CBT (research and technique)

What is the aim of CBT?

CBT focuses on changing maladaptive thinking or changing one's relationship to maladaptive thinking.

they minimize negative self defeating thoughts, and cultivate positive goal consisten thoughts

Cognitive reappraisal

CBT technique used to identify and change the way an individual views experiences, events, ideas and or emotions in order to change their affective impact.

most common CBT technique in therapeutic spaces

neuro-imaging evidence for cognitive reappraisal

existing models agree that reappraisal activates control regions in pre-frontal cortex (PFC) to modulate emotional response in amygdala

neuroimaging studies using reappraisal strategies in response to negativty images:

dampended amygdala activity

Activatd PFC - cognitive elaboration

LTC (lateral temporal cortex)

posterior parietal cortex

Emotional regulation is modulated by a few regions of the brain (T/F?)

false. emotional regulation is modulated by a rich inter-connection between various regions of the ACC, amygdala, and PFC.

Cognitive reappraisal correlated with specific types of electrical activity changes in the brain (T/F)?

True. emotion regulation can reduce the magnitude of late positive potential (LPP).

LPP enhanced for both unpleasant pleasant stimiuli

What is LPP?

LPP (late positive potential) is a type of event-related potental that begins around 400-500 ms after on-set of a stimulus.

What is a caveat for Reappraisal?

reappraisal is ADAPTIVE (positive) when stressors are uncontrollable - when person can regulate only the self

MALADAPTIVE when stressors CAN be controlled -when person can change the situation

is positive or negative reappraisal more effective?

both positive and negative appraisal shortens duration of responses in amygdala, insula, superior temporal gryus and lengthened response in prefrontal regions.

negative reappraisael dereased intension of amygdala activation

intensity of medial prefrontal cortrex (involved in cognitive control of emotion) increased in positive reappraisal - suggest positive appraisal may require more cognitive effort into thinking about potential meanings associated with stimulus.

findings form individuals engaging in positive appraisal in response to negative stimuli

reported largest increase in positive emotion and decrease in negative emotion following positive reappraisal.

What impact do thoughts have on physiological changes in the body?

show a negative relationship between thoughts and physiological changes in body:

more negative thinking = increase activation of amygdala and reduction of activity in control center of prefrontal.

Modern CBT variants now mainly focus on? What effect does this have on individuals?

using emotions to guide thoughts instead of thoughts guiding emotion

becoming more aware of how you feel in response to certain thoughts

The effect of SUPPRESSING negative feelings instead of REAPPRAISING them

people who deny or suppress their emotions experience less positive emotion and greater negative emotin

worse interpersonal functionnig

lower levels of well being

Give examples of how reframing our view of stress can change how it affects us

view stress as a necessary means for growth. necessary to thrive and excel.

Study on preschoolers stress

preschoolers more outgoing and socially competent showed high active in brain circuit that trigger stress hormone

opposite pattern in preschoolers who were unhappy and socially isolated.

What is defensive pessimism? What are it's effects?

when people use fear of failure to motivate themselves to succeed

can lead to greater burnout, low self esteem, unhappiness.

What is the relationship between age and reappraisal?

effectiveness of reappraisal increases with age.

activity in pre-frontal correspondingly increased with age.

older individuals show greater drops in negative affect and decrease in rostrolateral prefrontal amygdala connectivity after reappraisal.

What is Behavioural Activation? What are it's effects?

most popular form of treatment for emotion dysregulation.

fosugin on behaviours and maintinaing regular routines that induce pleasure and accomplihsment.

OCD and CBT

OCD patients are asked to experience OCD symptoms without reacting emotionally.

taught to:

relabel

reattribute

refocus

revalue

What is the worry circuit in individuals with OCD? How does CBT decrease hyperactivity in worry circuit

orbitofrontal (serves to identify when something is amiss)

striatum (caudate nucleus) - involved in execution of motor behaviour -> inputs from orbiotfrontal and amygdala

CBT reduced metabolic activity in brain ciruit.

FMRI study showed degree of imporvement in OCD symptoms correlated with increase in right dorsolateral anterior cingulate cortex acitivty -> involved in reapprasial and suppression of negative emotions

CBT for major Depressive Disorder: How does it work? What are it's effects?

patients learn to view depressive thoughts as electrical events in the brain

feel sadness and experience disappointment without letting those thoughts elaborate

what are consistent findings of therapy outcomes for CBT and IPT?

altered functioning in:

dorsolateral prefrontal cortex: important for executive function and working memory, altered function may reflect improved problem-solving

ventrolaeral prefrotnal region (right hempsiere), anterior posterior cunglate (APC) and medial prefrontal regions, reflect improved affect regulation and self perception

It is difficult to characterize the function(s) of aparticular brain region because

The same brain areas are active in many different tasks• Each task results in activation in several areas.

There are different pathways for resolving issues related toemotional dysregulation• Different types of therapy might utilize different pathways

overall modulation of omplex system rather than any one focal regional change that may be most critical for disease remission

How is placebo considered a form of psychological treatment?

brain changes associated with placebos tend to shadow true drug response pattern

What was the effect of CBT on patients with post-traumatic disorder?

increased hippo-campal volume

decreased amygdala activation

increased dorsolateral prefrontal activation

increased glucocorticoid receptor FKBP5

What was the effect of CBT on patients with phobias?

pre-treatment

-patients had significant activation of right dorsolateral prefrontal cortex. (may reflect attempts to self regulate fear)

- parahippocampal gyrus (related to automatic reactivastion of contextual fear memory)

post-treatment:

no significant activation in pre-frontal cortex or para-hippocampal gyrus.

What may be individual differences when treating patients with CBT?

eg. those who responded to behavioural therapy showed higher metabolism in left frontal orbital cortex before treatment in individuals with OCD.

How can neuroimaging data show the effectiveness of CBT?

differences in neural connectivity and changes in brain structure can show how well CBT reduced symptoms of those with social anxiety disorder.

Challenges for using optogeneitcs to treat depression in humans

optogenetics requires cells to be genetically engineered to produce opsins

highly invasive technique

no real breakthroughs in use of opto-genetics in humans, but technique has helped to elucidate brain circuits involved in mental illnesses.