Neural effects of cognitive–behavioural therapy on dysfunctional attitudes in depression

Article


Sankar, A., Scott, J., Paszkiewicz, A., Giampietro, V. P., Steiner, H. and Fu, C. 2014. Neural effects of cognitive–behavioural therapy on dysfunctional attitudes in depression. Psychological Medicine. 45 (7), pp. 1425-1433.
AuthorsSankar, A., Scott, J., Paszkiewicz, A., Giampietro, V. P., Steiner, H. and Fu, C.
Abstract

Background.
Dysfunctional attitudes are a feature of depression that has been correlated with receptor binding abnormalities in limbic and cortical regions. We sought to investigate the functional neuroanatomy of dysfunctional attitudes in major depressive disorder (MDD) and the effects of treatment with cognitive–behavioural therapy (CBT).

Method.
Participants were 16 patients with unipolar depression in an acute depressive episode (mean age 40.0 years) and 16 matched healthy controls (mean age 39.9 years). Patients were medication free and received a course of treatment
with CBT. All participants underwent functional magnetic resonance imaging (fMRI) scans at baseline and at week 16, prior to the initiation of therapy and following the course of CBT for patients. During each fMRI scan, participants indicated their attributions to statements from a modified Dysfunctional Attitudes Scale (mDAS-48).

Results.
MDD patients in an acute depressive episode endorsed a greater number of extreme responses to DAS statements, which normalized following CBT treatment. Extreme attributions were associated with greater activation in
the left hippocampal region, inferior parietal lobe and precuneus in MDD patients as compared with healthy controls as a main effect of group. An interaction effect was found in the left parahippocampal region, which showed less attenuation in MDD patients at the follow-up scan relative to healthy controls.

Conclusions.
Attenuation of activity in the parahippocampal region may be indicative of an improvement in dysfunctional thinking following CBT treatment in depression, while persistent engagement of regions involved in attentional processing and memory retrieval with extreme attributions reflects a trait feature of depression.

JournalPsychological Medicine
Journal citation45 (7), pp. 1425-1433
ISSN1469-8978
0033-2917
Year2014
PublisherCambridge University Press
Publisher's version
License
CC BY-NC-ND
Web address (URL)http://dx.doi.org/10.1017/S0033291714002529
Publication dates
Print22 Oct 2014
Publication process dates
Deposited10 Apr 2015
Accepted24 Sep 2014
Copyright information© Cambridge University Press 2014
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