Neural Mechanisms of Cognitive Reappraisal of Negative Self-Beliefs in Social Anxiety Disorder

Goldin, Philippe R.; Manber-Ball, Tali; Werner, Kelly; Heimberg, Richard G.; Gross, James J.

doi:10.1016/j.biopsych.2009.07.014

Cited by 265 publications

(276 citation statements)

References 60 publications

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“…The superior frontal gyrus, particularly the dorsolateral PFC, has been implicated in top-down control and emotion regulation in healthy adults (Ochsner and Gross, 2005). However, individuals with anxiety disorders, including a large subsample of these GAD and PD patients (Ball et al, 2013), have demonstrated reduced engagement of this region during emotion regulation (Goldin et al, 2009a;Goldin et al, 2009b). The anterior insula is critical for interoception (Craig, 2009) and integration of emotional information (Lamm and Singer, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Individuals with anxiety disorders have been hypothesized to have difficulty with emotion regulation (Aldao et al, 2010) and have demonstrated hypoactivation in dorsolateral, dorsomedial, and ventrolateral prefrontal cortex (PFC) during emotion regulation (Ball et al, 2013;Goldin et al, 2009a;Goldin et al, 2009b). We therefore sought to examine emotion regulation-related brain activation as predictors of CBT outcome.…”

Section: Introductionmentioning

confidence: 99%

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Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Ball

Stein

Ramsawh

et al. 2013

Neuropsychopharmacol

102

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The possibility of individualized treatment prediction has profound implications for the development of personalized interventions for patients with anxiety disorders. Here we utilize random forest classification and pre-treatment functional magnetic resonance imaging (fMRI) data from individuals with generalized anxiety disorder (GAD) and panic disorder (PD) to generate individual subject treatment outcome predictions. Before cognitive behavioral therapy (CBT), 48 adults (25 GAD and 23 PD) reduced (via cognitive reappraisal) or maintained their emotional responses to negative images during fMRI scanning. CBT responder status was predicted using activations from 70 anatomically defined regions. The final random forest model included 10 predictors contributing most to classification accuracy. A similar analysis was conducted using the clinical and demographic variables. Activations in the hippocampus during maintenance and anterior insula, superior temporal, supramarginal, and superior frontal gyri during reappraisal were among the best predictors, with greater activation in responders than non-responders. The final fMRI-based model yielded 79% accuracy, with good sensitivity (0.86), specificity (0.68), and positive and negative likelihood ratios (2.73, 0.20). Clinical and demographic variables yielded poorer accuracy (69%), sensitivity (0.79), specificity (0.53), and likelihood ratios (1.67, 0.39). This is the first use of random forest models to predict treatment outcome from pre-treatment neuroimaging data in psychiatry. Together, random forest models and fMRI can provide single-subject predictions with good test characteristics. Moreover, activation patterns are consistent with the notion that greater activation in cortico-limbic circuitry predicts better CBT response in GAD and PD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Ball

Stein

Ramsawh

et al. 2013

Neuropsychopharmacol

102

View full text Add to dashboard Cite

show abstract

“…However, it is important to note that worry was more uniquely related to early LPP increases whereas trait reappraisal seemed to account for worry's association with later LPP effects. Further supporting the practice effects prediction was the observation that worry, but not trait reappraisal, was associated with enhanced SPN magnitude during the cue-to-picture period, suggesting that worriers engage in greater anticipatory and preparatory processes while waiting to reappraise the upcoming unpleasant scene (Aldao & Mennin, 2012;Campbell-Sills et al, 2011;Goldin et al, 2009). Critically, rather than helping worriers regulate their emotions, this enhanced preparatory activity appeared to be ineffective in so far as worry predicted parietal LPP enhancements.…”

Section: Basic Science Implicationsmentioning

confidence: 86%

“…Adjusting for the missing suicide item on the BDI-II, 19% of the sample reported experiencing moderate to severe depressive symptoms based on the standard severity ranges (Beck et al, 1996). Even with the missing suicide item, the mean reported for the current sample is double that reported for control samples in other emotion regulation studies of anxiety (e.g., Goldin et al, 2009 …”

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confidence: 90%

Neural markers of positive reappraisal and their associations with trait reappraisal and worry.

Moser¹,

Hartwig²,

Moran³

et al. 2014

Journal of Abnormal Psychology

103

127

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Positively reinterpreting negative experiences is important for psychological well-being and represents a key mechanism of cognitive-behavioral therapies for emotional problems. Yet, little is known about the neural mechanisms that underlie this process and how they relate to clinically relevant individual differences. Here we demonstrate using event-related potentials (ERPs) that positively reappraising distress-inducing images is associated with early increases in frontal control activity and later decreases in parietal arousal-related activity. Moreover, we show that people's chronic tendencies to reappraise versus worry modulate neural activity in opposing directions-trait reappraisal predicts decreases in parietal arousal-related activity during positive reappraisal implementation whereas worry predicts increases in the same waveform. These findings provide novel insights into the neural time course of positive reappraisal. They also speak to the potential clinical utility of neurophysiological measures as relatively inexpensive, noninvasive biomarkers that could serve as risk indicators and treatment mediators.

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“…The effect of cognitive-linguistic regulation of emotional reactivity to social threat (Goldin et al 2009a) and to negative self-beliefs (Goldin et al 2009b) was explicitly assessed in two different experiments. In both, the authors reported reduced activation in brain areas related to attention and cognitive control of emotion in SAD patients compared to healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Neural response to the observable self in social anxiety disorder

et al. 2012

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Background. Distorted images of the observable self are considered crucial in the development and maintenance of social anxiety. We generated an experimental situation in which participants viewed themselves from an observer's perspective when exposed to scrutiny and evaluation by others.Method. Twenty patients with social anxiety disorder (SAD) and 20 control subjects were assessed using functional magnetic resonance imaging (fMRI) during the public exposure of pre-recorded videos in which they were each shown performing a verbal task. The examiners acted as the audience in the experiment and rated performance. Whole-brain functional maps were computed using Statistical Parametric Mapping.Results. Robust activation was observed in regions related to self-face recognition, emotional response and general arousal in both study groups. Patients showed significantly greater activation only in the primary visual cortex. By contrast, they showed significant deactivation or smaller activation in dorsal frontoparietal and anterior cingulate cortices relevant to the cognitive control of negative emotion. Task-related anxiety ratings revealed a pattern of negative correlation with activation in this frontoparietal/cingulate network. Importantly, the relationship between social anxiety scores and neural response showed an inverted-U function with positive correlations in the lower score range and negative correlations in the higher range.Conclusions. Our findings suggest that exposure to scrutiny and evaluation in SAD may be associated with changes in cortical systems mediating the cognitive components of anxiety. Disorder severity seems to be relevant in shaping the neural response pattern, which is distinctively characterized by a reduced cortical response in the most severe cases.

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Neural Mechanisms of Cognitive Reappraisal of Negative Self-Beliefs in Social Anxiety Disorder

Cited by 265 publications

References 60 publications

Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Single-Subject Anxiety Treatment Outcome Prediction using Functional Neuroimaging

Neural markers of positive reappraisal and their associations with trait reappraisal and worry.

Neural response to the observable self in social anxiety disorder

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