Tag Archives: CBT Normalizes Brain’s Electrical Activity for People W/ Social Anxiety Disorder

The Association for Psychological Science’s journal *Psychological Science* has scheduled an article for publication in a future issue:
“Changes in EEG Cross-Frequency Coupling During Cognitive Behavioral Therapy for Social Anxiety Disorder.”

The authors are Vladimir Miskovic, David A. Moscovitch, Diane L. Santesso, Randi E. McCabe, Martin M. Antony, and Louis A. Schmidt.

Here’s how the article starts:

[begin excerpt]

Studies examining the neural correlates of psychological treatment are far outnumbered by studies investigating the neural correlates of pharmacological interventions, despite evidence that psychotherapy and medications have equal clinical efficacy for the treatment of anxiety (Otto, Behar, Smits, & Hofmann, 2009), with psychotherapy being more costeffective over the long term (Heuzenroeder et al., 2004).

A promising line of research involves tracking brain activity before and after the delivery of evidence-based psychological treatments that are standardized and proven to reduce symptoms.

One example of such a treatment is cognitive behavioral therapy (CBT), a highly structured and collaborative form of psychotherapy that helps patients identify and modify the maladaptive, interactive patterns of thoughts and behaviors underlying their emotional dysfunction (Barlow, 2008).

Currently, the majority of research on brain changes in response to psychotherapy consists of nuclear and magnetic imaging studies involving activation comparisons before and after treatment1 (Roffman, Marci, Glick, Dougherty, & Rauch, 2005).

Rather than producing regionally isolated alterations, psychotherapeutic interventions seem to produce changes in the dynamic interactions between cortical and subcortical brain regions.

For example, psychotherapy for obsessive-compulsive disorder reduces correlated activity in corticostriatal- thalamic circuits (Schwartz, Stoessel, Baxter, Martin, & Phelps, 1996), and depression treatment affects the balance of fronto-limbic activity (Goldapple et al., 2004).

Compared with studies using functional MRI and PET scans, studies quantifying psychotherapy-related electrophysiological changes are rare (for exceptions, see Leutgeb, Schafer, & Schienle, 2009; Oathes et al., 2008; Rabe, Zoellner, Beauducel, Maercker, & Karl, 2008).

Brain electrical measures (EEGs) reveal the oscillatory characteristics of neuronal mass activity, and unlike blood-oxygenation levels (Attwell & Iadecola, 2002), they provide a direct index of synchronous dendritic potentials in real time.

Accordingly, EEG measures may be uniquely suited to examining the interactive brain dynamics that are assumed to accompany successful clinical treatments.

[end excerpt]

Here’s how the Discussion section starts: “The findings reported here indicate that effective group CBT for SAD was associated with changes in brain electrical activity that pointed to a potential neural correlate of psychotherapy. Reductions in correlated delta-beta EEG spectral power (i.e., cross-frequency coupling) were observed during both resting and speech-anticipation conditions and were detectable by the midtreatment assessment, although the strongest differences emerged for the pretreatment to posttreatment comparisons. It is interesting that the clinical group showed increased delta-beta coupling in the right midfrontal electrode compared with a post hoc control group with low social anxiety. However, there were no significant differences in coupling between these two groups when the clinical group was assessed at posttreatment, and this suggests that brain electrical activity was normalized in patients following the completion of therapy.”

Here’s how the article ends: “Overall, this study suggests that predictable changes in mass activity of the brain accompany completion of CBT for SAD, and that these changes parallel improvements resulting from clinical intervention. There is both theoretical and practical value to discovering neural correlates associated with clinical symptom reduction. Theoretically, these findings are informative with regard to the sorts of distributed patterns of brain activity that may underlie the presentation of social anxiety as well as their capacity for environmental modification. At a practical level, identifying neural correlates of psychotherapy may suggest possible treatment markers and may have inherent value as a treatment tool in itself through the development of neurofeedback techniques.”

Newstip by Dr. Ken Pope.