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Neural effects of cognitive-behavioural therapy on dysfunctional attitudes in depression

Lookup NU author(s): Emeritus Professor Jan Scott


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Background. Dysfunctional attitudes are a feature of depression that has been correlated with receptor binding abnormalities in limbic and cortical regions. We sought to investigate the functional neuroanatomy of dysfunctional attitudes in major depressive disorder (MDD) and the effects of treatment with cognitive-behavioural therapy (CBT).Method. Participants were 16 patients with unipolar depression in an acute depressive episode (mean age 40.0 years) and 16 matched healthy controls (mean age 39.9 years). Patients were medication free and received a course of treatment with CBT. All participants underwent functional magnetic resonance imaging (fMRI) scans at baseline and at week 16, prior to the initiation of therapy and following the course of CBT for patients. During each fMRI scan, participants indicated their attributions to statements from a modified Dysfunctional Attitudes Scale (mDAS-48).Results. MDD patients in an acute depressive episode endorsed a greater number of extreme responses to DAS statements, which normalized following CBT treatment. Extreme attributions were associated with greater activation in the left hippocampal region, inferior parietal lobe and precuneus in MDD patients as compared with healthy controls as a main effect of group. An interaction effect was found in the left parahippocampal region, which showed less attenuation in MDD patients at the follow-up scan relative to healthy controls.Conclusions. Attenuation of activity in the parahippocampal region may be indicative of an improvement in dysfunctional thinking following CBT treatment in depression, while persistent engagement of regions involved in attentional processing and memory retrieval with extreme attributions reflects a trait feature of depression.

Publication metadata

Author(s): Sankar A, Scott J, Paszkiewicz A, Giampietro VP, Steiner H, Fu CHY

Publication type: Article

Publication status: Published

Journal: Psychological Medicine

Year: 2015

Volume: 45

Issue: 7

Pages: 1425-1433

Print publication date: 01/05/2015

Online publication date: 22/10/2014

Acceptance date: 24/09/2014

ISSN (print): 0033-2917

ISSN (electronic): 1469-8978

Publisher: Cambridge University Press


DOI: 10.1017/S0033291714002529


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