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Study: Cognitive Behavioral Therapy (CBT), not medication, drives long-term rewiring of the brain to help reduce psychosis symptoms

Talk­ing ther­a­py changes the brain’s wiring, study reveals for first time (Sci­enceDai­ly):

A new study from King’s Col­lege Lon­don and South Lon­don and Maud­s­ley NHS Foun­da­tion Trust has shown for the first time that cog­ni­tive behav­iour ther­a­py (CBT) strength­ens spe­cif­ic con­nec­tions in the brains of peo­ple with psy­chosis, and that these stronger con­nec­tions are asso­ci­at­ed with long-term reduc­tion in symp­toms and recov­ery eight years lat­er.

In the orig­i­nal study, par­tic­i­pants under­went fMRI imag­ing to assess the brain’s response to images of faces express­ing dif­fer­ent emo­tions, before and after six months of CBT. Par­tic­i­pants were already tak­ing med­ica­tion when they took part in the study, and so were com­pared to a group receiv­ing med­ica­tion only. The group receiv­ing med­ica­tion only did not show any increas­es in con­nec­tiv­i­ty, sug­gest­ing that the effects on brain con­nec­tions could be attrib­uted to the CBT…

For the new study, the health of 15 of the 22 par­tic­i­pants who received CBT was tracked for eight years through their med­ical records…The results show that increas­es in con­nec­tiv­i­ty between sev­er­al brain regions — most impor­tant­ly the amyg­dala (the brain’s threat cen­tre) and the frontal lobes (which are involved in think­ing and rea­son­ing) — are asso­ci­at­ed with long-term recov­ery from psy­chosis. This is the first time that changes in the brain asso­ci­at­ed with CBT have been shown to be asso­ci­at­ed with long-term recov­ery in peo­ple with psy­chosis.”

Study: Brain con­nec­tiv­i­ty changes occur­ring fol­low­ing cog­ni­tive behav­iour­al ther­a­py for psy­chosis pre­dict long-term recov­ery (Trans­la­tion­al Psy­chi­a­try)

  • From the abstract: Lit­tle is known about the psy­chobi­o­log­i­cal mech­a­nisms of cog­ni­tive behav­iour­al ther­a­py for psy­chosis (CBTp) and which spe­cif­ic process­es are key in pre­dict­ing favourable long-term out­comes. Fol­low­ing the­o­ret­i­cal mod­els of psy­chosis, this proof-of-con­cept study inves­ti­gat­ed whether the long-term recov­ery path of CBTp com­pleters can be pre­dict­ed by the neur­al changes in threat-based social affec­tive pro­cess­ing that occur dur­ing CBTp. We fol­lowed up 22 par­tic­i­pants who had under­gone a social affec­tive pro­cess­ing task dur­ing func­tion­al mag­net­ic res­o­nance imag­ing along with self-report and clin­i­cian-admin­is­tered symp­tom mea­sures, before and after receiv­ing CBTp…findings show that reor­gan­i­sa­tion occur­ring at the neur­al lev­el fol­low­ing psy­cho­log­i­cal ther­a­py can pre­dict the sub­se­quent recov­ery path of peo­ple with psy­chosis across 8 years. This nov­el method­ol­o­gy shows promise for fur­ther stud­ies with larg­er sam­ple size, which are need­ed to bet­ter exam­ine the sen­si­tiv­i­ty of psy­chobi­o­log­i­cal process­es, in com­par­i­son to exist­ing clin­i­cal mea­sures, in pre­dict­ing long-term out­comes.

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