1. Rumination induction task in fMRI: Effects of rumination focused cognitive behavioral therapy and stability in youth.
- Author
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Westlund Schreiner M, Jacobsen AM, Farstead BW, Miller RH, Jacobs RH, Thomas LR, Bessette KL, Pazdera M, Crowell SE, Kaufman EA, Feldman DA, Roberts H, Welsh RC, Watkins ER, and Langenecker SA
- Abstract
Background: Rumination is implicated in the onset and maintenance of major depressive disorder (MDD). Rumination-Focused Cognitive Behavioral Therapy (RF-CBT) effectively targets rumination and may change resting-state brain connectivity and change in activation during a rumination induction task (RIT) post-intervention predicts depressive symptoms two years later. We examined brain activation changes during an RIT in adolescents with remitted MDD following RF-CBT and evaluated RIT reliability (or stability) during treatment as usual (TAU)., Method: Fifty-five adolescents ages 14-17 completed an RIT at baseline, were randomized to 10-14 sessions of RF-CBT (n = 30) or treatment as usual (n = 25) and completed an RIT at post-treatment or equivalent time delay. The RIT includes recalling negative memories (Rumination Instruction), dwelling on their meaning/consequences (Rumination Prompt), and imagining unrelated scenes and objects (Distraction). We assessed activation change in the RF-CBT group using paired-samples t-tests. We assessed reliability (or stability) via intraclass correlation coefficients (ICCs) of five rumination-related ROIs for TAU and RF-CBT separately across task blocks., Results: Following treatment, participants receiving RF-CBT demonstrated increased activation of left precuneus during Rumination Instruction and of left angular and superior temporal gyri during Rumination Prompt blocks (p < .01). From baseline to post-treatment, across most ROIs and task blocks, the RF-CBT group demonstrated poor stability (M = 0.21, range = -0.19-0.69), while the TAU group demonstrated fair-to-excellent stability (M = 0.52, range = 0.27-0.86)., Conclusion: RF-CBT changes activation of rumination-related circuitry during state-induced rumination, offering exciting avenues for future interventions. The RIT has fair-to-excellent stability among individuals not explicitly treated for rumination, and as expected, RIT stability is disrupted by RF-CBT., Competing Interests: Declaration of competing interest This research was funded by the National Institutes of Mental Health (NIMH; R61MH118060/R33MH118060) awarded to Drs. Scott Langenecker and Edward Watkins. The authors have no financial conflicts of interest. This study was approved by the Institutional Review Board at the University of Utah., (Copyright © 2024 Elsevier B.V. All rights reserved.)
- Published
- 2024
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