by esperanza Magazine

The process of finding the right treatment has just been made a little easier.

 

Newswise — CHICAGO— Jun 14, 2018—People react differently to positive events in their lives. For some, a small reward can have a large impact on their mood, while others may get a smaller emotional boost from the same positive event.

These reactions can not only be objectively measured in a simple office evaluation, but researchers from the University of Illinois at Chicago report that they can help clinicians determine whether a patient with anxiety or depression is responding to treatment and if they will do better on an antidepressant drug, or in talk therapy. Their results are published in the Journal of Clinical Psychiatry.

“About 50 percent of people prescribed either selective serotonin reuptake inhibitors, or SSRIs, — a class of antidepressants — or cognitive behavioral therapy get better with those treatments,” said Katie Burkhouse, assistant professor of psychiatry in the UIC College of Medicine and lead author on the paper. “We haven’t had an objective way to measure whether a patient is improving with treatment or which patients will do better on SSRIs versus cognitive behavioral therapy, until now.”

In a previous study, Burkhouse showed that lower electrical activity in the brain in response to receiving a reward – known as the reward positivity – was associated with greater symptoms of depression. When someone experiences something rewarding in their environment, their brain reacts with an increase in activity. However, patients with depression tend not to respond to rewards at the same level as healthy controls.  These differences in electrical activity in response to receiving rewards can be measured using electroencephalography, or EEG, which records electrical signals from the brain through the scalp using a cap embedded with electrodes. A larger reward positivity signal reflects an enhanced brain response to receiving a reward.

Burkhouse and her colleagues wanted to see if they could use reward positivity to predict which patients would do better on SSRIs versus cognitive behavioral therapy, or CBT. They also wanted to see whether changes in reward positivity were associated with symptom improvement over the course of treatment.

“There are serious considerations that go into prescribing either of these treatments,” Burkhouse said. “SSRIs can have unwanted side effects, while CBT requires a significant amount of time and commitment, and practitioners trained in delivering CBT can be hard to find and those that practice this form of therapy may be booked and not able to take on new patients.”

For the study, Burkhouse and her colleagues recruited 63 patients who have a history of anxiety or depression and 25 healthy participants with no history of mental health problems. Participants wore the EEG cap while undergoing a simple computer task. They were asked to choose one of two doors on a computer screen and were instructed that if the right door was chosen, the participant would win a small amount of money. If the wrong door was chosen, they would lose money. Next, participants with anxiety or depression were randomly chosen to take an SSRI every day for 12 weeks, or receive 12 weekly sessions of CBT delivered by a psychotherapist. After treatment, all participants completed the monetary reward task again to assess whether there were changes in neural reactivity related to receiving a reward.

There were two significant findings of the study, according to Burkhouse.

“The more that reward positivity increased from the baseline measurement to the final post-treatment measurement, the more participants reported a lessening of their depression or anxiety symptoms with treatment. This means that reward positivity closely follows symptom improvement as treatment progresses, and as such, can be used to help determine if a particular treatment is working for a patient or not,” said Burkhouse. The second finding was that participants with a blunted reward positivity before starting treatment had a greater reduction in depressive symptoms if they were assigned to receive SSRIs, but not talk therapy.

“These findings could help bring precision medicine closer to reality for patients with anxiety and depressive disorders,” said Dr. K. Luan Phan, professor of psychiatry in the UIC College of Medicine and a senior author on the paper.

Many patients who seek treatment for their anxiety and depression don’t always do well with the first therapy prescribed due to not being able to tolerate side effects of drugs or not being able to commit to weeks of talk therapy, said Phan, who holds the University of Illinois Center on Depression and Resilience Professorship.

“We can say with heightened certainty that being able to give them a treatment that will work for them is a big step towards helping more patients get relief from their symptoms sooner,” said Phan.

Stephanie Gorka, Heide Klumpp, Amy Kennedy, Shannon Karich, Jennifer Francis, Dr. Olusola Ajilore, Michelle Craske, Scott Langenecker and Stewart Shankman are co-authors on the paper.

This research was funded by grant R01 MH101497 from the National Institute of Mental Health and grant UL1 RR029879 from the UIC Center for Clinical and Translational Science.

 

Source: University of Illinois at Chicago

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by esperanza Magazine

A radical new model of emotion paints a daunting picture: mental health treatment could be ineffective, or even detrimental, to about 50% of the population.

 

Newswise — ITHACA, N.Y. – Treatment for the most common mental health problems could be ineffective or even detrimental to about 50 percent of the population, according to a radical new model of emotion in the brain.

Since the 1970s, hundreds of studies have suggested that each hemisphere of the brain is home to a specific type of emotion. Emotions linked to approaching and engaging with the world – like happiness, pride and anger – lives in the left side of the brain, while emotions associated with avoidance – like disgust and fear – are housed in the right.

But those studies were done almost exclusively on right-handed people. That simple fact has given us a skewed understanding of how emotion works in the brain, according to Daniel Casasanto, associate professor of human development and psychology at Cornell University.

That longstanding model is, in fact, reversed in left-handed people, whose emotions like alertness and determination are housed in the right side of their brains, Casasanto suggests in a new study. Even more radical: The location of a person’s neural systems for emotion depends on whether they are left-handed, right-handed or somewhere in between, the research shows.

The study, “Approach motivation in human cerebral cortex,” is published in Philosophical Transactions of the Royal Society B: Biological Sciences.

According to the new theory, called the “sword and shield hypothesis,” the way we perform actions with our hands determines how emotions are organized in our brains. Sword fighters of old would wield their swords in their dominant hand to attack the enemy — an approach action — and raise their shields with their non-dominant hand to fend off attack — an avoidance action. Consistent with these action habits, results show that approach emotions depend on the hemisphere of the brain that controls the dominant “sword” hand, and avoidance emotions on the hemisphere that controls the non-dominant “shield” hand.

The work has implications for a current treatment for recalcitrant anxiety and depression called neural therapy. Similar to the technique used in the study and approved by the Food and Drug Administration, it involves a mild electrical stimulation or a magnetic stimulation to the left side of the brain, to encourage approach-related emotions.

But Casasanto’s work suggests the treatment could be damaging for left-handed patients. Stimulation on the left would decrease life-affirming approach emotions. “If you give left-handers the standard treatment, you’re probably going to make them worse,” Casasanto said.

“And because many people are neither strongly right- nor left-handed, the stimulation won’t make any difference for them, because their approach emotions are distributed across both hemispheres,” he said.

“This suggests strong righties should get the normal treatment, but they make up only 50 percent of the population. Strong lefties should get the opposite treatment, and people in the middle shouldn’t get the treatment at all.”

However, Casasanto cautions that this research studied only healthy participants and more work is needed to extend these findings to a clinical setting.

The research was funded by a James S. McDonnell Foundation Scholar Award and the National Science Foundation.

Cornell University has television, ISDN and dedicated Skype/Google+ Hangout studios available for media interviews. For additional information, see this Cornell Chronicle Story. 

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by esperanza Magazine

Maintaining a self-compassionate mindset gradually improves body image, according to research.

 

Newswise — EVANSTON, Ill. — Jun 21, 18— Body dissatisfaction among women is widespread and can lead to a number of worrisome outcomes, including eating disorders, depression and anxiety. While researchers know a lot about what makes women’s body image worse, they are still short on empirically supported interventions for improving women’s body image.

Renee Engeln, a professor of instruction in psychology in the Weinberg College of Arts and Sciences at Northwestern University, said positive body image interventions focused on telling women they’re beautiful the way they are or exhorting them to “love their bodies” are often doomed to fail.

In a new study, Engeln, author of “Beauty Sick” (HarperCollins, 2017), tested the effect of three specific writing exercises on college women’s body satisfaction, along with co-author Natalie G. Stern also of Northwestern.

“In the first two studies, we found that spending just 15 minutes writing and reviewing one of three specific types of letters to oneself can significantly increase women’s body satisfaction — at least short-term,” Engeln said.

In two of the letter-writing interventions, the focus was on self-compassion. One was a basic self-compassion letter; the other was a self-compassionate letter directed specifically at the body.

“To induce a self-compassionate mind frame, women wrote letters to themselves from the perspective of an unconditionally loving friend who knew them well, saw all their perceived flaws and still responded with kindness and acceptance,” Engeln said.

“The third type of letter-writing intervention asked women to write a letter to their body, showing gratitude for all of its functions — everything it does to help you get through every day. Relative to control conditions, all three of these letters increased body satisfaction,” she said.

In the final study, the researchers turned the letter-writing instructions into a simpler, faster writing activity that could be completed online. It was the same basic idea, but women wrote a series of sentences instead of a more formal letter. More than 1,000 college women completed the online study, which once again showed that self-compassion and body functionality-focused letters could improve body image.

“The letters women in the study wrote were astounding. They were moving and inspirational, several brought tears to our eyes,” Engeln said. “Many participants asked if they could take a copy of their letter home with them. It seems that even women who struggle with body image can practice a kinder, gentler way of thinking about their body. They just might need a framework to help guide them.”

For more than a decade, Engeln has been studying cultural factors that make it difficult for women to have healthy relationships with their bodies.

“We’ve learned enough to confidently say that it’s healthier to avoid things like idealized media images of women, social media comparisons or negative body talk, but this is the first piece of evidence we can use to make a firm recommendation about a positive step women can take toward improving body image,” Engeln said.

The letters women wrote for this study were so moving that the researchers hope to create a website where women can submit letters they write to their bodies and share them with others.

“We think this could be a fabulous way to create a source of inspiration and comfort for women who have body image struggles,” Engeln said. “Of course, we also look forward to additional research, testing how these approaches can be implemented on a broader scale, perhaps through using a smartphone app.”

 

Source: Northwestern University

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