)
- Qiaoli Huang
- School of Psychological and Cognitive Sciences, Peking University, Beijing 100871, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
- Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China
- Department of Psychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig 04103, Germany
| | - Minghao Luo
- School of Psychological and Cognitive Sciences, Peking University, Beijing 100871, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
- Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China
| | - Yuanyuan Mi
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing 100084, China
| | - Huan Luo
- School of Psychological and Cognitive Sciences, Peking University, Beijing 100871, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
- Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China
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14
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Werbart A, Rådberg U, Holm I, Forsström D, Berman AH. The meaning and feeling of the time and space between psychotherapy sessions and everyday life: Client experiences of transitions. Psychother Res 2023:1-14. [PMID: 37890094 DOI: 10.1080/10503307.2023.2274061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE To explore how clients in psychodynamic or psychoanalytic psychotherapy, conducted in the traditional in-person setting, experience the transitions in time and space between psychotherapy sessions and everyday life. METHOD Twelve semi-structured interviews were analyzed with inductive experiential thematic analysis, focusing on how the participants experience and make sense of the phenomenon in focus. RESULTS The participants described therapy as a sheltered space where they could be open, vulnerable, receptive, and present. Approaching and leaving psychotherapy sessions, the participants established different behavioral patterns and routines dealing with their anxieties and resistances. In this in-between area, the participants could handle interconnections and differences between therapy and everyday life. Participants stressed the clinical impact of transitions: transitions affect both therapy and everyday life; disturbed transitions have an adverse impact; transitions are insufficiently addressed in therapy. CONCLUSION Transitions between therapy and life appear to be an essential but seldom recognized part of the therapy process beyond the borders of therapy sessions. Implications of these findings for psychotherapy training and practice are discussed, and a tentative transtheoretical framework for further research is proposed.
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Affiliation(s)
- Andrzej Werbart
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Ulf Rådberg
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Isa Holm
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - David Forsström
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Anne H Berman
- Department of Psychology, Uppsala University, Uppsala, Sweden
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15
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Feinstein D. Using energy psychology to remediate emotional wounds rooted in childhood trauma: preliminary clinical guidelines. Front Psychol 2023; 14:1277555. [PMID: 37920741 PMCID: PMC10619750 DOI: 10.3389/fpsyg.2023.1277555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/13/2023] [Indexed: 11/04/2023] Open
Abstract
Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood, such as violence, abuse, severe neglect, or mental health problems in caregivers. The negative physical and mental health consequences of severe or multiple ACEs provide a major challenge for the health care community. Psychotherapies that utilize a mind-body approach in treating ACE-related conditions are seen by their proponents as having advantages for bringing healing and restoration compared with talk, introspective, interpersonal, and exposure therapies that do not intervene at the body level, as famously encapsulated by Bessel van der Kolk's observation that "the body keeps the score." A mind-body approach whose use has been rapidly increasing in clinical settings as well as on a self-help basis is called "energy psychology." Energy psychology combines conventional therapeutic techniques such as cognitive restructuring and psychological exposure with the stimulation of acupuncture points (acupoints) by tapping on them. A review of the development, efficacy, and plausible mechanisms of energy psychology is presented, and several strengths are enumerated, such as how integrating acupoint tapping into conventional exposure methods enhances the speed and power of outcomes. The impact of energy psychology protocols on the three brain networks most centrally involved with ACEs is also examined. Finally, recommendations are offered for using an energy psychology approach at each stage of therapy with individuals who have endured severe or multiple ACES, from establishing a therapeutic alliance to assessment to treatment to follow-up.
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16
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Kip A, Schoppe L, Arntz A, Morina N. Efficacy of imagery rescripting in treating mental disorders associated with aversive memories - An updated meta-analysis. J Anxiety Disord 2023; 99:102772. [PMID: 37699277 DOI: 10.1016/j.janxdis.2023.102772] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/09/2023] [Accepted: 09/03/2023] [Indexed: 09/14/2023]
Abstract
Imagery rescripting (ImRs) is frequently applied to treat different psychological complaints. We conducted an updated meta-analysis based on randomised controlled trials on the efficacy of ImRs for mental disorders associated with aversive memories. Medline, PsycInfo, and Web of Science were searched up to May 2023. Seventeen trials were included with a total of 908 participants (417 in the ImRs condition), suffering from posttraumatic stress disorder, anxiety disorders, depression, or eating disorders. Random effect models yielded an overall effect of g = 0.68 (95 % CI 0.18 to 1.18; k = 7) compared to passive controls (mostly waitlist). The effect compared to (prolonged) exposure, cognitive restructuring, and EMDR was non-significant (g = -0.01; 95 % CI -0.18 to 0.15; k = 11). Follow-up assessments indicated a long-term treatment effect. Results suggest that ImRs can effectively treat a variety of psychological disorders and produce similar treatment effects as evidence-based interventions. Limitations include the bounded number of included trials for each mental disorder. The meta-analysis was registered on PROSPERO (CRD42020220696) and received no funding.
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Affiliation(s)
- Ahlke Kip
- Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany.
| | - Luisa Schoppe
- Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS Amsterdam, the Netherlands
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany
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17
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Chaddad A, Wu Y, Kateb R, Bouridane A. Electroencephalography Signal Processing: A Comprehensive Review and Analysis of Methods and Techniques. SENSORS (BASEL, SWITZERLAND) 2023; 23:6434. [PMID: 37514728 PMCID: PMC10385593 DOI: 10.3390/s23146434] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/16/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
The electroencephalography (EEG) signal is a noninvasive and complex signal that has numerous applications in biomedical fields, including sleep and the brain-computer interface. Given its complexity, researchers have proposed several advanced preprocessing and feature extraction methods to analyze EEG signals. In this study, we analyze a comprehensive review of numerous articles related to EEG signal processing. We searched the major scientific and engineering databases and summarized the results of our findings. Our survey encompassed the entire process of EEG signal processing, from acquisition and pretreatment (denoising) to feature extraction, classification, and application. We present a detailed discussion and comparison of various methods and techniques used for EEG signal processing. Additionally, we identify the current limitations of these techniques and analyze their future development trends. We conclude by offering some suggestions for future research in the field of EEG signal processing.
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Affiliation(s)
- Ahmad Chaddad
- School of Artificial Intelligence, Guilin University of Electronic Technology, Guilin 541004, China
- The Laboratory for Imagery, Vision and Artificial Intelligence, Ecole de Technologie Supérieure, Montreal, QC H3C 1K3, Canada
| | - Yihang Wu
- School of Artificial Intelligence, Guilin University of Electronic Technology, Guilin 541004, China
| | - Reem Kateb
- College of Computer Science and Engineering, Taibah University, Madinah 41477, Saudi Arabia
| | - Ahmed Bouridane
- Centre for Data Analytics and Cybersecurity, University of Sharjah, Sharjah 27272, United Arab Emirates
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18
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Lear MK, Smith SM, Pilecki B, Stauffer CS, Luoma JB. Social anxiety and MDMA-assisted therapy investigation: a novel clinical trial protocol. Front Psychiatry 2023; 14:1083354. [PMID: 37520237 PMCID: PMC10379654 DOI: 10.3389/fpsyt.2023.1083354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Background Social anxiety disorder (SAD) is a serious and prevalent psychiatric condition that heavily impacts social functioning and quality of life. Though efficacious treatments exist for SAD, remission rates remain elevated and a significant portion of those affected do not access effective treatment, suggesting the need for additional evidence-based treatment options. This paper presents a protocol for an open-label pilot study of MDMA-assisted therapy (MDMA-AT) for social anxiety disorder. The study aims to assess preliminary treatment outcomes, feasibility and safety, and psychological and physiological processes of change in the treatment of SAD with MDMA-AT. A secondary aim includes the development of a treatment manual for MDMA-AT for SAD. Method The outlined protocol is a randomized, open-label delayed treatment study. We will recruit 20 participants who meet criteria with moderate-to-severe social anxiety disorder (SAD) of the generalized subtype. Participants will be randomly assigned to an immediate treatment (n = 10) or delayed treatment condition (n = 10). Those in the immediate treatment condition will proceed immediately to active MDMA-AT consisting of three preparation sessions, two medicine sessions in which they receive oral doses of MDMA, and six integration sessions over approximately a 16-week period. The delayed treatment condition will receive the same intervention after a 16-week delay. Our primary outcome is SAD symptom reduction as measured by the Liebowitz Social Anxiety Scale administered by blinded raters at post-treatment and 6 month follow up. Secondary outcomes include changes in functional impairment, feasibility and safety measures, and novel therapeutic processes of change including shame and shame-related coping, belongingness, self-concealment, and self-compassion at post-treatment. Exploratory outcomes are also discussed. Discussion The results of this pilot trial advance the field's understanding of the acceptability and potential effectiveness of MDMA-AT for social anxiety disorder and provide an overview of relevant therapeutic mechanisms unique to SAD. We hope findings from this protocol will inform the design of subsequent larger-scale randomized controlled trials (RCT) examining the efficacy of MDMA-AT for SAD. Clinical trial registration https://clinicaltrials.gov/, NCT05138068.
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Affiliation(s)
- M. Kati Lear
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
| | - Sarah M. Smith
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
| | - Brian Pilecki
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
| | - Chris S. Stauffer
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Jason B. Luoma
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
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19
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Kokorikou DS, Sarigiannidis I, Fiore VG, Parkin B, Hopkins A, El-Deredy W, Dilley L, Moutoussis M. Testing hypotheses about the harm that capitalism causes to the mind and brain: a theoretical framework for neuroscience research. FRONTIERS IN SOCIOLOGY 2023; 8:1030115. [PMID: 37404338 PMCID: PMC10315660 DOI: 10.3389/fsoc.2023.1030115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
In this paper, we will attempt to outline the key ideas of a theoretical framework for neuroscience research that reflects critically on the neoliberal capitalist context. We argue that neuroscience can and should illuminate the effects of neoliberal capitalism on the brains and minds of the population living under such socioeconomic systems. Firstly, we review the available empirical research indicating that the socio-economic environment is harmful to minds and brains. We, then, describe the effects of the capitalist context on neuroscience itself by presenting how it has been influenced historically. In order to set out a theoretical framework that can generate neuroscientific hypotheses with regards to the effects of the capitalist context on brains and minds, we suggest a categorization of the effects, namely deprivation, isolation and intersectional effects. We also argue in favor of a neurodiversity perspective [as opposed to the dominant model of conceptualizing neural (mal-)functioning] and for a perspective that takes into account brain plasticity and potential for change and adaptation. Lastly, we discuss the specific needs for future research as well as a frame for post-capitalist research.
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Affiliation(s)
- Danae S. Kokorikou
- Psychoanalysis Unit, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Ioannis Sarigiannidis
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Vincenzo G. Fiore
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Beth Parkin
- Department of Psychology, School of Social Sciences, University of Westminster, London, United Kingdom
| | - Alexandra Hopkins
- Department of Psychology, Royal Holloway, University of London, London, United Kingdom
| | - Wael El-Deredy
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile
| | - Laura Dilley
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom
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20
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Pierce ZP, Black JM. The Neurophysiology Behind Trauma-Focused Therapy Modalities Used to Treat Post-Traumatic Stress Disorder Across the Life Course: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:1106-1123. [PMID: 34866515 DOI: 10.1177/15248380211048446] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This review presents the current state of understanding of trauma-informed modalities in light of current research in neuroscience, analyzing which brain structures and processes are impacted by these modalities. Studies included in the present review met the inclusion criteria of 1) addressing post-traumatic stress disorder (PTSD) in a specific population, 2) treatment of PTSD using any of the evidence-based trauma-informed modalities considered in this review, and 3) presenting functional magnetic resonance imagery (fMRI) data, derived from BOLD signals and voxel-compression maps, of brain structures impacted by these trauma-informed modalities. Articles for this review were collated through PubMed and MEDLINE, using key terms in descending order, such as 'childhood trauma', 'adolescent trauma', and 'adulthood trauma', to 'PTSD', 'fMRI', and so on, depending on the modality in question. Based on these criteria and research methods, 37 studies remained for inclusion in the present review. Among a number of critical findings, this review demonstrates that eye movement desensitization and reprocessing (EMDR) and mindfulness therapy effectively deactivate hindbrain regions implicated in the downregulation of autonomic nervous system (ANS) hyperarousal. This review also shows that trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR activate the hippocampus, anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC)-areas that are implicated in crucial cognitive, affective, and behavioral processes that aid trauma survivors in navigating their challenges.
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Affiliation(s)
- Zachary P Pierce
- School of Social Work, 6019Boston College, Chestnut Hill, MA
- The Cell to Society Laboratory, School of Social Work, 6019Boston College, Chestnut Hill, MA
| | - Jessica M Black
- School of Social Work, 6019Boston College, Chestnut Hill, MA
- The Cell to Society Laboratory, School of Social Work, 6019Boston College, Chestnut Hill, MA
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21
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Gong H, Cao Q, Li M. Social memory characteristics of non-clinical college students with social anxiety. J Affect Disord 2023; 326:147-154. [PMID: 36708955 DOI: 10.1016/j.jad.2023.01.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/31/2022] [Accepted: 01/21/2023] [Indexed: 01/27/2023]
Abstract
According to the cognitive theory of social anxiety, the cognitive schema of people with social anxiety makes them easily attracted by threatening information and memory processing. Two experiments explored the social memory characteristics of college students with social anxiety. In Experiment 1, the study investigated the social memory bias of college students with social anxiety. In Experiment 2, cue word technology was used to investigate the social autobiographical memory amount and generalization degree of college students with social anxiety using cue words. The results showed that: (1) Compared with low social anxiety college students, college students with high social anxiety had a memory bias for negative social information, but did not have a negative memory bias for irrelevant social information; (2) Compared with low social anxiety college students, college students with high social anxiety had more negative social autobiographical memory; (3) Compared with low social anxiety college students, college students with high social anxiety have a higher degree of social autobiographical memory generalization. This study revealed that college students with high social anxiety had a negative memory bias toward social information, the amount of negative social autobiographical memory was larger and the degree of social autobiographical memory generalization was higher, providing new perspectives for future interventions in this population.
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Affiliation(s)
- Huoliang Gong
- School of Psychology, Henan University, Kaifeng, China.
| | - Qiudi Cao
- School of Psychology, Henan University, Kaifeng, China
| | - Mengge Li
- School of Psychology, South China Normal University, Guangzhou, China.
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22
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Cammisuli DM, Castelnuovo G. Neuroscience-based psychotherapy: A position paper. Front Psychol 2023; 14:1101044. [PMID: 36860785 PMCID: PMC9968886 DOI: 10.3389/fpsyg.2023.1101044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/11/2023] [Indexed: 02/15/2023] Open
Abstract
In the recent years, discoveries in neuroscience have greatly impacted upon the need to modify therapeutic practice starting from the evidence showing some cerebral mechanisms capable of coping with mental health crisis and traumatic events of the individual's life history by redesigning the narrative plot and the person's sense of the Self. The emerging dialogue between neuroscience and psychotherapy is increasingly intense and modern psychotherapy cannot ignore the heritage deriving from studies about neuropsychological modification of memory traces, neurobiology of attachment theory, cognitive mechanisms involved in psychopathology, neurophysiology of human empathy, neuroimaging evidence about psychotherapeutic treatment, and somatoform disorders connecting the brain and the body. In the present article, we critically examined sectorial literature and claimed that psychotherapy has to referred to a neuroscience-based approach in order to adopt the most tailored interventions for specific groups of patients or therapy settings. We also provided recommendations for care implementation in clinical practice and illustrated challenges of future research.
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Affiliation(s)
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, Milan, Italy,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy,*Correspondence: Gianluca Castelnuovo ✉
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23
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[25 Years of TraumaTherapy with Children and Adolescents ‒ a Personal-Professional Review]. Prax Kinderpsychol Kinderpsychiatr 2023; 72:85-95. [PMID: 36744501 DOI: 10.13109/prkk.2023.72.2.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The author was fortunate to experience and help shape the development of the trauma approach with children and adolescents from the very beginning. This brought a great joy for and in the therapeutic work, an intense impulse for one's own inner work, an intellectual pleasure in working out new concepts andmany wonderful encounters in all the workshops with people who had the welfare of children so much at heart. He is deeply convinced that the future belongs to this approach because it is effective and counteracts the "privatization of stress" (Fisher, 2013).
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24
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[Resource-Oriented Narrative TraumaTherapy (Resonat): Treating Complex Trauma Disorders in Children and Adolescents Gently and Specifically]. Prax Kinderpsychol Kinderpsychiatr 2023; 72:96-112. [PMID: 36744502 DOI: 10.13109/prkk.2023.72.2.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Resource-oriented narrative trauma therapy (ResonaT; Hiller u. Hensel, 2019) is an innovative and creative approach within existing narrative trauma procedures. It is based on the three core elements of modern trauma therapy (actualisation, resource activation, dual attention) and invokes the neurobiological self-healing mechanism of memory reconsolidation. Due to its low demands on the children, its resourceful and gentle actualisation of the traumatic material, the distance-creating use of animal protagonists and a supportive therapeutic relationship, it is particularly suitable for children and adolescents with complex trauma sequelae. Through specific structuring (orientation to the leading symptoms, elaboration of central basic emotions, allocation of current triggers to earlier traumatic events), the narratives can be formulated precisely for each child.The workload for the therapists is made considerably easier by the availability of around 100 elaborated, topic-specific narratives.
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25
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Harvey AR. Injury, illness, and emotion: A review of the motivational continuum from trauma through recovery from an ecological perspective. Brain Behav Immun Health 2023; 27:100586. [PMID: 36655055 PMCID: PMC9841046 DOI: 10.1016/j.bbih.2022.100586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/15/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Image 1.
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26
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Kindt M, Elsey JWB. A paradigm shift in the treatment of emotional memory disorders: Lessons from basic science. Brain Res Bull 2023; 192:168-174. [PMID: 36442693 DOI: 10.1016/j.brainresbull.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/10/2022] [Accepted: 11/24/2022] [Indexed: 11/26/2022]
Abstract
Experiments demonstrating post-reactivation amnesia for learned fear in animals have generated a novel and influential hypothesis on the plasticity of memory, usually referred to as memory reconsolidation. The clinical potential of pharmacologically disrupting the process of memory reconsolidation has sparked a wave of interest into whether this phenomenon can also be demonstrated in humans, and ultimately harnessed for therapeutic purposes. In this essay we outline how the work of Karim Nader and colleagues has moved the field forward from a focus on extinction learning to the prospect of disrupting memory reconsolidation. We then review some promising findings on the necessary conditions, as well as potential boundary conditions, of pharmacologically disrupting the process of memory reconsolidation obtained in our laboratory. Even though laboratory experiments in animals and humans suggest that we may be at the brink of a breakthrough in fundamentally changing emotional memories, the necessary and sufficient conditions for targeting and disrupting memory reconsolidation in clinical practice are largely unknown. There is likely no universally effective reactivation procedure for triggering the reconsolidation of clinically significant emotional memories, and the impact of subtle boundary conditions observed in basic experiments compounds this issue. Notwithstanding these challenges, the discovery of changing emotional memory through disrupting the process of memory reconsolidation has unquestionably invigorated the field.
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27
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Beutel M, Krakau L, Kaufhold J, Bahrke U, Grabhorn A, Hautzinger M, Fiedler G, Kallenbach-Kaminski L, Ernst M, Rüger B, Leuzinger-Bohleber M. Recovery from chronic depression and structural change: 5-year outcomes after psychoanalytic and cognitive-behavioural long-term treatments (LAC depression study). Clin Psychol Psychother 2023; 30:188-201. [PMID: 36239414 DOI: 10.1002/cpp.2793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 09/07/2022] [Accepted: 10/10/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Psychotherapy of chronic depression has remained a challenge due to limited prognosis and high rates of recurrence. We present 5-year outcome data from a multicentre trial comparing psychoanalytic (PAT) and cognitive-behavioural (CBT) long-term treatments with randomized and preferred allocations analysing symptom (N = 227) and structural change (N = 134) trajectories. METHOD Self- and blinded expert ratings of depression symptoms were performed at yearly intervals using the Beck Depression Inventory-II (BDI-II) and Quick Inventory of Depressive Symptoms (QIDS-C). Blinded expert ratings of Operationalized Psychodynamic Diagnosis (OPD) and the Heidelberg Restructuring Scale (HRS) at baseline, 1, 3, and 5 years assessed structural change in a subsample. RESULTS Lasting and comparable symptom changes were achieved by PAT and CBT. However, compared to CBT, PAT was more successful in restructuring, a major goal of long-term psychodynamic treatments with high frequency and duration. LIMITATIONS Due to practical reasons, the time criterion for chronic depression of an acute phase had to be defined for over 1 year in the present study, which does not correspond to the DSM-5 criterion of 2 years. Therapy duration and session frequency were not incorporated into the statistical models. CONCLUSION Long-term psychotherapy helps patients with a yearlong history of depression and often multiple unsuccessful treatment attempts to achieve lasting symptom changes. Future follow-up will clarify whether restructuring promotes further sustainable improvements.
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Affiliation(s)
- Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | - Lina Krakau
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | | | | | | | - Martin Hautzinger
- Department of Clinical Psychology, University of Tübingen, Tübingen, Germany
| | - Georg Fiedler
- Center for Suicidal Research, University Hospital Eppendorf, Hamburg, Germany
| | | | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | | | - Marianne Leuzinger-Bohleber
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.,Department of Psychoanalysis, University of Kassel, Kassel, Germany.,IDeA Center (Center for Adaptive and Individual Development and Adaptive Education for Children-at-Risk), Frankfurt, Germany
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Tanzilli A, Trentini C, Grecucci A, Carone N, Ciacchella C, Lai C, Sabogal-Rueda MD, Lingiardi V. Therapist reactions to patient personality: A pilot study of clinicians’ emotional and neural responses using three clinical vignettes from in treatment series. Front Hum Neurosci 2022; 16:1037486. [DOI: 10.3389/fnhum.2022.1037486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/02/2022] [Indexed: 11/29/2022] Open
Abstract
IntroductionTherapists’ responses to patients play a crucial role in psychotherapy and are considered a key component of the patient–clinician relationship, which promotes successful treatment outcomes. To date, no empirical research has ever investigated therapist response patterns to patients with different personality disorders from a neuroscience perspective.MethodsIn the present study, psychodynamic therapists (N = 14) were asked to complete a battery of instruments (including the Therapist Response Questionnaire) after watching three videos showing clinical interactions between a therapist and three patients with narcissistic, histrionic/borderline, and depressive personality disorders, respectively. Subsequently, participants’ high-density electroencephalography (hdEEG) was recorded as they passively viewed pictures of the patients’ faces, which were selected from the still images of the previously shown videos. Supervised machine learning (ML) was used to evaluate whether: (1) therapists’ responses predicted which patient they observed during the EEG task and whether specific clinician reactions were involved in distinguishing between patients with different personality disorders (using pairwise comparisons); and (2) therapists’ event-related potentials (ERPs) predicted which patient they observed during the laboratory experiment and whether distinct ERP components allowed this forecast.ResultsThe results indicated that therapists showed distinct patterns of criticized/devalued and sexualized reactions to visual depictions of patients with different personality disorders, at statistically systematic and clinically meaningful levels. Moreover, therapists’ late positive potentials (LPPs) in the hippocampus were able to determine which patient they observed during the EEG task, with high accuracy.DiscussionThese results, albeit preliminary, shed light on the role played by therapists’ memory processes in psychotherapy. Clinical and neuroscience implications of the empirical investigation of therapist responses are discussed.
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Cawley E, Piazza G, Das RK, Kamboj SK. A systematic review of the pharmacological modulation of autobiographical memory specificity. Front Psychol 2022; 13:1045217. [PMID: 36452391 PMCID: PMC9703074 DOI: 10.3389/fpsyg.2022.1045217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/27/2022] [Indexed: 08/31/2023] Open
Abstract
Background Over-general autobiographical memory (AM) retrieval is proposed to have a causal role in the maintenance of psychological disorders like depression and PTSD. As such, the identification of drugs that modulate AM specificity may open up new avenues of research on pharmacological modeling and treatment of psychological disorders. Aim The current review summarizes randomized, placebo-controlled studies of acute pharmacological modulation of AM specificity. Method A systematic search was conducted of studies that examined the acute effects of pharmacological interventions on AM specificity in human volunteers (healthy and clinical participants) measured using the Autobiographical Memory Test. Results Seventeen studies were identified (986 total participants), of which 16 were judged to have low risk of bias. The presence and direction of effects varied across drugs and diagnostic status of participants (clinical vs. healthy volunteers). The most commonly studied drug-hydrocortisone-produced an overall impairment in AM specificity in healthy volunteers [g = -0.28, CI (-0.53, -0.03), p = 0.03], although improvements were reported in two studies of clinical participants. In general, studies of monoamine modulators reported no effect on specificity. Conclusion Pharmacological enhancement of AM specificity is inconsistent, although monaminergic modulators show little promise in this regard. Drugs that reduce AM specificity in healthy volunteers may be useful experimental-pharmacological tools that mimic an important transdiagnostic impairment in psychological disorders. Systematic review registration PROSPERO, identifier CRD42020199076, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020199076.
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Affiliation(s)
- Emma Cawley
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Welling H, Ofer N. Pain dynamics: an integrative roadmap for navigating through the experiential process. PERSON-CENTERED & EXPERIENTIAL PSYCHOTHERAPIES 2022. [DOI: 10.1080/14779757.2022.2131605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Neta Ofer
- The New Wave in Psychotherapy Program at the Baruch Ivcher School of Psychology, Riechman University, Herzliya, Israel
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Abstract
This commentary is part of a special issue honoring Karim Nader and his focal role in igniting the reconsolidation field. The commentary describes in broad strokes the evolution of the field, its branches, major challenges, and future endeavors.
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Affiliation(s)
- Daniela Schiller
- Department of Neuroscience, Department of Psychiatry, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Irarrázaval L, Kalawski JP. Phenomenological considerations on empathy and emotions in psychotherapy. Front Psychol 2022; 13:1000059. [PMID: 36300059 PMCID: PMC9589103 DOI: 10.3389/fpsyg.2022.1000059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
In this article we will present a phenomenological approach to empathy and its relationship with emotions in the context of psychotherapy, highlighting the importance of empathy as a key element of the therapist-client relationship and therapeutic process, regardless of the therapist’s approach. We will use a consensus definition of empathy taken from phenomenologically oriented philosophy to analyze therapist’s empathy, as well as client’s self-empathy and client’s empathic communication with others. We will discuss emotions as they usually manifest in the context of psychotherapy, specifically describing how certain emotions can disturb empathic communication in close personal relationships and how it is possible to reestablish empathic communication in psychotherapy. This article it is not only based on evidence from scientific literature but also incorporates the authors’ practical knowledge of psychotherapy.
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Affiliation(s)
- Leonor Irarrázaval
- Facultad de Salud y Ciencias Sociales, Escuela de Psicología, Universidad de Las Américas, Viña del Mar, Chile
- Unidad de Filosofía, Departamento de Psiquiatría y Salud Mental, Hospital Clínico, Universidad de Chile, Santiago, Chile
- *Correspondence: Leonor Irarrázaval,
| | - Juan Pablo Kalawski
- Facultad de Ciencias Sociales y Humanidades, Grupo de Investigación en Psicología Clínica y Psicoterapia, Carrera de Psicología, Universidad Autónoma de Chile, Temuco, Chile
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McEvoy PM, Hyett MP, Johnson AR, Erceg-Hurn DM, Clarke PJF, Kyron MJ, Bank SR, Haseler L, Saulsman LM, Moulds ML, Grisham JR, Holmes EA, Moscovitch DA, Lipp OV, Rapee RM. Impacts of imagery-enhanced versus verbally-based cognitive behavioral group therapy on psychophysiological parameters in social anxiety disorder: Results from a randomized-controlled trial. Behav Res Ther 2022; 155:104131. [PMID: 35696837 DOI: 10.1016/j.brat.2022.104131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/03/2022] [Accepted: 06/01/2022] [Indexed: 11/24/2022]
Abstract
Social anxiety disorder (SAD) is associated with marked physiological reactivity in social-evaluative situations. However, objective measurement of biomarkers is rarely evaluated in treatment trials, despite potential utility in clarifying disorder-specific physiological correlates. This randomized controlled trial sought to examine the differential impact of imagery-enhanced vs. verbal-based cognitive behavioral group therapy (IE-CBGT, n = 53; VB-CBGT, n = 54) on biomarkers of emotion regulation and arousal during social stress in people with SAD (pre- and post-treatment differences in heart rate variability (HRV) and skin conductance). We acquired psychophysiological data from randomized participants across four social stress test phases (baseline, speech preparation, speech, interaction) at pre-treatment, and 1- and 6-months post-treatment. Analyses revealed that IE-CBGT selectively attenuated heart rate as indexed by increases in median heart rate interval (median-RR) compared to VB-CBGT at post-treatment, whereas one HRV index showed a larger increase in the VB-CBGT condition before but not after controlling for median-RR. Other psychophysiological indices did not differ between conditions. Lower sympathetic arousal in the IE-CBGT condition may have obviated the need for parasympathetic downregulation, whereas the opposite was true for VB-CBGT. These findings provide preliminary insights into the impact of imagery-enhanced and verbally-based psychotherapy for SAD on emotion regulation biomarkers.
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Affiliation(s)
- Peter M McEvoy
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia; Centre for Clinical Interventions, Perth, WA, Australia.
| | - Matthew P Hyett
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Andrew R Johnson
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - David M Erceg-Hurn
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia; Centre for Clinical Interventions, Perth, WA, Australia
| | - Patrick J F Clarke
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Michael J Kyron
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Samantha R Bank
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia; Centre for Clinical Interventions, Perth, WA, Australia
| | - Luke Haseler
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Lisa M Saulsman
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Michelle L Moulds
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Jessica R Grisham
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - David A Moscovitch
- Centre for Mental Health Research and Treatment, Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Ottmar V Lipp
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
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van Trigt S, van der Zweerde T, van Someren E, van Straten A, van Marle H. Guided internet-based cognitive behavioral therapy for insomnia in patients with borderline personality disorder: Study protocol for a randomized controlled trial. Internet Interv 2022; 29:100563. [PMID: 35899204 PMCID: PMC9310106 DOI: 10.1016/j.invent.2022.100563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 11/14/2022] Open
Abstract
Borderline personality disorder (BPD) is a highly disabling psychiatric disorder with emotion dysregulation at its core, resulting in affective instability, impulsivity and sometimes self-harming or suicidal behavior. Sleep is increasingly recognized to play a crucial role in emotion regulation. BPD patients often suffer from (severe) insomnia, potentially aggravating symptoms and preventing recovery from BPD. Yet, the effects of insomnia treatments have not been investigated in context of BPD. Guided internet-based cognitive behavioral therapy for insomnia (iCBT-I; i-Sleep) has been proven effective in improving both insomnia and affective symptoms. In this randomized controlled trial among 96 patients with a DSM-5 diagnosis of BPD (or other personality disorder with ≥4 BPD traits) and insomnia symptoms, we will test the effectiveness of iCBT-I before regular BPD treatment starts, during the waitlist period, on BPD symptoms. Patients in the control group monitor their sleep through a sleep diary during the waitlist period and also receive standard BPD treatment after that. Using linear mixed models we will test the hypothesis that the iCBT-I group improves more than the control group on BPD symptoms (primary outcome), insomnia severity, additional subjective and objective sleep variables, emotion regulation, comorbid anxiety and depression complaints, and quality of life. These effects are thought to arise from a direct effect of improved sleep on emotion regulation and a synergistic effect on the consolidation and internalization of the BPD treatment effect. To our knowledge, this is the first trial assessing effectiveness of CBT-I in patients with BPD (traits). The accessibility of the studied intervention greatly facilitates clinical implication in case of positive results.
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Affiliation(s)
- S. van Trigt
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands,Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands,Corresponding author at: Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - T. van der Zweerde
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands,GGZ inGeest Mental Health Care, Amsterdam, the Netherlands
| | - E.J.W. van Someren
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands,Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands,Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands,Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, the Netherlands
| | - A. van Straten
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands,Vrije Universiteit Amsterdam, Clinical, Neuro and Developmental Psychology, Amsterdam, the Netherlands
| | - H.J.F. van Marle
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands,GGZ inGeest Mental Health Care, Amsterdam, the Netherlands,Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands
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van der Heijden AC, van den Heuvel OA, van der Werf YD, Talamini LM, van Marle HJF. Sleep as a window to target traumatic memories. Neurosci Biobehav Rev 2022; 140:104765. [PMID: 35803396 DOI: 10.1016/j.neubiorev.2022.104765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a severe psychiatric disorder in which traumatic memories result in flashbacks and nightmares. With one-third of patients not responding to standard exposure-based psychotherapy, new treatment strategies are needed. Sleep offers a unique time window to enhance therapeutic efficacy. Traumatic memories that are neutralized in therapy need to be stored back into memory (consolidated) during sleep to solidify the treatment effect. New basic research shows that memory consolidation can be enhanced by presenting sounds or scents that were linked to the memory at encoding, again during sleep. This procedure, termed targeted memory reactivation (TMR), has, despite its clinical potential, not been tested in (PTSD) patients. In this narrative review, we explore the potential of TMR as a new sleep-based treatment for PTSD. First we provide the necessary background on the memory and sleep principles underlying PTSD as well as the present applications and conditional factors of TMR. Then, we will discuss the outstanding questions and most promising experimental avenues when testing TMR to treat traumatic memories.
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Affiliation(s)
- A C van der Heijden
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Department Anatomy & Neuroscience, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety Psychosis Stress Sleep, Amsterdam, the Netherlands.
| | - O A van den Heuvel
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Department Anatomy & Neuroscience, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Compulsivity Impulsivity and Attention, Amsterdam, the Netherlands
| | - Y D van der Werf
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Department Anatomy & Neuroscience, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Compulsivity Impulsivity and Attention, Amsterdam, the Netherlands
| | - L M Talamini
- University of Amsterdam, Dept. of Psychology, Brain & Cognition, Nieuwe Achtergracht 129B, 1018 WS Amsterdam, the Netherlands
| | - H J F van Marle
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Department Anatomy & Neuroscience, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety Psychosis Stress Sleep, Amsterdam, the Netherlands; GGZ inGeest Mental Health Care, Amstelveenseweg 589, 1081 JC Amsterdam, the Netherlands
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Moyano MD, Carbonari G, Bonilla M, Pedreira ME, Brusco LI, Kaczer L, Forcato C. Non-linear susceptibility to interferences in declarative memory formation. PLoS One 2022; 17:e0270678. [PMID: 35767523 PMCID: PMC9242448 DOI: 10.1371/journal.pone.0270678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
After encoding, memories go through a labile state followed by a stabilization process known as consolidation. Once consolidated they can enter a new labile state after the presentation of a reminder of the original memory, followed by a period of re-stabilization (reconsolidation). During these periods of lability the memory traces can be modified. Currently, some studies show a rapid stabilization after 30 min, while others show that stabilization occurs after longer periods (e.g. > 6 h). Here we investigate the effect of an interference treatment on declarative memory consolidation, comparing distinct time intervals after acquisition. On day 1, participants learned a list of non- syllable pairs (List 1). 5 min, 30 min, 3 h or 8 h later, they received an interference list (List 2) that acted as an amnesic agent. On day 2 (48 h after training) participants had to recall List 1 first, followed by List 2. We found that the List 1 memory was susceptible to interference when List 2 was administered 5 min or 3 h after learning but not when it was administered 30 min or 8 h after. We propose the possibility that this rapid memory protection could be induced by a fast and transient neocortical integration. Our results open a discussion about the contribution of molecular and systemic aspects to memory consolidation.
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Affiliation(s)
- Malen D. Moyano
- Laboratorio de Sueño y Memoria, Departamento de Ciencias de la Vida, Instituto Tecnológico (ITBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Giulia Carbonari
- Laboratorio de Sueño y Memoria, Departamento de Ciencias de la Vida, Instituto Tecnológico (ITBA), Buenos Aires, Argentina
| | - Matías Bonilla
- Laboratorio de Sueño y Memoria, Departamento de Ciencias de la Vida, Instituto Tecnológico (ITBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - María E. Pedreira
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
- IFIBYNE-CONICET, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Luis I. Brusco
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
- Centro de Neuropsiquiatría y Neurología de la Conducta-CENECON, Facultad de Ciencias Médicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Laura Kaczer
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
- IFIBYNE-CONICET, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Forcato
- Laboratorio de Sueño y Memoria, Departamento de Ciencias de la Vida, Instituto Tecnológico (ITBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
- * E-mail:
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38
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Emotion-Based Interventions for Clinicians. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chiasson C, Moorman J, Romano E, Smith A. Traumatic Autobiographical Memories: Preliminary fMRI Findings Among Men With Histories of Childhood Sexual Abuse. Am J Mens Health 2022; 16:15579883221096566. [PMID: 35536174 PMCID: PMC9096212 DOI: 10.1177/15579883221096566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Childhood sexual abuse (CSA) is associated with autobiographical memory (AM) disturbances. AM is important for future thinking, sense of self, and coping with negative emotions. CSA is under-researched among men, with research examining long-term neural correlates limited even further. This study explored the neural correlates of re-experiencing traumatic/negative memories to examine the influence of CSA on AM into adulthood. Fifteen males who experienced CSA, with and without posttraumatic stress disorder (PTSD; CSA+PTSD, n = 6; CSA–PTSD, n = 9) and control males without CSA histories nor PTSD (n = 11) completed a script-driven imagery paradigm during functional magnetic resonance imaging (fMRI). Males with CSA histories, with and without PTSD, processed their negative autobiographical memories with less activation compared to control males. The CSA+PTSD group of males had less activation in the left superior occipital, left superior parietal and left parahippocampal gyri compared to control participants. The CSA–PTSD group had reduced activation in the same regions to a lesser extent. This study provides preliminary empirical evidence to suggest CSA impacts AM for traumatic experiences, and the impact is notable even for men who experienced CSA but do not have PTSD. This study highlights the need for more research with men who have experienced CSA, so that, we can fully understand the neural correlates of emotional memories, and better support the mental health and continued wellness of men who experienced CSA.
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Affiliation(s)
- Carley Chiasson
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jessie Moorman
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Elisa Romano
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Andra Smith
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
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Levis M, Ludmer DJ, Shiner B. Self-guided online therapeutic assessment in substance abuse care: A Conflict Analysis implementation and feasibility case study. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2022. [DOI: 10.1016/j.chbr.2022.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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41
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Rafei P, Rezapour T, Batouli SAH, Verdejo-García A, Lorenzetti V, Hatami J. How do cannabis users mentally travel in time? Evidence from an fMRI study of episodic future thinking. Psychopharmacology (Berl) 2022; 239:1441-1457. [PMID: 34694424 DOI: 10.1007/s00213-021-06002-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE Episodic future thinking (EFT) is a cognitive function that allows individuals to imagine novel experiences that may happen in the future. Prior studies show that EFT is impaired in different groups of substance users. However, there is no evidence regarding the neurobiological mechanisms of EFT in cannabis users. OBJECTIVES We aimed to compare brain activations of regular cannabis users and non-using controls during an EFT fMRI task. Exploratory analyses were also conducted to investigate the association between EFT and cannabis use variables (e.g., duration of use, age onset, frequency of use). METHODS Twenty current cannabis users and 22 drug-naïve controls underwent an fMRI scanning session while completing a task involving envisioning future-related events and retrieval of past memories as a control condition. The EFT fMRI task was adapted from the autobiographical interview and composed of 20 auditory cue sentences (10 cues for past and 10 cues for future events). Participants were asked to recall a past or generate a future event, in response to the cues, and then rate their vividness after each response. RESULTS We found that cannabis users compared to non-user controls had lower activation within the cerebellum, medial and superior temporal gyrus, lateral occipital cortex, and occipital fusiform gyrus while envisioning future events. Cannabis users rated the vividness of past events significantly lower than non-users (P < 0.005). There were marginal group differences for rating the vividness of future events (P = 0.052). Significant correlations were also found between the medial and superior temporal gyrus activities and behavioral measures of EFT and episodic memory. CONCLUSIONS Cannabis users, compared to drug-naïve controls, have lower brain activation in EFT relevant regions. Thus, any attempts to improve aberrant EFT performance in cannabis users may benefit from EFT training.
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Affiliation(s)
- Parnian Rafei
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Tara Rezapour
- Department of Cognitive Psychology, Institute of Cognitive Sciences Studies (ICSS), Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Medical Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Antonio Verdejo-García
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Valentina Lorenzetti
- Healthy Brain and Mind Research Centre, School of Behavioral & Health Sciences, Neuroscience of Addiction and Mental Health Program, Australian Catholic University, Victoria, Australia
| | - Javad Hatami
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
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Luoma JB, Shahar B, Kati Lear M, Pilecki B, Wagner A. Potential processes of change in MDMA-Assisted therapy for social anxiety disorder: Enhanced memory reconsolidation, self-transcendence, and therapeutic relationships. Hum Psychopharmacol 2022; 37:e2824. [PMID: 34739165 PMCID: PMC9285360 DOI: 10.1002/hup.2824] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 10/04/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated during sessions involving MDMA administration in the treatment of social anxiety disorder. DESIGN This is a narrative review that integrates research on the etiology and maintenance of social anxiety disorder and mechanisms of action of MDMA to examine how MDMA may enhance psychotherapy outcomes. RESULTS We first outline how MDMA may enhance memory reconsolidation in social anxiety disorder. We then discuss how MDMA may induce experiences of self-transcendence and self-transcendent emotions such as compassion, love, and awe; and how these experiences may be therapeutic in the context of social anxiety disorder. We subsequently discuss the possibility that MDMA may enhance the strength and effectiveness of the therapeutic relationship which is a robust predictor of outcomes across many disorders as well as a potential key ingredient in treating disorders where shame and social disconnection are central factors. CONCLUSION We discuss how processes of change may extend beyond the MDMA dosing sessions themselves.
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Affiliation(s)
- Jason B. Luoma
- Portland Psychotherapy Clinic, Research, & Training CenterPortlandOregonUSA
| | - Ben Shahar
- The Hebrew University of JerusalemJerusalemIsrael
| | - M. Kati Lear
- Portland Psychotherapy Clinic, Research, & Training CenterPortlandOregonUSA
| | - Brian Pilecki
- Portland Psychotherapy Clinic, Research, & Training CenterPortlandOregonUSA
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Ravindran S. Profile of Lynn Nadel. Proc Natl Acad Sci U S A 2022; 119:e2204299119. [PMID: 35439055 PMCID: PMC9170041 DOI: 10.1073/pnas.2204299119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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44
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Beisel JMS, Maza FJ, Justel N, Larrosa PNF, Delorenzi A. Embodiment of an Emotional State Concurs with a Stress-Induced Reconsolidation Impairment Effect on an Auditory Verbal Word-List Memory. Neuroscience 2022; 497:239-256. [PMID: 35472504 DOI: 10.1016/j.neuroscience.2022.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 12/12/2022]
Abstract
Stress alters memory. Understanding how and when acute stress improves or impairs memory is a challenge. Stressors can affect memory depending on a combination of factors. Typically, mild stressors and stress hormones might promote consolidation of memory processing and impair memory retrieval. However, studies have shown that during reconsolidation, stressors may either enhance or impair recalled memory. We propose that a function of reconsolidation is to induce changes in the behavioral expression of memory. Here, we adapted the Rey Auditory Verbal Learning Test (RAVLT) to evaluate the effect of cold pressor stress (CPS) during the reconsolidation of this declarative memory. A decay in memory performance attributable to forgetting was found at the time of memory reactivation 5 d after training (day 6). Contrary to our initial predictions, the administration of CPS after memory reactivation impaired long-term memory expression (day 7), an effect dependent on the presence of a mismatch during Reactivation Session. No differences in recognition tests were found. To assess putative sources of the negative memory modulation effects induced during reconsolidation, current emotional state was evaluated immediately after Testing Session (day 7). An increase in arousal was revealed only when CPS was administered concurrently with memory reactivation-labilization. The possibility of integration during reconsolidation of independent associations of these emotive components in the trace is a critical factor in modulating neutral memories during reconsolidation by stressors.
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Affiliation(s)
- Jessica Mariel Sánchez Beisel
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBA-CONICET), Ciudad Universitaria, Pabellón IFIBYNE, Argentina
| | - Francisco Javier Maza
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBA-CONICET), Ciudad Universitaria, Pabellón IFIBYNE, Argentina
| | - Nadia Justel
- Lab. Interdisciplinario de Neurociencia Cognitiva (LINC), CEMSC3, ICIFI, UNSAM CONICET, Argentina
| | - Pablo Nicolas Fernandez Larrosa
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBA-CONICET), Ciudad Universitaria, Pabellón IFIBYNE, Argentina; Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Argentina.
| | - Alejandro Delorenzi
- Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBA-CONICET), Ciudad Universitaria, Pabellón IFIBYNE, Argentina; Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Argentina.
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Xenakis I, Arnellos A. Ontological and conceptual challenges in the study of aesthetic experience. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2062314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ioannis Xenakis
- Department of Product and Systems Design Engineering, Complex Systems and Service Design Lab, University of the Aegean, Syros, Greece
| | - Argyris Arnellos
- Department of Product and Systems Design Engineering, Complex Systems and Service Design Lab, University of the Aegean, Syros, Greece
- IAS-Research Centre for Life, Mind & Society, Department of Logic and Philosophy of Science, University of the Basque Country, San Sebastián, Spain
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46
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Dopamine-related polymorphisms and Affective Working Memory in aging. Neurobiol Learn Mem 2022; 191:107623. [DOI: 10.1016/j.nlm.2022.107623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/17/2022] [Accepted: 04/19/2022] [Indexed: 11/20/2022]
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De Brigard F, Umanath S, Irish M. Rethinking the distinction between episodic and semantic memory: Insights from the past, present, and future. Mem Cognit 2022; 50:459-463. [PMID: 35288812 DOI: 10.3758/s13421-022-01299-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 12/26/2022]
Abstract
On the 50th anniversary of Tulving's introduction of the celebrated distinction between episodic and semantic memory, it seems more than fitting to revisit his proposal in light of recent conceptual and methodological advances in the field. This Special Issue of Memory & Cognition brings together researchers doing cutting-edge work at the intersection between episodic and semantic memory to showcase studies directly probing this psychological distinction, as well as articles that seek to provide conceptual and theoretical accounts to understand their interaction. The 14 articles presented here highlight the need to critically examine the way in which we conceptualize not only the relationship between episodic and semantic memory, but also the interplay between declarative and non-declarative memory, and the myriad implications of such conceptual changes. In many ways, we suggest this Special Issue might serve as a call to action for our field, inspiring future work to challenge pre-existing conceptions and stimulate new directions in this fast-moving field.
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Affiliation(s)
- Felipe De Brigard
- Department of Philosophy, Department of Psychology and Neuroscience, Center for Cognitive Neuroscience, Duke University, Durham, NC, 27708, USA.
| | - Sharda Umanath
- Department of Psychology, Claremont McKenna College, Claremont, CA, 91711, USA
| | - Muireann Irish
- School of Psychology and Brain and Mind Centre, The University of Sydney, Camperdown, NSW, 2050, Australia
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Quirin M, Kuhl J. The concert of personality: Explaining personality functioning and coherence by personality systems interactions. EUROPEAN JOURNAL OF PERSONALITY 2022. [DOI: 10.1177/08902070221078478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Several psychological approaches concern explaining the dynamic psychological processes and mechanisms that render personality a coherent whole, a “well-sounding concert.” Building upon personality systems interactions (PSI) theory, which explains personality functioning on the basis of interactions among cognitive and affective-motivational personality systems, we demonstrate how diverse perspectives on personality coherence may functionally be integrated. To do so, we describe interactions among four cognitive personality systems considered to underlie and optimize two meta principles of personality functioning—self-growth (in terms of the integration of adverse experiences) and action control (in terms of goal pursuit). These meta principles establish different subtypes of personality coherence differentially focused by psychological perspectives. We highlight the interdisciplinary relevance and practical application of the present approach and conclude with implications for future research.
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Affiliation(s)
- Markus Quirin
- Faculty of Sport and Health Sciences, Technical University of Munich, München, Germany
- Private University of Applied Sciences PFH, Göttingen
| | - Julius Kuhl
- Department of Psychology, Osnabrueck University, Osnabrück, Germany
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Steinmair D, Löffler-Stastka H. Personalized treatment - which interaction ingredients should be focused to capture the unconscious. World J Clin Cases 2022; 10:2053-2062. [PMID: 35321177 PMCID: PMC8895185 DOI: 10.12998/wjcc.v10.i7.2053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/14/2021] [Accepted: 02/13/2022] [Indexed: 02/06/2023] Open
Abstract
A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic conditions. Implementing mental health care in physical care services is still insufficient. Thus, interdisciplinary communication across treatment providers is essential. The standardized language provided by the diagnostic statistical manual favors a clear conceptualization. However, this approach might not focus on the individual, as thinking in categories might impede recognizing the continuum from healthy to diseased. Psychoanalytic theory is concerned with an individual’s unconscious conflictual wishes and motivations, manifested through enactments like psychic symptoms or (maladaptive) behavior with long-term consequences if not considered. Such modifiable internal and external factors often are inadequately treated. However, together with the physical chronic condition constraints, these factors determine degrees of freedom for a self-determined existence. The effect of therapeutic interventions, and especially therapy adherence, relies on a solid therapeutic relationship. Outcome and process research still investigates the mechanism of change in psychotherapeutic treatments with psychanalysis’s focus on attachment problems. This article examines existing knowledge about the mechanism of change in psychoanalysis under the consideration of current trends emerging from psychotherapy research. A clinical example is discussed. Additionally, further directions for research are given. The theoretical frame in psychoanalytic therapies is the affect-cognitive interface. Subliminal affect-perception is enabled via awareness of subjective meanings in oneself and the other; shaping this awareness is the main intervention point. The interactional ingredients, the patient’s inherent bioenvironmental history meeting the clinician, are relevant variables. Several intrinsic, subliminal parameters relevant for changing behavior are observed. Therapeutic interventions aim at supporting the internalization of the superego’s functions and at making this ability available in moments of self-reflection. By supporting mentalization abilities, a better understanding of oneself and higher self-regulation (including emotional regulation) can lead to better judgments (application of formal logic and abstract thinking). Thus, this facilitates enduring behavior change with presumably positive effects on mental and physical health.
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Affiliation(s)
- Dagmar Steinmair
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Wien 1090, Österreich, Austria
| | - Henriette Löffler-Stastka
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Wien 1090, Österreich, Austria
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Mugnaini M, Alfei JM, Bueno AM, Ferrer Monti RI, Urcelay GP. Fear memory modulation by incentive down and up-shifts. Behav Brain Res 2022; 422:113766. [DOI: 10.1016/j.bbr.2022.113766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/20/2021] [Accepted: 01/17/2022] [Indexed: 11/02/2022]
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