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Based on the results of current research, the book offers a Green , Benicio N. This book is a hands-on guide for facilitating treatment of anxiety and depression during pregnancy and the postpartum period. Women will learn about why anxiety and related difficulties can increase Sign in to My Account. Karnac Books on Twitter. Karnac Books on Facebook. Attachment Theory. Autism and Aspergers.
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Jung and Analytical Psychology. Lacanian Psychoanalysis. Improvements in obsessions, which usually catch up longer term, 61 in contrast, may correspond with normalization of hyperactive CSTC circuits seen in other studies. A third finding was that, post-CBT, functional connectivity between several sites was higher in OCD than in the control group. There were no significant connectivity differences between OCD and healthy controls pretreatment differences in one connection between left inferior parietal lobule and left precentral gyrus were evident only for lenient statistical thresholding.
The additional connectivity analysis testing CTSC regions-of-interest using nodes derived from a meta-analysis of obsessive compulsive studies, again revealed no significant differences between the OCD and control groups. Thus, two different functional connectivity analyses support the idea that connectivity-strengthening processes may reflect effects of CBT independent of normalization of pathophysiological circuits.
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Only one connection right caudate—right intracalcarine cortex in a network that increased pre-to-post-CBT overlapped with a connection that was significantly greater in OCD than controls post-CBT, although several of the same nodes were involved in both pre-vs-post and OCD-vs-control findings, including ACC, occipital cortex, caudate, thalamus, parietal operculum and precentral gyrus.
Additional regions superior parietal lobule, angular gyrus, postcentral gyrus and supplementary motor area involved in the latter, supports CBT-effects being neuroanatomically more widespread than previously imagined. Pre-treatment, OCD symptom severity was associated with connectivity between right and left insula.
Similarly, two other studies found strong associations between OCD symptoms and insula. If, however, intensive CBT more consistently engages one specific set of symptoms across patients for example, resisting compulsive behaviors over common network mechanisms, that could lead to appreciable group-wise pre-to-post-CBT increases in connectivity, as well as post-CBT differences in connectivity between OCD and controls, as observed in this study.
A limitation of this study is that the functional node set, chosen for comparison with other investigations, 15 , 41 , 58 , 65 did not include the amygdala, which has a possible role in aberrant OCD connectivity 66 and CBT response prediction. Finally, the sample size was larger for the OCD than for the control group; thus power was lower for between-group than for pre-post-CBT comparisons. Increased cerebellar to striatal and prefrontal connectivity may reflect CBT strengthening the ability to resist compulsions and the acquisition of new non-compulsive goal-directed behaviors and thought patterns.
Mechanisms of CBT, at least immediately following intensive treatment, may involve cross-network strengthening of compensatory processes rather than normalizing of pathophysiological circuits. Multiple pathways to functional impairment in obsessive-compulsive disorder. Clin Psychol Rev. A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Psychological treatment of obsessive-compulsive disorder: a meta-analysis. Psychological treatment of obsessive-compulsive disorder in children and adolescents: a meta-analysis.
Span J Psychol. A preliminary study of partial hospital management of severe obsessive-compulsive disorder. Psychiatr Serv. Inpatient treatment of patients with severe obsessive-compulsive disorder. Hosp Community Psychiatry. The neural bases of obsessive-compulsive disorder in children and adults.
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Dev Psychopathol. Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neurosci Biobehav Rev. Global resting-state functional magnetic resonance imaging analysis identifies frontal cortex, striatal, and cerebellar dysconnectivity in obsessive-compulsive disorder. Biol Psychiatry. Altered function and connectivity of the medial frontal cortex in pediatric obsessive-compulsive disorder.
Obsessive-compulsive disorder: beyond segregated cortico-striatal pathways.
Trends Cogn Sci. Plos One ; 7 : e Abnormal small-world architecture of top-down control networks in obsessive-compulsive disorder. J Psychiatry Neurosci. The effects of pharmacological treatment on functional brain connectome in obsessive-compulsive disorder. Biological Psychiatry. Brain connectivity and prediction of relapse after cognitive-behavioral therapy in obsessive-compulsive disorder.
Front Psychiatry ; 6 : Network-based statistic: identifying differences in brain networks. Neuroimage ; 53 : — Impact of cognitive behavioral therapy for social anxiety disorder on the neural dynamics of cognitive reappraisal of negative self-beliefs: randomized clinical trial. JAMA Psychiatry ; 70 : — Altered neural correlates of affective processing after internet-delivered cognitive behavior therapy for social anxiety disorder. Psychiatry Res. Predicting long-term outcome of Internet-delivered cognitive behavior therapy for social anxiety disorder using fMRI and support vector machine learning.
Translational Psychiatry ; 5 : e Schizophr Bull. Neurosubstrates of remission following prolonged exposure therapy in veterans with posttraumatic stress disorder. Psychother Psychosom. Neural correlates of procedural variants in cognitive-behavioral therapy: a randomized, controlled multicenter FMRI study.
Microstructural brain abnormalities and symptom dimensions in child and adolescent patients with obsessive-compulsive disorder: a diffusion tensor imaging study. Depression and anxiety ; 31 : — Neurocognitive dysfunction and regional cerebral blood flow in medically naive patients with obsessive-compulsive disorder. Developmental neuropsychology ; 39 : 37— Abnormal functional connectivity of brain network hubs associated with symptom severity in treatment-naive patients with obsessive—compulsive disorder: A resting-state functional MRI study. Progress in Neuro-Psychopharmacology and Biological Psychiatry ; 66 : — Resting-state functional connectivity abnormalities in patients with obsessive—compulsive disorder and their healthy first-degree relatives.
Altered corticostriatal functional connectivity in obsessive-compulsive disorder.
Jordana Muroff, Abigail Ross, and Joseph Rothfarb
Arch Gen Psychiatry. Corticostriatal functional connectivity in non-medicated patients with obsessive-compulsive disorder.
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