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Yan H, Han Y, Shan X, Li H, Liu F, Li P, Zhao J, Guo W. Breaking the Fear Barrier: Aberrant Activity of Fear Networks as a Prognostic Biomarker in Patients with Panic Disorder Normalized by Pharmacotherapy. Biomedicines 2023; 11:2420. [PMID: 37760861 PMCID: PMC10525800 DOI: 10.3390/biomedicines11092420] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Panic disorder (PD) is a prevalent type of anxiety disorder. Previous studies have reported abnormal brain activity in the fear network of patients with PD. Nonetheless, it remains uncertain whether pharmacotherapy can effectively normalize these abnormalities. This longitudinal resting-state functional magnetic resonance imaging study aimed to investigate the spontaneous neural activity in patients with PD and its changes after pharmacotherapy, with a focus on determining whether it could predict treatment response. The study included 54 drug-naive patients with PD and 54 healthy controls (HCs). Spontaneous neural activity was measured using regional homogeneity (ReHo). Additionally, support vector regression (SVR) was employed to predict treatment response from ReHo. At baseline, PD patients had aberrant ReHo in the fear network compared to HCs. After 4 weeks of paroxetine treatment (20 mg/day), a significant increase in ReHo was observed in the left fusiform gyrus, which had shown reduced ReHo before treatment. The SVR analysis showed significantly positive correlations (p < 0.0001) between the predicted and actual reduction rates of the severity of anxiety and depressive symptoms. Here, we show patients with PD had abnormal spontaneous neural activities in the fear networks. Furthermore, these abnormal spontaneous neural activities can be partially normalized by pharmacotherapy and serve as candidate predictors of treatment response. Gaining insight into the trajectories of brain activity normalization following treatment holds the potential to provide vital insights for managing PD.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Yiding Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China;
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China;
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar 161006, China;
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
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Gros DF, Saulnier KG, Allan NP. Exploring trajectories in transdiagnostic behavior therapy. J Trauma Stress 2023; 36:668-681. [PMID: 37549108 PMCID: PMC10530591 DOI: 10.1002/jts.22963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 08/09/2023]
Abstract
Transdiagnostic treatments have been designed to target common processes for clusters of disorders. One such treatment, transdiagnostic behavior therapy (TBT), targets avoidance across emotional disorders, including posttraumatic stress disorder (PTSD), depressive disorders, and anxiety disorders, and has demonstrated efficacy in randomized controlled trials. The current study was designed to examine whether distinct treatment trajectories would emerge in a sample of 112 veterans receiving TBT and whether diagnostic comorbidity, baseline levels of several transdiagnostic risk factors, or treatment engagement influence trajectory membership. Growth mixture modeling revealed three distinct trajectories across depression, ds = 0.55-1.09; PTSD ds = -0.07-1.43; and panic disorder symptoms, ds = -0.13-1.09. Notably, for PTSD and panic disorder symptoms, separate classes for responders and nonresponders emerged among participants with high baseline symptom levels. Findings for the risk factors suggested that PTSD and panic nonresponders evidenced significantly higher behavioral avoidance at baseline and reduced engagement in treatment procedures and homework completion compared to responders. Together, the findings provide additional support for the use of TBT in the treatment of emotional disorders, including PTSD. Potential adaptations are discussed for patients with significantly elevated behavioral avoidance to improve treatment engagement and related outcomes.
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Affiliation(s)
- Daniel F. Gros
- Mental Health Service, Ralph H. Johnson VA Healthcare System, Charleston, South Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kevin G. Saulnier
- VA Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan, USA
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Nicholas P. Allan
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, New York, USA
- Department of Psychiatry, Ohio State University, Columbus, Ohio, USA
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Bai P. Application and Mechanisms of Internet-Based Cognitive Behavioral Therapy (iCBT) in Improving Psychological State in Cancer Patients. J Cancer 2023; 14:1981-2000. [PMID: 37497400 PMCID: PMC10367931 DOI: 10.7150/jca.82632] [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: 01/13/2023] [Accepted: 04/18/2023] [Indexed: 07/28/2023] Open
Abstract
This review article is an overview of the effectiveness of internet-based cognitive behavioral therapy (iCBT) in Improving Psychological State in Cancer Patients. iCBT's effectiveness has been investigated in treating and managing conditions like depression, psychiatric disorders, generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), adjustment disorder, bipolar disorder, chronic pain, and phobias. iCBT's role in the treatment of medical conditions such as diabetes mellitus with comorbid psychiatric illnesses was also explored. We conducted a thorough literature search using PubMed, Embase, Google Scholar, and Wanfang with no restrictions on the date. iCBT's role in treating and controlling psychiatric illnesses in cancer patients has been established in the literature. Development and popularization of iCBT, treament forms of iCBT, platforms for iCBT, application of iCBT, strategies and efficacy of iCBT for insomnia in cancer patients, current status of iCBT application, and genetic researches on iCBT for anxiety disorders were all reviewed and discussed in this review. From the data compiled, we conclude that iCBT is useful in treating or improving psychological state in cancer patients.
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Affiliation(s)
- Ping Bai
- Department of Operating Rooms, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
- Department of Operating Rooms, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, 065001, China
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Goldwaser EL, Miller CWT. The Genetic and Neural Circuitry Predictors of Benefit From Manualized or Open-Ended Psychotherapy. Am J Psychother 2020; 73:72-84. [DOI: 10.1176/appi.psychotherapy.20190041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eric Luria Goldwaser
- Department of Psychiatry, University of Maryland Medical Center and Sheppard Pratt Health System, Baltimore
| | - Christopher W. T. Miller
- Department of Psychiatry, University of Maryland Medical Center and Sheppard Pratt Health System, Baltimore
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Vismara M, Girone N, Cirnigliaro G, Fasciana F, Vanzetto S, Ferrara L, Priori A, D’Addario C, Viganò C, Dell’Osso B. Peripheral Biomarkers in DSM-5 Anxiety Disorders: An Updated Overview. Brain Sci 2020; 10:E564. [PMID: 32824625 PMCID: PMC7464377 DOI: 10.3390/brainsci10080564] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/12/2022] Open
Abstract
Anxiety disorders are prevalent and highly disabling mental disorders. In recent years, intensive efforts focused on the search for potential neuroimaging, genetic, and peripheral biomarkers in order to better understand the pathophysiology of these disorders, support their diagnosis, and characterize the treatment response. Of note, peripheral blood biomarkers, as surrogates for the central nervous system, represent a promising instrument to characterize psychiatric disorders, although their role has not been extensively applied to clinical practice. In this report, the state of the art on peripheral biomarkers of DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) Anxiety Disorders is presented, in order to examine their role in the pathogenesis of these conditions and their potential application for diagnosis and treatment. Available data on the cerebrospinal fluid and blood-based biomarkers related to neurotransmitters, neuropeptides, the hypothalamic-pituitary-adrenal axis, neurotrophic factors, and the inflammation and immune system are reviewed. Despite the wide scientific literature and the promising results in the field, only a few of the proposed peripheral biomarkers have been defined as a specific diagnostic instrument or have been identified as a guide in the treatment response to DSM-5 Anxiety Disorders. Therefore, further investigations are needed to provide new biological insights into the pathogenesis of anxiety disorders, to help in their diagnosis, and to tailor a treatment.
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Affiliation(s)
- Matteo Vismara
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Nicolaja Girone
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Giovanna Cirnigliaro
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Federica Fasciana
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Simone Vanzetto
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Luca Ferrara
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Alberto Priori
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy;
| | - Claudio D’Addario
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy;
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Caterina Viganò
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Bernardo Dell’Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy;
- Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA 94305, USA
- “Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche”, University of Milan, 20100 Milan, Italy
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Palmer R, Owen J, Frazier P. Trajectories of changes in distress in counseling center clients: a replication study. Psychother Res 2020; 31:289-301. [PMID: 32366192 DOI: 10.1080/10503307.2020.1757175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: Latent growth mixture modeling (LGMM) and latent class growth analysis (LCGA) are methods of identifying subgroups of individuals with similar trajectories during the course of psychotherapy. Due to inconsistent methodology, previous LGMM/LCGA psychotherapy research has led to inconsistent findings. The purpose of this study was to contribute to our understanding of individual differences in change trajectories during psychotherapy using LGMM/LCGA by attempting to replicate a previous study by Owen et al. (2015. Trajectories of change in psychotherapy. Journal of Clinical Psychology, 71(9), 817-827). Method: This study used LGMM/LCGA to model trajectories of change in a sample of 2538 psychotherapy clients at a university student counseling center. This was a secondary analysis of naturalistically-collected outcome data using The Behavioral Health Measure. Results: LGMM models did not converge. A 2-class LCGA model was selected based on fit statistics and parsimony. One class was labeled as Slow and Steady Change Before Plateau, whereas the other was labeled as Early Rapid Change Before Plateau. We also extended these findings by considering variables associated with class membership. Conclusions: These classes followed similar trajectories to two of the classes identified by Owen et al. These results indicate that latent trajectory modeling may lead to replicable findings. Furthermore, these results have implications for managing expectations about change in psychotherapy.
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Affiliation(s)
- Riley Palmer
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Jesse Owen
- Morgridge College of Education, University of Denver, Denver, CO, USA
| | - Patricia Frazier
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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De Venter M, Illegems J, Van Royen R, Sabbe BGC, Moorkens G, Van Den Eede F. The Relationship Between Childhood Trauma and the Response to Group Cognitive-Behavioural Therapy for Chronic Fatigue Syndrome. Front Psychiatry 2020; 11:536. [PMID: 32595538 PMCID: PMC7304305 DOI: 10.3389/fpsyt.2020.00536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/26/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the relationship between childhood trauma and the response to group cognitive-behavioural therapy (GCBT) for chronic fatigue syndrome (CFS). METHODS A single cohort study conducted in an outpatient university referral center for CFS including a well-documented sample of adult patients meeting the CDC criteria for CFS and having received 9 to 12 months of GCBT. A mixed effect model was adopted to examine the impact of childhood trauma on the treatment response in general and over time. The main outcome measures were changes in fatigue, as assessed with the Checklist Individual Strength (total score), and physical functioning, as gauged with the Short Form 36 Health Survey subscale, with the scales being completed at baseline, immediately after treatment completion and after 1 year. RESULTS We included 105 patients with CFS. Childhood trauma was not significantly associated with the response to GCBT over time on level of fatigue or physical functioning. CONCLUSION Childhood trauma does not seem to have an effect on the treatment response to dedicated GCBT for CFS sufferers over time. Therefore, in the allocation of patients to this kind of treatment, a history of childhood trauma should not be seen as prohibitive.
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Affiliation(s)
- Maud De Venter
- University Psychiatric Department, Campus Antwerp University Hospital (UZA), Edegem, Belgium.,Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UA), Antwerp, Belgium
| | - Jela Illegems
- Behaviour Therapy Division for Fatigue and Functional Symptoms, Antwerp University Hospital (UZA), Edegem, Belgium.,Department of Internal Medicine, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Rita Van Royen
- Behaviour Therapy Division for Fatigue and Functional Symptoms, Antwerp University Hospital (UZA), Edegem, Belgium.,Department of Internal Medicine, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Bernard G C Sabbe
- Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UA), Antwerp, Belgium
| | - Greta Moorkens
- Behaviour Therapy Division for Fatigue and Functional Symptoms, Antwerp University Hospital (UZA), Edegem, Belgium.,Department of Internal Medicine, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Filip Van Den Eede
- University Psychiatric Department, Campus Antwerp University Hospital (UZA), Edegem, Belgium.,Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UA), Antwerp, Belgium.,Behaviour Therapy Division for Fatigue and Functional Symptoms, Antwerp University Hospital (UZA), Edegem, Belgium
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Pittig A, Treanor M, LeBeau RT, Craske MG. The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research. Neurosci Biobehav Rev 2018; 88:117-140. [DOI: 10.1016/j.neubiorev.2018.03.015] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 12/25/2022]
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Santacana M, Arias B, Mitjans M, Bonillo A, Montoro M, Rosado S, Guillamat R, Vallès V, Pérez V, Forero CG, Fullana MA. Correction: Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder: No Association with the BDNF Gene or Childhood Maltreatment. PLoS One 2016; 11:e0167833. [PMID: 27907177 PMCID: PMC5132167 DOI: 10.1371/journal.pone.0167833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0158224.].
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