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2018-09-28Zeitschriftenartikel DOI: 10.1159/000493146
Effects of Cognitive Behavioral Therapy on Neural Processing of Agoraphobia-Specific Stimuli in Panic Disorder and Agoraphobia
dc.contributor.authorWittmann, André
dc.contributor.authorSchlagenhauf, Florian
dc.contributor.authorGuhn, Anne
dc.contributor.authorLueken, Ulrike
dc.contributor.authorElle, Manja
dc.contributor.authorStoy, Meline
dc.contributor.authorLiebscher, Carolin
dc.contributor.authorBermpohl, Felix
dc.contributor.authorFydrich, Thomas
dc.contributor.authorPfleiderer, Bettina
dc.contributor.authorBruhn, Harald
dc.contributor.authorGerlach, Alexander L.
dc.contributor.authorStraube, Benjamin
dc.contributor.authorWittchen, Hans-Ulrich
dc.contributor.authorArolt, Volker
dc.contributor.authorHeinz, Andreas
dc.contributor.authorKircher, Tilo
dc.contributor.authorStröhle, Andreas
dc.date.accessioned2020-04-01T09:43:56Z
dc.date.available2020-04-01T09:43:56Z
dc.date.issued2018-09-28none
dc.date.updated2019-11-29T00:35:16Z
dc.identifier30269148
dc.identifier.issn0033-3190
dc.identifier.urihttp://edoc.hu-berlin.de/18452/22066
dc.description.abstractBackground: Patients suffering from panic disorder and agoraphobia are significantly impaired in daily life due to anxiety about getting into a situation due to apprehension about experiencing a panic attack, especially if escape may be difficult. Dysfunctional beliefs and behavior can be changed with cognitive behavioral therapy; however, the neurobiological effects of such an intervention on the anticipation and observation of agoraphobia-specific stimuli are unknown. Methods: We compared changes in neural activation by measuring the blood oxygen level-dependent signal of 51 patients and 51 healthy controls between scans before and those after treatment (group by time interaction) during anticipation and observation of agoraphobia-specific compared to neutral pictures using 3-T fMRI. Results: A significant group by time interaction was observed in the ventral striatum during anticipation and in the right amygdala during observation of agoraphobia-specific pictures; the patients displayed a decrease in ventral striatal activation during anticipation from pre- to posttreatment scans, which correlated with clinical improvement measured with the Mobility Inventory. During observation, the patients displayed decreased activation in the amygdala. These activational changes were not observed in the matched healthy controls. Conclusions: For the first time, neural effects of cognitive behavioral therapy were shown in patients suffering from panic disorder and agoraphobia using disorder-specific stimuli. The decrease in activation in the ventral striatum indicates that cognitive behavioral therapy modifies anticipatory anxiety and may ameliorate abnormally heightened salience attribution to expected threatening stimuli. The decreased amygdala activation in response to agoraphobia-specific stimuli indicates that cognitive behavioral therapy can alter the basal processing of agoraphobia-specific stimuli in a core region of the fear network.eng
dc.language.isoengnone
dc.publisherHumboldt-Universität zu Berlin
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectAgoraphobiaeng
dc.subjectAnxietyeng
dc.subjectAmygdalaeng
dc.subjectVentral striatumeng
dc.subjectFunctional MRIeng
dc.subjectPsychotherapyeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleEffects of Cognitive Behavioral Therapy on Neural Processing of Agoraphobia-Specific Stimuli in Panic Disorder and Agoraphobianone
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:11-110-18452/22066-0
dc.identifier.doi10.1159/000493146none
dc.identifier.doihttp://dx.doi.org/10.18452/21325
dc.type.versionpublishedVersionnone
local.edoc.container-titlePsychotherapy and Psychosomaticsnone
local.edoc.pages16none
local.edoc.anmerkungThis publication is with permission of the rights owner freely accessible due to an alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.none
local.edoc.type-nameZeitschriftenartikel
local.edoc.institutionLebenswissenschaftliche Fakultätnone
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-publisher-nameS. Karger AGnone
local.edoc.container-publisher-placeBasel, Switzerlandnone
local.edoc.container-volume87none
local.edoc.container-issue6none
local.edoc.container-firstpage350none
local.edoc.container-lastpage365none
dc.description.versionPeer Reviewednone
dc.identifier.eissn1423-0348
local.edoc.affiliationWittmann, André; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationSchlagenhauf, Florian; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationGuhn, Anne; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationLueken, Ulrike; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germanynone
local.edoc.affiliationElle, Manja; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationStoy, Meline; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationLiebscher, Carolin; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationBermpohl, Felix; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationFydrich, Thomas; Institute of Psychology, Psychotherapy and Somatopsychology, Humboldt Universität zu Berlin, Berlin, Germanynone
local.edoc.affiliationPfleiderer, Bettina; Department of Clinical Radiology, University of Münster, Münster, Germanynone
local.edoc.affiliationBruhn, Harald; Department of Radiology, University of Jena, Jena, Germanynone
local.edoc.affiliationGerlach, Alexander L.; Department of Psychology, University of Cologne, Cologne, Germanynone
local.edoc.affiliationStraube, Benjamin; Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germanynone
local.edoc.affiliationWittchen, Hans-Ulrich; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germanynone
local.edoc.affiliationArolt, Volker; Department of Psychiatry, University of Münster, Münster, Germanynone
local.edoc.affiliationHeinz, Andreas; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone
local.edoc.affiliationKircher, Tilo; Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germanynone
local.edoc.affiliationStröhle, Andreas; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germanynone

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