Fournier Jay C, Price Rebecca B
Department of Psychiatry, University of Pittsburgh School of Medicine.
Focus (Am Psychiatr Publ). 2014 Jul 1;12(3):290-298. doi: 10.1176/appi.focus.12.3.290.
Technological advances in neuroimaging have enabled researchers to examine, , the relationship between psychotherapeutic interventions and markers of brain activity. This review focuses on two kinds of neuroimaging studies in psychotherapy: those that examine the patterns of brain activity associated with response to treatments and those that examine the changes that occur in brain activity during treatment. A general, hypothetical neural model of psychotherapy is presented, and support for the model is evaluated across anxiety disorders and major depression. Neuroimaging studies are broadly consistent in observing associations between response to psychotherapy and baseline activity in several key regions within the prefrontal cortex, basal ganglia, and limbic areas. These regions are involved in the generation and regulation of emotion, fear responding, and response to reward. Pre-post examinations of change following psychotherapy also typically observe that psychological treatments for anxiety and depression can affect neural activity in these regions. Despite general consensus that activity in these regions is associated with psychotherapy, substantial discrepancy persists regarding the precise direction of the observed relationships. Methodological challenges of the existing literature are considered, and future directions are discussed.
神经成像技术的进步使研究人员能够研究心理治疗干预与大脑活动标志物之间的关系。本综述聚焦于心理治疗中的两类神经成像研究：一类研究与治疗反应相关的大脑活动模式，另一类研究治疗过程中大脑活动发生的变化。本文提出了一个通用的、假设性的心理治疗神经模型，并在焦虑症和重度抑郁症中评估了对该模型的支持。神经成像研究在观察心理治疗反应与前额叶皮质、基底神经节和边缘区域内几个关键区域的基线活动之间的关联方面大致一致。这些区域参与情绪的产生和调节、恐惧反应以及对奖励的反应。心理治疗后变化的前后检查通常也观察到，针对焦虑和抑郁的心理治疗会影响这些区域的神经活动。尽管普遍认为这些区域的活动与心理治疗有关，但在观察到的关系的确切方向上仍存在很大差异。本文考虑了现有文献的方法学挑战，并讨论了未来的方向。
