Emotional Reactivity and Regulation in Panic Disorder: Insights from a Functional Magnetic Resonance Imaging Study of Cognitive Behavioral Therapy

      For more than a century, psychologists and psychiatrists have sought to understand the biological bases of mental disorders, with a view to fashioning more effective treatments. Advances in functional neuroimaging have made it possible for clinical researchers to make significant strides towards realizing this long-held goal, allowing them to do the following: 1) characterize differences in neural responses between patients with various psychiatric conditions and healthy subjects (HS), and 2) examine the neural correlates of psychosocial and biologic treatments.
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        • Kessler R.
        • Berglund P.
        • Demler O.
        Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.
        Arch Gen Psychiatry. 2005; 62 ([published correction appears in Arch Gen Psychiatry 2005;62:768]): 593-602
        • Etkin A.
        • Wager T.
        Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia.
        Am J Psychiatry. 2007; 164: 1476-1488
        • Kircher T.
        • Arolt V.
        • Jansen A.
        • Pyka M.
        • Reinhardt I.
        • Kellermann T.
        • et al.
        Effect of cognitive-behavioral therapy on neural correlates of fear conditioning in panic disorder.
        Biol Psychiatry. 2013; 73: 93-101
        • Porto P.R.
        • Oliveira L.
        • Mari J.
        • Volchan E.
        • Figueira I.
        • Ventura P.
        Does cognitive behavioral therapy change the brain?.
        J Neuropsychiatry Clin Neurosci. 2009; 21: 114-125
        • Lissek S.
        • Rabin S.
        • Heller R.E.
        • Lukenbaugh D.
        • Geraci M.
        • Pine D.S.
        • et al.
        Overgeneralization of conditioned fear as a pathogenic marker of panic disorder.
        Am J Psychiatry. 2010; 167: 47-55
        • Kessler R.
        • Chiu W.
        • Jin R.
        The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication.
        Arch Gen Psychiatry. 2006; 63: 415-424
        • Sakai Y.
        • Kumano H.
        • Nishikawa M.
        • Sakano Y.
        • Kaiya H.
        • Imabayashi E.
        • et al.
        Cerebral glucose metabolism associated with a fear network in panic disorder.
        Neuroreport. 2005; 16: 927-931
        • Prasko J.
        • Horácek J.
        • Záleský R.
        • Kopecek M.
        • Novák T.
        • Pasková B.
        • et al.
        The change of regional brain metabolism (18FDG PET) in panic disorder during the treatment with cognitive behavioral therapy or antidepressants.
        Neuroendocrinology Letters. 2004; 25: 340-348
        • Sakai Y.
        • Kumano H.
        • Nishikawa M.
        • Sakano Y.
        • Kaiya H.
        • Imabayashi E.
        • et al.
        Changes in cerebral glucose utilization in patients with panic disorder treated with cognitive-behavioral therapy.
        Neuroimage. 2006; 33: 218-226
        • Gross J.J.
        • Thompson R.A.
        Emotion regulation: Conceptual foundations.
        in: Gross J.J. Handbook of Emotion Regulation. Guilford Press, New York2007: 3-24

      Linked Article

      • Effect of Cognitive-Behavioral Therapy on Neural Correlates of Fear Conditioning in Panic Disorder
        Biological PsychiatryVol. 73Issue 1
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          Learning by conditioning is a key ability of animals and humans for acquiring novel behavior necessary for survival in a changing environment. Aberrant conditioning has been considered a crucial factor in the etiology and maintenance of panic disorder with agoraphobia (PD/A). Cognitive-behavioral therapy (CBT) is an effective treatment for PD/A. However, the neural mechanisms underlying the effects of CBT on conditioning processes in PD/A are unknown.
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