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Amygdala response to self-critical stimuli and symptom improvement in psychotherapy for depression

  • Nadja Doerig (a1), Tobias Krieger (a2), David Altenstein (a3), Yolanda Schlumpf (a4), Simona Spinelli (a5), Jakub Späti (a6), Janis Brakowski (a7), Boris B. Quednow (a8), Erich Seifritz (a9) and Martin grosse Holtforth (a10)...
Abstract
Background

Cognitive–behavioural therapy is efficacious in the treatment of major depressive disorder but response rates are still far from satisfactory.

Aims

To better understand brain responses to individualised emotional stimuli and their association with outcome, to enhance treatment.

Method

Functional magnetic resonance imaging data were collected prior to individual psychotherapy. Differences in brain activity during passive viewing of individualised self-critical material in 23 unmedicated out-patients with depression and 28 healthy controls were assessed. The associations between brain activity, cognitive and emotional change, and outcome were analysed in 21 patients.

Results

Patients showed enhanced activity in the amygdala and ventral striatum compared with the control group. Non-response to therapy was associated with enhanced activity in the right amygdala compared with those who responded, and activity in this region was negatively associated with outcome. Emotional but not cognitive changes mediated this association.

Conclusions

Amygdala hyperactivity may lessen symptom improvement in psychotherapy for depression through attenuating emotional skill acquisition.

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Copyright
Corresponding author
Nadja Doerig, Binzmuehlestrasse 14/19, 8050 Zurich, Switzerland. Email: nadja.doerig@psychologie.uzh.ch
Footnotes
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This research was supported by the Swiss National Foundation (grant PP00P1-123377/1 to M.G.H. and grant PZ00P3-126363 to S.S.) as well as a research grant by the Foundation for Research in Science and the Humanities at the University of Zurich to M.G.H. and the Clinical Research Priority Program Molecular Imaging at the University of Zurich to E.S. B.B.Q. was subsidised by grants from the Swiss National Science Foundation (grant PP00P1-12351611 and PP00P1-14632611).

Declaration of interest

None.

Footnotes
References
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Amygdala response to self-critical stimuli and symptom improvement in psychotherapy for depression

  • Nadja Doerig (a1), Tobias Krieger (a2), David Altenstein (a3), Yolanda Schlumpf (a4), Simona Spinelli (a5), Jakub Späti (a6), Janis Brakowski (a7), Boris B. Quednow (a8), Erich Seifritz (a9) and Martin grosse Holtforth (a10)...
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