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  Effects of cognitive behavioral therapy on neural processing of agoraphobia-specific stimuli in panic disorder and agoraphobia

Wittmann, A., Schlagenhauf, F., Guhn, A., Lueken, U., Elle, M., Stoy, M., et al. (2018). Effects of cognitive behavioral therapy on neural processing of agoraphobia-specific stimuli in panic disorder and agoraphobia. Psychotherapy and Psychosomatics, 87(6), 350-365. doi:10.1159/000493146.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0002-5E4E-F Version Permalink: http://hdl.handle.net/21.11116/0000-0003-BFC3-A
Genre: Journal Article

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 Creators:
Wittmann, A.1, 2, 3, 4, Author
Schlagenhauf, Florian1, 2, 3, 4, 5, Author              
Guhn , A.1, 2, 3, 4, Author
Lueken , U.6, Author
Elle, M.1, 2, 3, 4, Author
Stoy , M.1, 2, 3, 4, Author
Liebscher , C.1, 2, 3, 4, Author
Bermpohl , F.1, 2, 3, 4, 7, Author
Fydrich , T.8, Author
Pfleiderer, B.9, Author
Bruhn, H.10, Author
Gerlach, A. L.11, Author
Straube , B.12, Author
Wittchen , H.-U.13, Author
Arolt , V.14, Author
Heinz , A.1, 2, 3, 4, Author
Kircher , T.12, Author
Ströhle, A.1, 2, 3, 4, Author
Affiliations:
1Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany, ou_persistent22              
2FU Berlin, Germany, ou_persistent22              
3Humboldt University Berlin, Germany, ou_persistent22              
4Berlin Institute of Health (BIH), Germany, ou_persistent22              
5Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
6Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Germany, ou_persistent22              
7Berlin School of Mind and Brain, Humboldt University Berlin, Germany, ou_persistent22              
8Psychotherapy and Somatopsychology, Department of Psychology, Humboldt University Berlin, Germany, ou_persistent22              
9Department of Clinical Radiology, Münster University, Germany, ou_persistent22              
10Department of Radiology, Friedrich Schiller University Jena, Germany, ou_persistent22              
11Department of Psychology, University of Cologne, Germany, ou_persistent22              
12Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany, ou_persistent22              
13Institute of Clinical Psychology and Psychotherapy, TU Dresden, Germany, ou_persistent22              
14Department of Psychiatry, Münster University, Germany, ou_persistent22              

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Free keywords: Agoraphobia; Anxiety; Amygdala; Ventral striatum; Functional MRI; Psychotherapy
 Abstract: Background: Patients suffering from panic disorder and agoraphobia are significantly impaired in daily life due to anxiety about getting into a situation due to apprehension about experiencing a panic attack, especially if escape may be difficult. Dysfunctional beliefs and behavior can be changed with cognitive behavioral therapy; however, the neurobiological effects of such an intervention on the anticipation and observation of agoraphobia-specific stimuli are unknown. Methods: We compared changes in neural activation by measuring the blood oxygen level-dependent signal of 51 patients and 51 healthy controls between scans before and those after treatment (group by time interaction) during anticipation and observation of agoraphobia-specific compared to neutral pictures using 3-T fMRI. Results: A significant group by time interaction was observed in the ventral striatum during anticipation and in the right amygdala during observation of agoraphobia-specific pictures; the patients displayed a decrease in ventral striatal activation during anticipation from pre- to posttreatment scans, which correlated with clinical improvement measured with the Mobility Inventory. During observation, the patients displayed decreased activation in the amygdala. These activational changes were not observed in the matched healthy controls. Conclusions: For the first time, neural effects of cognitive behavioral therapy were shown in patients suffering from panic disorder and agoraphobia using disorder-specific stimuli. The decrease in activation in the ventral striatum indicates that cognitive behavioral therapy modifies anticipatory anxiety and may ameliorate abnormally heightened salience attribution to expected threatening stimuli. The decreased amygdala activation in response to agoraphobia-specific stimuli indicates that cognitive behavioral therapy can alter the basal processing of agoraphobia-specific stimuli in a core region of the fear network.

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Language(s): eng - English
 Dates: 2016-08-172018-08-202018-09-282018-11
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1159/000493146
PMID: 30269148
Other: Epub 2018
 Degree: -

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Project name : -
Grant ID : 01GV0612
Funding program : BMBF Psychotherapy Research Funding Initiative
Funding organization : German Federal Ministry of Education and Research (BMBF)

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Title: Psychotherapy and Psychosomatics
  Other : Psychother. Psychosom.
Source Genre: Journal
 Creator(s):
Affiliations:
Publ. Info: Basel : S. Karger
Pages: - Volume / Issue: 87 (6) Sequence Number: - Start / End Page: 350 - 365 Identifier: ISSN: 0033-3190
CoNE: https://pure.mpg.de/cone/journals/resource/991042746875438