Functional neural changes associated with psychotherapy in anxiety disorders - A meta-analysis of longitudinal fMRI studies

Schrammen E, Roesmann K, Rosenbaum D, et al.

Neuroscience and Biobehavioral Reviews. 2022 

Sep;142:104895.

Abstract 

Successful psychotherapy for anxiety disorders is thought to be linked to functional neural changes in prefrontal control areas and fear-related limbic regions. Thus, discovering such therapy-associated neural changes might point to relevant mechanisms of action. Using AES-SDM, we conducted a coordinate-based meta-analysis of 22 whole-brain datasets (n = 419 anxiety patients) from 18 studies identified by our systematic literature search following PRISMA criteria (preregistration available at OSF: https://osf.io/dgc4p). In these studies, fMRI data was collected in response to negative stimuli during cognitive-emotional tasks before and after psychotherapy. Post-psychotherapy, activation decreased in the right insula, the anterior cingulate cortex, and the dorsolateral prefrontal cortex; no region had increased activation. A subgroup analysis for CBT revealed additional decrease in the supplementary motor area. Reduced activation in limbic and frontal regions might indicate therapy-associated normalization regarding the perception of internal and external threat, subsequent allocation of cognitive resources, and changes in cognitive control. Due to the integration of diverse treatments and experimental tasks, these changes presumably reflect global effects of successful psychotherapy.

Highlights

• We conducted a coordinate-based meta-analysis of studies assessing fMRI pre- and post-therapy in anxiety disorders.

• Our results are based on whole-brain findings and include more than 50% original statistical maps.

• From pre to post, activation decreased in the insula, the anterior cingulate cortex, and the dorsolateral prefrontal cortex.

• Subgroup-analysis for CBT and exposure revealed an additional cluster of activation decrease in the supplementary motor area.

The research is here.

Fetal frontolimbic connectivity prospectively associates with aggression in toddlers

Hendrix, C. L., Ji, L.,  et al. (2022).

Biological Psychiatry Global Open Science. 

https://doi.org/10.1016/j.bpsgos.2022.09.003

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Abstract

Background

Aggression is a major public health concern that emerges early in development and lacks optimized treatment, highlighting need for improved mechanistic understanding of aggression etiology. The present study leverages fetal resting-state functional MRI (rsfMRI) to identify candidate neurocircuitry for the onset of aggressive behaviors, prior to symptom emergence.

Methods

Pregnant mothers were recruited during the third trimester of pregnancy to complete a fetal rsfMRI scan. Mothers subsequently completed the Child Behavior Checklist to assess child aggression at 3 years postpartum (N=79). Independent component analysis was used to define frontal and limbic regions of interest.

Results

Child aggression was not related to within network connectivity of subcortical limbic regions or within medial prefrontal network connectivity in fetuses. However, weaker functional coupling between the subcortical limbic network and medial prefrontal network in fetuses was prospectively associated with greater maternal-rated child aggression at 3 years of age even after controlling for maternal emotion dysregulation and toddler language ability. We observed similar, but weaker, associations between fetal frontolimbic FC and toddler internalizing symptoms.

Conclusion

Neural correlates of aggressive behavior may be detectable in utero, well before the onset of aggression symptomatology. These preliminary results highlight frontolimbic connections as potential candidate neurocircuitry that should be further investigated in relation to the unfolding of child behavior and psychiatric risk.

Discussion

In a prospective study of 79 mother-child dyads, we found that lower intrinsic functional coupling between medial prefrontal and limbic regions prior to birth was associated with greater maternal report of aggressive behavior when children reached 3 years of age. This association was specific to between network coactivation, as neither within-network connectivity of the mPFC nor within-network connectivity of the limbic network was associated with subsequent child aggression. Our results are consistent with extant fMRI studies showing links between aggressive behavior and altered frontolimbic circuitry in childhood, adolescence, and adulthood, and extend these findings to demonstrate prospective associations with frontolimbic connections measured prior to the onset of symptomatology and prior to birth.

The research is here.

Not quite Minority Report, but stunning nonetheless.

Neural processes in antecedent anxiety modulate risk-taking behavior

Nash, K., Leota, J., & Tran, A. (2021). 

Scientific Reports, 11.

Abstract

Though real-world decisions are often made in the shadow of economic uncertainties, work problems, relationship troubles, existential angst, etc., the neural processes involved in this common experience remain poorly understood. Here, we randomly assigned participants (N = 97) to either a poignant experience of forecasted economic anxiety or a no-anxiety control condition. Using electroencephalography (EEG), we then examined how source-localized, anxiety-specific neural activation modulated risky decision making and strategic behavior in the Balloon Analogue Risk Task (BART). Previous research demonstrates opposing effects of anxiety on risk-taking, leading to contrasting predictions. On the one hand, activity in the dorsomedial PFC/anterior cingulate cortex (ACC) and anterior insula, brain regions linked with anxiety and sensitivity to risk, should mediate the effect of economic anxiety on increased risk-averse decision-making. On the other hand, activation in the ventromedial PFC, a brain region important in emotion regulation and subjective valuation in decision-making, should mediate the effect of economic anxiety on increased risky decision-making. Results revealed evidence related to both predictions. Additionally, anxiety-specific activation in the dmPFC/ACC and the anterior insula were associated with disrupted learning across the task. These results shed light on the neurobiology of antecedent anxiety and risk-taking and provide potential insight into understanding how real-world anxieties can impact decision-making processes. 

Discussion

Rarely, in everyday life, must we make a series of decisions as anxious events fit in and out of awareness. Rather, we often face looming anxieties that spill over into the decisions we make. Here, we experimentally induced this real-world experience, in which we examined how antecedent anxiety and the accompanying neural processes modulated decision-making in a risk-taking task. Based on past research demonstrating that anxiety can have diverging effects on risk-taking, we formulated contrasting predictions. An anxious experience should modulate dmPFC/dACC and anterior insula activity, brain regions tightly linked with anxious worry, and this anxiety-specific activation should predict more risk-averse decisions in the BART. Alternatively, anxiety should modulate activation in the vmPFC, a brain region important in emotion regulation and decision-making and this anxiety-specific activation should then predict more risk-seeking decisions in the BART, through disrupted cognitive control or heightened sensitivity to reward.

We found evidence related to both predictions. On the one hand, right anterior insula activation specific to

antecedent anxiety predicted decreased risk-taking. This finding is consistent with considerable research on the neural mechanisms of risk and the limited prior research on incidental anxiety and decision-making. For example, the threat of shock during a decision-making task increased the anterior insula’s coding of negative evaluations and this activation predicted increased rejection rate of risky lottery decisions. For the first time, we extend these prior results to antecedent anxiety. The experience of economic anxiety is a poignant and difficult to regulate event. Presumably, right anterior insula activation caused by the economic anxiety manipulation sustained a more cautious approach to negative outcomes that trickled-down to risk-averse decision-making.

The research is here.

‘Breakthrough’ finding shows how modern humans grow more brain cells than Neanderthals

Rodrigo Pérez Ortega

Science.org

Originally posted 8 SEP 22

We humans are proud of our big brains, which are responsible for our ability to plan ahead, communicate, and create. Inside our skulls, we pack, on average, 86 billion neurons—up to three times more than those of our primate cousins. For years, researchers have tried to figure out how we manage to develop so many brain cells. Now, they’ve come a step closer: A new study shows a single amino acid change in a metabolic gene helps our brains develop more neurons than other mammals—and more than our extinct cousins, the Neanderthals.

The finding “is really a breakthrough,” says Brigitte Malgrange, a developmental neurobiologist at the University of Liège who was not involved in the study. “A single amino acid change is really, really important and gives rise to incredible consequences regarding the brain.”

What makes our brain human has been the interest of neurobiologist Wieland Huttner at the Max Planck Institute of Molecular Cell Biology and Genetics for years. In 2016, his team found that a mutation in the ARHGAP11B gene, found in humans, Neanderthals, and Denisovans but not other primates, caused more production of cells that develop into neurons. Although our brains are roughly the same size as those of Neanderthals, our brain shapes differ and we created complex technologies they never developed. So, Huttner and his team set out to find genetic differences between Neanderthals and modern humans, especially in cells that give rise to neurons of the neocortex. This region behind the forehead is the largest and most recently evolved part of our brain, where major cognitive processes happen.

The team focused on TKTL1, a gene that in modern humans has a single amino acid change—from lysine to arginine—from the version in Neanderthals and other mammals. By analyzing previously published data, researchers found that TKTL1 was mainly expressed in progenitor cells called basal radial glia, which give rise to most of the cortical neurons during development.

The info is here.

A guide to establishing ethics committees in behavioral health settings

Cox D. J. (2020). 

Behavior analysis in practice, 13(4), 939–949.

https://doi.org/10.1007/s40617-020-00455-6

Abstract

Ethical statements typically involve rules. All rules can vary in accuracy and specificity depending on the context to which they are applied. Codes of ethics often involve ethical rules that are written generally to cover the wide-ranging set of possible situations any one member of the profession may encounter. But, despite being written generally, codes of ethics are applied to specific situations that professional members encounter. The application of general rules to specific contexts can sometimes be challenging and complex. Healthcare organizations have several options to help their employees behave ethically. One approach is to appoint a single ethics coordinator (Brodhead & Higbee, 2012). In contrast, the dominant approach in most healthcare organizations is to develop an organizational ethics committee (Moon, 2009). Despite the popularity of the ethics committee in other professions, it is unknown the extent to which organizations that provide ABA services have established and operate ethics committees. Ethics coordinator roles and ethics committees each have benefits and drawbacks. This article reviews the benefits and drawbacks of appointing an ethics coordinator and establishing an ethics committee. And, for interested organizations, this article outlines the steps and considerations that organizations can use to guide the creation of an ethics committee.

Conclusion 

Codes of ethics that guide helping professionals have to be written generally to cover the wide-ranging set of possible situations any one member of the profession may encounter. Despite being written generally, ethical guidelines are applied to specific situations that professional members encounter. The application of general rules to specific contexts can sometimes be challenging and complex (e.g., Bailey & Burch, 2011; Sush & Najdowski, 2019). Healthcare organizations can take several strategies to help their employees behave ethically. One approach is to appoint a single ethics coordinator (Brodhead & Higbee, 2012). In contrast, the dominant approach in most healthcare organizations is to develop an organizational ethics committee (Moon, 2019). Despite the popularity of the ethics committee in other professions, it is unknown the extent to which organizations that provide ABA services have established and operate ethics committees. For organizations interested in establishing an ethics committee, this article provided an overview of the steps that should likely be considered.

A pdf is here.

Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations

Ogbu-Nwobodo, L., Shim, R.S., et al.

October 27, 2022

N Engl J Med 2022; 387:1613-1617

DOI: 10.1056/NEJMms2211124

Here is an excerpt:

Abortion and Mental Health

To begin with, abortion does not lead to mental health harm — a fact that has been established by data and recognized by the National Academies of Sciences, Engineering, and Medicine and the American Psychological Association The Turnaway Study, a longitudinal study that compared mental health outcomes among people who obtained an abortion with those among people denied abortion care, found that abortion denial was associated with initially higher levels of stress, anxiety, and low self-esteem than was obtaining of wanted abortion care. People who had an abortion did not have an increased risk of any mental health disorder, including depression, anxiety, suicidal ideation, post-traumatic stress disorder, or substance use disorders. Whether people obtained or were denied an abortion, those at greatest risk for adverse psychological outcomes after seeking an abortion were those with a history of mental health conditions or of child abuse or neglect and those who perceived abortion stigma (i.e., they felt others would look down on them for seeking an abortion). Furthermore, people who are highly oppressed and marginalized by society are more vulnerable to psychological distress.

There is evidence that people seeking abortion have poorer baseline mental health, on average, than people who are not seeking an abortion. However, this poorer mental health results in part from structural inequities that disproportionately expose some populations to poverty, trauma, adverse childhood experiences (including physical and sexual abuse), and intimate partner violence. People seek abortion for many reasons, including (but not limited to) timing issues, the need to focus on their other children, concern for their own physical or mental health, the desire to avoid exposing a child to a violent or abusive partner, and the lack of financial security to raise a child.

In addition, for people with a history of mental illness, pregnancy and the postpartum period are a time of high risk, with increased rates of recurrence of psychiatric symptoms and of adverse pregnancy and birth outcomes. Because of stigma and discrimination, birthing or pregnant people with serious mental illnesses or substance use disorders are more likely to be counseled by health professionals to avoid or terminate pregnancies, as highlighted by a small study of women with bipolar disorder. One study found that among women with mental health conditions, the rate of readmission to a psychiatric hospital was not elevated around the time of abortion, but there was an increased rate of hospitalization in psychiatric facilities at the time of childbirth. Data also indicate that for people with preexisting mental health conditions, mental health outcomes are poor whether they obtain an abortion or give birth.

The Role of Structural Racism

Structural racism — defined as ongoing interactions between macro-level systems and institutions that constrain the resources, opportunities, and power of marginalized racial and ethnic groups — is widely considered a fundamental cause of poor health and racial inequities, including adverse maternal health outcomes. Structural racism ensures the inequitable distribution of a broad range of health-promoting resources and opportunities that unfairly advantage White people and unfairly disadvantage historically marginalized racial and ethnic groups (e.g., education, paid leave from work, access to high-quality health care, safe neighborhoods, and affordable housing). In addition, structural racism is responsible for inequities and poor mental health outcomes among many diverse populations.

The information is here.

What Makes a Great Life?

Jon Clifton

Gallup.com

Originally posted 22 SEPT 22

While many things contribute to a great life, Gallup finds five aspects that all people have in common: their work, finances, physical health, communities, and relationships with family and friends. If you are excelling in each of these elements of wellbeing, you are highly likely to be thriving in life.

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Gallup's research as well as research by the global community of wellbeing practitioners has produced hundreds, if not thousands, of discoveries.

One of the most famous discoveries is the U-curve of happiness, which shows how age is associated with wellbeing. Young people rate their lives high, and so do older people. But middle-aged people rate their lives the lowest. This trend holds every year in almost every country in the world. It is nicknamed the "U-curve" of happiness because when you look at the graph, it looks like a "U." Some jokingly say that the chart is smiling.

Some discoveries are astonishing; others feel like they reveal a "blandly sophomoric secret," as George Gallup referred to some of his longevity findings. For example, you could argue that the U-curve of happiness simply quantifies conventional wisdom -- that people have midlife crises.

Here are a few of the discoveries that are truly compelling:

• People who love their jobs do not hate Mondays.
• Education-related debt can cause an emotional scar that remains even after you pay off the debt.
• Volunteering is not just good for the people you are helping; it is also good for you.
• Exercising is better at eliminating fatigue than prescription drugs.
• Loneliness can double your risk of dying from heart disease.

We could list every insight ever produced from this research and encourage leaders to work on all of them. Instead, we took another approach. Using all these insights from across the industry combined with our surveys and analysis, we created the five elements of wellbeing. And our ongoing global research confirms that the five elements of wellbeing are significant drivers of a great life everywhere.

The info is here.

How the Classics Changed Research Ethics

Scott Sleek

Psychological Science

Originally posted 31 AUG 22

Here is an excerpt:

Social scientists have long contended that the Common Rule was largely designed to protect participants in biomedical experiments—where scientists face the risk of inducing physical harm on subjects—but fits poorly with the other disciplines that fall within its reach.

“It’s not like the IRBs are trying to hinder research. It’s just that regulations continue to be written in the medical model without any specificity for social science research,” she explained. 

The Common Rule was updated in 2018 to ease the level of institutional review for low-risk research techniques (e.g., surveys, educational tests, interviews) that are frequent tools in social and behavioral studies. A special committee of the National Research Council (NRC), chaired by APS Past President Susan Fiske, recommended many of those modifications. Fisher was involved in the NRC committee, along with APS Fellows Richard Nisbett (University of Michigan) and Felice J. Levine (American Educational Research Association), and clinical psychologist Melissa Abraham of Harvard University. But the Common Rule reforms have yet to fully expedite much of the research, partly because the review boards remain confused about exempt categories, Fisher said.  

Interference or support? 

That regulatory confusion has generated sour sentiments toward IRBs. For decades, many social and behavioral scientists have complained that IRBs effectively impede scientific progress through arbitrary questions and objections. 

In a Perspectives on Psychological Science paper they co-authored, APS Fellows Stephen Ceci of Cornell University and Maggie Bruck of Johns Hopkins University discussed an IRB rejection of their plans for a study with 6- to 10-year-old participants. Ceci and Bruck planned to show the children videos depicting a fictional police officer engaging in suggestive questioning of a child.  

“The IRB refused to approve the proposal because it was deemed unethical to show children public servants in a negative light,” they wrote, adding that the IRB held firm on its rejection despite government funders already having approved the study protocol (Ceci & Bruck, 2009). 

Other scientists have complained the IRBs exceed their Common Rule authority by requiring review of studies that are not government funded. In 2011, psychological scientist Jin Li sued Brown University in federal court for barring her from using data she collected in a privately funded study on educational testing. Brown’s IRB objected to the fact that she paid her participants different amounts of compensation based on need. (A year later, the university settled the case with Li.) 

In addition, IRBs often hover over minor aspects of a study that have no genuine relation to participant welfare, Ceci said in an email interview.  

The article is here.

LinkedIn ran undisclosed social experiments on 20 million users for years to study job success

Kathleen Wong

USAToday.com

Originally posted 25 SEPT 22

A new study analyzing the data of over 20 million LinkedIn users over the timespan of five years reveals that our acquaintances may be more helpful in finding a new job than close friends.

Researchers behind the study say the findings will improve job mobility on the platform, but since users were unaware of their data being studied, some may find the lack of transparency concerning.  

Published this month in Science, the study was conducted by researchers from LinkedIn, Harvard Business School and the Massachusetts Institute of Technology between 2015 and 2019. Researchers ran "multiple large-scale randomized experiments" on the platform's "People You May Know" algorithm, which suggests new connections to users. 

In a practice known as A/B testing, the experiments included giving certain users an algorithm that offered different (like close or not-so-close) contact recommendations and then analyzing the new jobs that came out of those two billion new connections.

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A question of ethics

Privacy advocates told the New York Times Sunday that some of the 20 million LinkedIn users may not be happy  that their data was used without consent. That resistance is part of a longstanding  pattern of people's data being tracked and used by tech companies without their knowledge.

LinkedIn told the paper it "acted consistently" with its user agreement, privacy policy and member settings.

LinkedIn did not respond to an email sent by USA TODAY on Sunday. 

The paper reports that LinkedIn's privacy policy does state the company reserves the right to use its users' personal data.

That access can be used "to conduct research and development for our Services in order to provide you and others with a better, more intuitive and personalized experience, drive membership growth and engagement on our Services, and help connect professionals to each other and to economic opportunity." 

It can also be deployed to research trends.

The company also said it used "noninvasive" techniques for the study's research. 

Aral told USA TODAY that researchers "received no private or personally identifying data during the study and only made aggregate data available for replication purposes to ensure further privacy safeguards."

The info is here.