Slides and other information from the 2016 SIG Pre-Conference Institute are available here.
ABCT 2014: Conference Highlights
Thursday, Nov 20th, 1:00 – 6:00
Institute 7: Neurocognitive and Translational Interventions
Location: Room 305/306 (Level 3)
Presenters: Greg Siegle, Kristen Ellard, Christen Deveney, Jan Mohlman, Tracy Dennis, Rudi De Raedt, Natasha Hansen
This Institute will be a soup-to-nuts introduction to the emerging field of neurocognitive/translational interventions, including (a) the use of cognitive testing and biomarkers to understand individual differences in targetable mechanisms of psychological disorders; (b) the use of interventions that target neural mechanisms, which include behavioral, cognitive, neural stimulation, and neurofeedback approaches; (c) considerations involved in implementing these techniques in real-world clinical practices involving standards, affordable technologies, and how to evaluate evidence in light of a specific case presentation. The material will be a series of introductory talks to bring everyone up to speed on current technologies and perspectives on neurocognitive and translational interventions followed by hands-on demonstrations of actual neurocognitive interventions (full speaker and presenter list at http://www.neurocognitive-therapies.com/events.html). There will be a closing discussion and time to discuss the use of neurocognitive interventions in your lab/practice with the speakers. All presenters will emphasize the manner in which multidisciplinary, translational approaches can be applied to advance clinical care. This Institute will highlight, via neurocognitive interventions, ways in which clinical, treatment-oriented research and fields such as neuroscience, psychophysiology, and cognitive science can synergistically inform one another.
Friday, Nov 21 - 8:45am
SESSION LOCATION: Franklin Hall 9 (Level 4)
Symposium Title:New Directions in Implicit Associations Research in Psychopathology
A. J. Werntz; B. A. Teachman; E. Koster; A. J. Werntz; S. A. Steinman; J. J. Glenn; M. Nock; B. A. Teachman; J. J. Glenn; S. A. Steinman; A. J. Werntz; S. Slama; B. A. Teachman; M. Nock; A. R. Smith; E. M. Clerkin; D. R. Dodd; L. M. Fussner; K. P. Lindgren; M. L. Gasser; C. Neighbors; P. de Jong; H. Elgersma; K. Glashouwer; C. Bockting
Exciting advances in researchers’ ability to measure relatively automatic, biased cognitive processing, such as measures of implicit associations that assess attitudes that reside outside of conscious control, have enabled the field to ask novel questions about the role of implicit cognition in mental health. Previous research in the lab has established that implicit mental health associations relate to psychopathology symptoms across multiple disorders, including anxiety, depression, and alcohol use. More recently, researchers have extended the use of implicit cognition tools to large-scale, web-based studies and longitudinal prediction of change in psychopathology. Moreover, implicit cognition tools are now being used to examine automatic processing in domains central to psychopathology that do not fit traditional diagnostic categories, such as suicide and non-suicidal self-injury.In this symposium, we will present cutting-edge implicit cognition research that highlights how a better understanding of implicit associations across multiple mental health domains can inform both theories of psychopathology as well as clinical assessment. First, Alexandra Werntz will discuss findings from a largescale demonstration website, characterizing mental health associations relating to four disorder domains (alcohol use, anxiety, depression, eating disorders) in large, diverse samples. Next, Jeffrey Glenn will report findings related to implicit associations in suicide and non-suicidal self-injury, showing that these associations are even sensitive to recency of suicide attempt/self-injury. April Smith will then discuss the link between pain tolerance and implicit exercise associations, and their relevance to suicidal behaviors. Kristen Lindgren will present on the utility of the Drinking Identity IAT, including how and when it can predict drinking behaviors. Finally, Peter de Jong will report findings from a longitudinal study examining the predictive validity of negative-self implicit associations on the development of depression. Ernst Koster will then serve as Discussant for these talks, integrating the findings and illustrating how implicit association measures may allow us to better understand the onset, maintenance, and treatment of psychopathology.
Friday, Nov 21 - 8:30 AM – 9:30 AM
SESSION LOCATION: Liberty C (Level 3)
Symposium Title: Integrating Neurofeedback with CBT for Posttraumatic Stress Disorder
Presenters: Kate Nooner, Celeste De Bease, Laurence Hirshberg, Ruth Lanius,, Carmen P. McLean, Carmen Russoniell
Posttraumatic stress disorder (PTSD) is a persistent illness with more long-term sequelae than many other mental health problems. Few have assessed the combined effects of bio-behavioral and cognitive-behavioral treatments for PTSD. Neurofeedback (i.e., EEG biofeedback) is a type of operant conditioning in which an individual is reinforced when he or she has certain brain activity as measured by EEG. Neurofeedback (NFB) is one of the potentially efficacious non-pharmacological treatment options for PTSD, particularly when used in combination with cognitive-behavioral treatment (CBT). NFB acts directly on the specific brain activity that may be altered in PTSD, therein improving receptivity to CBT. NFB and CBT are medication free and thus remove concerns related to medication side effects and misuse. Combining NFB and CBT holds special interest for those with dual diagnosis. PTSD is associated with high rates of comorbidity, including substance-related disorders in adults and attention-deficit/hyperactivity disorder in children; NFB has also shown promise in treating these comorbid disorders. By serving as a low-risk, medication-free alternative, NFB is an option worthy of further exploration for those in need of an adjunctive strategy to use with CBT.
In this panel discussion, we explore approaches that integrate evidence-based CBT with NFB for children and adults with PTSD. This panel is comprised of diverse experts, including advocates and skeptics of NFB. The panel is drawn from rigorous clinical and academic research backgrounds. The range of knowledge on the panel includes: board certified EEG biofeedback, prolonged exposure therapy, trauma-focused CBT, dissemination, and special populations including veterans and children. Topics include natural entry points for integrating neurofeedback with CBT, as well as NFB as a tool for decreasing barriers to CBT. Challenges associated with providing evidence-based CBT and NFB in community settings as well as critical research needs will also be addressed. Integrating CBT and NFB has the potential to fill important treatment needs for many living with PTSD. This will be a multifaceted discussion, including vigorous debate of the strengths and weaknesses of linking these PTSD treatment approaches.
Friday, Nov. 21st- 12:15pm
Title: Cognitive Bias Modification: Advancing Clinical Science and Practice
Location: Franklin Hall 8
Speakers include: Shari A. Steinman, Lauren S. Hallion, Jessica R. Beadel, and E. Marie Parsons. The discussant is David F. Tolin.
The growing field of Cognitive Bias Modification (CBM) has two primary goals: 1) to test the causal claim in cognitive models of psychopathology, which posits that biases in the way individuals process information maintain and cause emotional disorders, and 2) to develop novel ways of treating psychopathology via brief computerized programs that shift cognitive bias. In the past few years, interest in CBM has skyrocketed, given its success at deepening our theoretical understanding of psychopathology, and its potential to provide the field with novel, efficacious treatments for psychopathology. In this symposium, we present the latest findings related to CBM, with a focus on how CBM can most effectively advance clinical science and practice.
First, Shari Steinman will introduce the audience to the field of CBM, and present data suggesting that CBM can reduce height phobia symptoms as effectively as therapist-directed exposure therapy. Next, two talks will evaluate the role of targeting specific beliefs and fear domains in CBM. Jessica Beadel will discuss novel findings that test the importance of fear domain match (the extent to which content of CBM matches the specific anxiety symptoms of the participant) on CBM. Following this, Marie Parsons will present data from a CBM intervention designed to shift a specific obsessive-compulsive (OC) related belief, rather than a broad range of OC-related beliefs. Next, Lauren Hallion will present data demonstrating the role of working memory and inhibition in ability to control thoughts. Her findings highlight promising targets of future CBM research, and provide a richer understanding of mechanisms underlying cognitive bias. Finally, David Tolin will serve as discussant, and consider how these novel findings advance theory and treatment of anxiety and OC-disorders, and discuss future directions for the field.
Friday 6:30-8:30pm--SIG Poster Expo/Cocktail Party
Saturday 9:30am—Neurocognitive Therapies/Translational Research SIG meeting
Featuring guest speaker, Sabine Wilhelm, Ph.D., starting at 9:30am
Title: Assessing and Modifying Anxiety Disorder-Related Attention and Interpretive Biases in Adults
Location: Franklin Hall 9 (Level 4)
A Srivastav M Dryman RG Heimberg L Tahara-Eckle AA Jendrusina D Skubic PM Enock DJ Robinaugh SG Hofmann H Braham RJ McNally
Psychopathology research is undergoing a shift, with increased emphasis placed upon implicit measurement procedures that aim to assess thoughts and processes that are automatic and putatively not adequately assessed via self-report. These implicit measurement procedures address dysfunctional attention, and interpretive and emotional biases that are implicated in the etiology and maintenance of disorders (De Houwer et al., 2009). In line with Beck’s cognitive approach to psychopathology (e.g., Beck & Clark, 1997), implicit tests have demonstrated expected cognitive biases in both clinical and non-clinical populations across a range of psychological disorders (Roefs et al., 2011). In addition to aiding the examination of cognitive biases, research is now focusing on developing cognitive tasks that can implicitly manipulate attention and interpretive biases to reduce anxiety (Bar-Haim et al., 2007) and promote enhanced emotional regulation (Mathews and Mackintosh, 2000). Although studies show mixed results (Hallion & Ruscio, 2011), the attention bias modification (ABM) and cognitive bias modification (CBM) training programs show potential as novel treatments to target automatic anxiety-related cognitive biases (Bar-Haim, 2010). The present symposium features talks that assess anxiety-related cognitivebiases and efforts at re-training.
Presentation time: Sunday, 10:15am
Session Location: Liberty A (Level 3)
Symposium Title: Advancing the Goals of Personalized Medicine in Mental Health: How Outcome Research and Moderators can Inform Treatment Selection
R. J. DeRubeis; Z. D. Cohen; Y. K. Ashar; S. Hollon; R. J. DeRubeis; S. Dimidjian; H. J. Dour; Z. D. Cohen; B. Mesri; J. W. Wiley; A. N. Niles; R. J. DeRubeis; M. Craske; S. Wiltsey Stirman; Z. D. Cohen; A. Kapelner; J. Bleich; B. Smith; R. J. DeRubeis; P. A. Resick; M. Huibers; Z. D. Cohen; L. Lemmons; A. Arntz; F. Peeters; R. J. DeRubeis; M. Craske; Z. D. Cohen
When two or more interventions are known to be generally effective in treating a patient’s condition, it is important to identify the best option for that patient. Insofar as patient characteristics predict differential response to the interventions, patient outcomes can be optimized by the intelligent use of such information. Although there are many potential predictors to be found in the literature, the field lacks analytic strategies that can transform prediction findings into feasible, outcome-enhancing recommendations.
We draw data from five unique studies to demonstrate how prognostic and prescriptive variables can be used to further the goals of personalized medicine. All four speakers will use data from randomized trials to illustrate how a novel treatment selection approach can be used to assign treatment in such a way as to enhance overall outcomes. The first presenter will introduce the treatment selection approach, called the Personalized Advantage Index (PAI), and will show how it can be used to help patients with major depressive disorder (MDD) decide between Behavioral Activation and Antidepressant Medication. The second presentation will apply the approach in two studies comparing Acceptance and Commitment Therapy to Cognitive Therapy in the treatment of anxiety disorders. The third presentation will focus on how the approach can be used in the treatment of post-traumatic stress disorder, using data from a randomized comparison of Cognitive Processing Therapy vs. Prolonged Exposure. The final presenter will illustrate how the treatment selection approach can be improved through the application of machine learning, and will draw data from a large randomized comparison of Cognitive Therapy vs. Interpersonal Therapy for the treatment of MDD. The discussant will review these diverse applications and will lead a conversation about the implications of these findings for treatment and the realization of personalized medicine in mental health.
ABCT 2013: Notable Symposia
Thursday, Nov 21st, 1:00 – 6:00
Institute 9: Neurocognitive and Translational Interventions
Greg Siegle, University of Pittsburgh
Rudi De Raedt, Ghent University
Rebecca Price, University of Pittsburgh
Thilo Deckersbach, Harvard University
This Institute will be a soup-to-nuts introduction to the emerging field of neurocognitive/translational interventions, including (a) the use of cognitive testing and biomarkers to understand individual differences in targetable mechanisms of psychological disorders, (b) the use of interventions that target neural mechanisms, which include behavioral, cognitive, neural stimulation, and neurofeedback approaches, (c) considerations involved in implementing these techniques in real-world clinical practices, and (d) considerations on dissemination of novel neurocognitive/translational interventions. The material will be a mix of hands-on demonstrations, how-to guides, data presentations, and talks. All presenters will emphasize the manner in which multidisciplinary, translational approaches can be applied to advance clinical care. This Institute will highlight, via neurocognitive interventions, ways in which clinical, treatment-oriented research and fields such as neuroscience, psychophysiology, and cognitive science, can synergistically inform one another.
You will learn:
Techniques useful for assessing individual differences in cognitive and neural mechanisms of psychological disorder
Nonpharmacological techniques for targeting specific cognitive and neural mechanisms
How to think about doing research on, and disseminating, novel neurocognitive interventions
Bar-Haim, Y. (2010). Research review: Attention bias modification (ABM): A novel treatment for anxiety disorders. Journal of Child Psychology and Psychiatry, 51, 859-870.
Floel, A., & Cohen, L.G. (2006). Translational studies in neurorehabilitation: From bench to bedside. Cognitive and Behavioral Neurology, 19, 1-10.
Siegle, G.J., Ghinassi, F., & Thase, M.E. (2007). Neurobehavioral therapies in the 21st century: Summary of an emerging field and an extended example of Cognitive Control Training for depression. Cognitive Therapy & Research, 31, 235-262.
Friday 9-10:30am—Neurocognitive Therapies/Translational Research SIG meeting
Friday 6:30-8:30pm--SIG poster expo/cocktail party
Fri, Nov 22 - 3:30 PM
Symposium Title: Brain Matters! Application of Novel Translational Research Findings to Anxiety and Depression
Chairs: Amanda Calkins, M.A., & Angela Fang, M.A.
Discussant: Thilo Deckersbach, Ph.D.
The National Institutes of Health (NIH) recently defined translational research as the following: “Translational research…is the process of applying discoveries generated during research in the laboratory, and in preclinical studies, to the development of trials and studies in humans.” (NIH, 2005). Therefore, translational research offers a biologically-based, cross-disciplinary approach to investigating core aspects of psychopathology, which may ultimately inform treatment. Recent research attention has focused on developing and testing neuroscience-guided treatment strategies that target specific neural circuitry through medications or behavioral interventions. The authors in this symposium will describe several such novel biological strategies in their application to depression and anxiety disorders. These approaches offer the promise of improved efficacy and potential for combination therapies. Each author will describe: the disorder-relevant underlying neurobiological correlates, how they integrated a neurobiological intervention with cognitive-behavioral treatments/assessments and the proposed mechanisms of symptom change.
First, Moshier and Otto will present data from a randomized trial examining a neurobehavioral intervention (Cognitive Control Training; CCT) as an adjunct to a four-week brief behavioral activation therapy for depressed outpatients (BATD). Second, Gutner and colleagues will discuss the effect of d-cycloserine, a cognitive enhancing pharmacological agent, and a subliminal cue exposure paradigm on ratings of fear and disgust for spider-fearful individuals. Third, Fang and Hofmann will describe the effect of oxytocin, a neuromodulating hormone nasal spray, on pro-social behavior and attentional processes in patients with generalized social phobia. Finally, Price and colleagues will present data on the acute effects of ketamine, a glutamate antagonist, on implicit and explicit suicidality in depressed patients.
Our discussant, Thilo Deckersbach, will highlight these findings by providing insights into the neuroscience of symptom change during these neurobiological approaches as well as the impact on cognitive-behavioral treatments/assessments. Common mechanisms across depression and anxiety will also be discussed. Taken together, these data contribute to expanding CBT principles of symptom change via neurobiological mechanisms.
Fri, Nov 22 - 2:30 PM
Symposium Title: Cognitive Bias Modification for Treatment of Anxiety Disorders: Big Picture Considerations for Implementation in the Clinical Setting
Debra Hope, University of Nebraska-Lincoln Michelle Capozzoli, University of Nebraska-Lincoln
Panelists: Nader Amir, UCSD/SDSU Yair Bar-Haim, Tel Aviv University Courtney Beard, Harvard University/McLean Hospital Bethany Teachman, University of Virginia Willem Van der Does, Leiden University Numerous past ABCT symposia have presented findings from individual research studies suggesting that cognitive bias modification (CBM), implicit attention and interpretation training administered through computerized programs, can produce clinically significant reductions in anxiety symptoms. Missing from these structured presentations is the larger perspective regarding the reliability, strength and generalizability of CBM effects. Although the popular press is touting the early successful findings of CBM interventions, panelists will critically consider what it takes to implement CBM in clinical practice. Potential benefits and caveats of therapeutic use of CBM will be addressed, as well as limitations in our understanding of CBM, including varying viewpoints on its efficacy and mechanisms of action. Relevant theories, such as disengagement and attentional control, will be discussed in the context of these programs. Panelists will describe the characteristics of those who have responded best to these interventions and how CBM may supplement traditional treatment packages.
Background on CBM: CBM interventions have been developed in response to the base of research demonstrating that individuals with anxiety disorders exhibit attention biases toward threat (for a review, see Bar-Haim et al., 2007), and tend to interpret ambiguous information in a threatening way (e.g., Mathews et al., 1997). Attention bias modification aims to implicitly train participants to guide attention away from threatening information, thus reducing anxiety symptoms. Similarly, interpretation bias modification implicitly guides participants to interpret ambiguous information in a non-threatening way. Compared to those completing control programs, individuals who have completed active CBM programs have demonstrated greater clinician-rated and self-reported reductions in anxiety symptoms and impairment as well as better overall response to behavioral tasks (e.g., Amir et al., 2008). Few studies have begun to implement CBM outside of the research laboratory on home computers or handheld devices (e.g., Amir & Taylor, 2011).
Sat, Nov 23 - 8:45 AM
Symposium Title: Dimensional Constructs and Neural Correlates of CBT Treatment Outcome in Anxiety Disorders Authors: S. Bruce1, 2; W. J. Brown1; S. E. Bruce1, 2; K. R. Buchholz1; L. Yan2; T. Durbin2; Y. I. Sheline2; K. R. Buchholz1; S. Bruce1, 2; L. Yan2; E. M. Koucky1; T. Artime1; W. J. Brown1; T. Durbin2; Y. I. Sheline2; G. J. Siegle3; S. Graur3; R. Price3; C. D. Ladouceur3; J. Silk3; N. D. Ryan3; T. Deckersbach4; S. Bruce1, 2; K. R. Buchholz1; W. J. Brown1; L. Yan2; Y. I. Sheline2
The purpose of this symposium is to present research on the neural correlates of the dimensional constructs of anxiety disorders. Recently, one of NIMH’s strategic plans (RDoC) calls for further research to classify psychopathology based on dimensions of observable behavior and neurobiological measures (e.g. fear circuitry), in order to integrate the development of new and/or optimally matched treatments for mental disorders. This symposium will focus on specific underlying dimensions (e.g. rumination, affectivity, vigilance) of anxiety disorders as well discuss recent CBT treatment outcome findings with respect to the neural correlates of effective treatment.
The first presentation will present findings on features of positive (PA) and negative affectivity (NA) at neural levels among women with PTSD. It is hypothesized that there is an association between affectivity and brain activation in areas thought responsible for emotion regulation in trauma survivors. Results suggest that NA is associated with activation in the dorsal anterior cingulate and insula, while PA was found to be associated with activation in the ventral anterior cingulate, the dorsolateral prefrontal cortex, and negatively associated with the amygdala.
he second presentation reports on the relationship between BOLD signals of the amygdala, sgACC, and dlPFC and self-reported rumination scores in women with PTSD using an emotional conflict task. Results suggest that self-reported rumination is significantly associated with BOLD signals in the amygdala and the sgACC when participants were asked to ignored fearful faces as compared to ignoring neutral faces in an emotional conflict task. A significant relationship between BOLD signals in the dlPFC and rumination scores was also observed in conditions in which participants attended to fearful faces as compared to attending neutral faces.
The third presentation will focus on the presence of vigilance and threat and its remediation in youth with anxiety before and after CBT using psychophysiology and functional magnetic resonance imaging. In pre-treatment assessments, both fMRI and psychophysiological data revealed variability across anxious youth such that there was no aggregate bias in any of eye-tracking, pupil dilation, or limbic or prefrontal reactivity revealed using fMRI. Following treatment, sustained limbic reactions increased in the anxious youth, suggesting an aggregate decrease in sustained regulatory control, possibly consistent with decreased avoidance. However, the initially observed variability moderated treatment-associated change in fMRI and psychophysiological activity such that many individuals appeared to normalize in their reactivity. This may suggest that change in CBT for youth anxiety is a function of initial presentation.
Finally, the fourth presentation will present data on the neural correlates of PTSD symptom reduction in individuals with PTSD. Specifically, biomarkers of PTSD as well as treatment outcome of cognitive processing therapy using neuroimaging techniques will be discussed in a sample of 19 women. Results indicate significant reductions in neural activity in response to an emotional conflict paradigm, including reductions in amygdala and insula activity, as well as reductions in the anterior cingulate cortex. Specific implications from this as well as the other three presentations will be discussed.
Sat, Nov 23 - 10:15 AM
TITLE: Neurobehavioral facets of emotion regulation in normative, disordered, and treatment contexts
Although the cognitive behavioral therapies (CBT) have accumulated the most empirical evidence of any psychosocial treatment in terms of clinical efficacy, elucidating the mechanisms by which they provide their acute and enduring treatment benefits has been more difficult to delineate. The search for mechanisms is more than an intellectual exercise. Rather, understanding the bases for how treatments like CBT provide their efficacy will likely result in larger effect sizes, and may reveal insights into how best to tailor our treatments to increase the range into subgroups of individuals who have yet to enjoy the clinical benefits. One potentially fruitful avenue of investigation derives from the disciplines of cognitive and affective neuroscience, which offer a wealth of basic research findings at many levels of analysis (e.g., genetic, neurobiological, physiological, behavioral) to improve our understanding of adaptive functioning and the ways in which normal functioning becomes disrupted in various emotional disorders. Thus, in direct response to the theme of this year’s conference to “harness the synergy of multidisciplinary sciences” and with the sincere desire to provide insight into improving the efficacy of our treatments, the papers herein are unified by a focus on integrating findings from cognitive and affective neuroscience into traditional CBT frameworks with the goal of elucidating bio-behavioral mechanisms of behavior change that may hold the promise of enhancing and advancing the signal and range of CBT. In particular, all the papers assembled examine neurobehavioral facets of emotion regulation in normative, disordered, and treatment contexts. First, Shepherd and colleagues present fMRI data examining the temporal course of neural activation (e.g., right ventrolateral prefrontal cortex) associated with intentional (deliberate) and incidental (automatic) emotion regulation processes in response to a disgust challenge. Second, Ellard and colleagues examine the temporal course of neural activations associated with instructions to worry, accept, or suppress emotional reactions in response to self-relevant worry statements among individuals with GAD. Third, Vago and colleagues examine the neural signatures associated discrete meditative practices among accomplished meditators. Fourth, in a sample of social anxiety disorder patients undergoing treatment with CBT, Gross and Goldin report findings indicating that clinical improvement was associated with changes neural circuitry associated with effective cognitive reappraisal (e.g., increases in dorsolateral and dorsomedial prefrontal cortex; greater dorsomedial prefrontal cortex-amygdala inverse functional connectivity). Finally, noted basic, translational, and treatment researcher, Michelle Craske will serve as discussant and contextualize the implications of the current studies in terms of providing synergy between CBT and neuroscience. Taken together, the scholars assembled in proposed symposium offer a glimpse into what can be gained from the synergy of multidisciplinary sciences.
Sat, Nov 23 - 3:30 PM
Symposium Title: Elucidating the mechanisms and moderators of meditation enriched treatments at the confluence of CBT, affective science, and contemplative practice
The infusion of meditation practices into traditional cognitive behavior therapies (CBTs) has made an indelible and far reaching mark on our field. Many meditation-enriched CBTs have emerged in the last fifteen years with impressive clinical efficacy (e.g., Hofmann, Sawyer, Witt, & Oh, 2010). Now that meditation has achieved mainstream status within traditional CBT, improving our understanding of the mechanisms by which it works, and refining the practices to achieve greater clinical impact has become a central focus. One promising avenue of inquiry is to draw upon basic and translational findings from cognitive and affective neuroscience, which provides a useful framework to advance our understanding of human capacities enhanced by meditation and interventions enriched with meditation. Our papers, while using a variety of methodologies, and drawing from diverse normative and patient samples, all converge on some important conclusions regarding the benefits and limitations of interventions enriched with meditation practices. First, Kathrine Shepherd reports on the development and validation of two objective behavioral tasks that assess decentering, the metacognitive process of viewing emotions and thoughts as temporary internal events, which has shown relevance to recovery and treatment durability in meditation-enriched treatments. Second, Kristen Ellard will present fMRI findings examining the functional neural pathways associated with instructions to observe accept emotional reactions versus worry in response to personally-relevant worry statements in GAD. Third, Joanna Arch will present findings demonstrating the salutary effects of self-compassion meditation on the physiological stress response in relation to a Trier challenge. Our final two papers report findings on recent clinical trials of mindfulness-based cognitive therapy (MBCT) in patients with a history of major depressive disorder. Specifically, Sean Barnes finds that patients receiving MBCT as compared to a waitlist control comparator evidence greater reductions in an objective measure of cognitive reactivity (e.g., reactivation of depressive beliefs following a sad mood induction). Fifth, Mark Lau presents results of a three arm RCT comparing MBCT, group relaxation training, and a waitlist control. Findings indicated that MBCT produced significantly greater reductions in cognitive reactivity and commensurate gains in state and trait mindfulness and self-compassion. Finally, we are fortunate to have Zindel Segal, noted depression and mindfulness researcher to serve as our discussant.
Symposium Title: Neural Mechanisms of Attention Bias and Attention Bias Modification: Cognitive Neuroscience Meets Cognitive-Behavioral Theory
Authors: R. Price; J. Silk; G. J. Siegle; C. D. Ladouceur; A. McFarland; R. E. Dahl, 1; N. D. Ryan; K. Perez-Edgar; B. Taber-Thomas; J. Hardee; N. Fox; D. S. Pine; M. Browning; M. Charles; P. Cowen; E. Holmes; C. Harmer; G. J. Siegle; N. Amir; K. E. Frosio; J. Boffa; J. M. Kuckertz; M. V. Strege
Selective attention towards negative information (or ‘attention bias’) was first described decades ago as a critical maintaining factor in Beck’s cognitive models of anxiety and depression (e.g., Beck, Emery, & Greenberg, 1985). Contemporary cognitive-behavioral models of anxiety and depression propose that attention bias is not merely a by-product of emotional distress, but actively contributes to the development and/or maintenance of disorders by promoting hyper-awareness of negative information and reinforcing maladaptive beliefs. Attention bias is therefore an explicit target of many first-line cognitive-behavioral treatments.
Subsequent research employing methodologies drawn from the field of cognitive science (e.g., reaction time and eyetracking measures of attention) has confirmed that theorized attention biases are observable in both pediatric and adult samples. More recently, techniques drawn from neuroscience and neurobiology have begun to be applied to further explicate the neural mechanisms underlying these behavioral effects. The promise of this multidisciplinary work, grounded in seminal cognitive-behavioral theory, is that it will not only improve our understanding of psychopathology, but also point the way to novel treatment strategies. Attention bias modification (ABM), a computer-based intervention designed to reverse attention bias through repetitive attention re-training, is one such example of a novel strategy that has shown initial promise. Understanding the neural mechanisms underlying 1) attention bias and 2) ABM’s promising effects can provide further opportunities to refine, synergistically combine, and/or personalize intervention approaches.
The authors in this symposium will describe findings pertinent to neural mechanisms of attention bias and ABM, across pediatric and adult anxiety and depression. First, Price et al. will describe an fMRI study of neural mechanisms of the dot-probe task, a widely used attention bias measure, in 90 anxious and 31 non-anxious youth. Findings suggest clinical status and behavioral effects are related to both cognitive and emotional/affective processing following attention manipulation. Next, Perez-Edgar et al. will describe findings from a longitudinal cohort that reveal interactions between behaviorally inhibited temperament, fronto-limbic activity patterns during the dot-probe task, and development of internalizing problems in young adulthood. Third, Amir et al. will discuss the application of principles of learning to improve the design and efficacy of ABM, and describe neural mechanisms of ABM revealed via experimental brain stimulation. Finally, Browning et al. will present data on the protective effects of ABM in previously depressed patients and share insights on ABM’s neural mechanisms gleaned from two neuroimaging studies in non-clinical participants.
As discussant Greg Siegle will underscore, this field of inquiry exemplifies the productive fusion that occurs when CBT theory is used in concert with emerging techniques drawn from neuroscience and cognitive science. Findings across the lifespan highlight novel opportunities to intervene mechanistically in individuals at-risk for, currently suffering from, and previously recovered from psychological disorders.
ABCT 2011: Notable Symposia
Highlights from ABCT 2011: Summaries from a Sampling of NT/TR Related Presentations
Psychophysiology, Neuroimaging, and Neuropsychology for the Clinic: How Close Are We? T. Deckersbach; C. Deveney; J. Mohlman; G. J. Siegle; A. Weissman
This symposium included a discussion of neuroimaging, psychophysiological, and neuropsychological techniques and how they may inform treatment decisions. It also explained how these measures may be used to understand mechanisms, improve clinical decision making, and augment treatments for mental illness. Dr. Deveney introduced the available techniques and reviewed the current research base in predicting and understanding clinical phenomenology and change. Drs. Deckersbach and Siegle discussed how psychological treatments might change if neuroimaging and biological measures were incorporated. Drs. Mohlman and Weissman addressed how these techniques can be useful when considering treatment options for special populations such as children and the elderly, including modifications of treatment protocols or aiding differential diagnoses when clinical presentations are similar. This panel was sponsored by the Neurocognitive Therapies/Translational Research SIG.
New Developments in Neurocognitive Enhancement: Novel Treatment Strategies and Challenges Across Mental Disorders C. Bowie; C. Bowie; M. Gupta; T. Deckersbach; W. Spaulding; J. Choi; J. Fiszdon; A. T. Peters; A. M. Rodman; A. D. Peckham; S. Ghaznavi; A. Nierenberg
This symposium reviewed therapies targeting cognitive remediation in psychological disorders. First, the panel discussed demographic, symptom, and cognitive variables that have been found to predict response to cognitive remediation in schizophrenia. These predictors were validated in a new sample of patients with schizophrenia who underwent a 2-month cognitive remediation program. Next, a cognitive remediation treatment for individuals with bipolar disorder with occupational impairment was discussed. This treatment was effective in improving work functioning, executive functioning, and overall psychosocial functioning. Third, a neurocognitive enhancement program for treatment-resistent major depressive disorder involving group treatment with computerized homework sessions was discussed. This treatment found that patients randomized to the cognitive remediation condition exhibited improvements in verbal memory, verbal working memory, executive functions, and information processing speed, as well as in symptoms of depression and anxiety. Fourth, a cognitive remediation program for Alzheimer’s disease was discussed that was designed to increase adherence to treatment by enhancing motivation and empowering patients to be actively involved in treatment, which was found to be superior to a standard memory training condition. Finally, cognitive treatments for early-onset schizophrenia were discussed and were found to be more substantial when implemented early.
CBT for Anxiety Disorders: Utilization of Neuroimaging as a Treatment Outcome Assessment Tool S. E. Bruce; S. E. Bruce; R. J. McNally; D. McMakin; J. Silk; A. McFarland; C. Ladouceur; E. Forbes; N. D. Ryan; R. E. Dahl; G. J. Siegle; S. G. Hofmann; O. Doehrmann; S. Ghosh; F. Polli; G. Reynolds; S. Whitfield-Gabrieli; M. H. Pollack; J. Gabrieli; R. Aupperle; H. Ramsawh; T. Flagan; S. Sullivan; G. Fonzo; A. N. Simmons; M. P. Paulus; M. B. Stein; C. Fales; K. R. Buchholz; W. J. Brown; L. Yan; A. Durbin; Y. Sheline
This symposium reported findings from studies using neuroimaging in anxiety disorders. The first presentation discussed research that found that positive affect is decreased in youth with anxiety disorders, and that CBT improved positive affect and was associated with increased connectivity with regions associated with affect regulation and self-processing. The second presentation reported that including neuroimaging of regions of the extra-striate visual cortex along with social anxiety symptoms improved prediction of response to CBT for social anxiety beyond the effects of initial symptoms. The third presentation discussed findings that activation within the medial PFC for negative affect-positive affect predicted better treatment response to CBT for social anxiety, whereas greater activation within the right posterior insula for negative affect-positive affect predicted poorer treatment response to CBT for generalized anxiety disorder. Finally, the fourth presentation reported that significant changes in brain activation associated with emotion and cognitive control in response to an emotional conflict paradigm were found after completion of cognitive processing therapy for PTSD.
Psychological Treatment and Assessment of Bipolar Disorder in Children and Adults: Effective Translation From Research to Clinical Practice S. H. Jones; E. A. Youngstrom; G. Perez Algorta; A. Van Meter; A. Freeman; M. Jenkins; O. Meyers; J. Calabrese; R. Findling; D. Miklowitz; K. Chang; L. Fiona; R. Morriss; S. H. Jones; E. Michalak; G. Murray; S. H. Jones; S. Higginson; L. Mulligan; S. Gina; M. Welford; T. Morrison; S. Hollon
From Cortex to Context: New Strategies and Refined Targets in the Interventions of Mood Disorders A. W. Calkins; T. Deckersbach; M. W. Otto; T. Deckersbach; A. Duffy; T. Chou; A. M. Rodman; A. Hay; J. Martowski; A. T. Peters; A. H. Ariel; A. D. Peckham; A. Nierenberg; C. M. D'Avanzato; J. Joormann; A. W. Calkins; G. J. Siegle; M. W. Otto; J. Mohlman; A. Collier; G. J. Siegle
Implicit Cognition in Anxiety Disorders: Development Maintenance and Treatment A. J. Ouimet; A. S. Radomsky; R. de Raedt; K. A. Glashouwer; P. J. de Jong; S. A. Steinman; B. A. Teachman; F. L. Smyth; A. J. Ouimet; K. C. Barber; A. S. Radomsky; J. M. Kuckertz; C. Prouvost; S. Najmi; N. Amir; A. K. Raes; E. W. Koster
Beyond Attention Bias: Understanding the Role of Attentional Mechanisms in the Development and Treatment of Anxiety in Youth A. S. Morrison; R. G. Heimberg; M. Coles; A. S. Morrison; R. G. Heimberg; L. Steinberg; A. P. Field; S. S. Rohani; S. Hutton; M. Reinholdt-Dunne; K. Mogg; S. A. Vangkilde; B. P. Bradley; B. H. Esbjørn; C. J. Lonigan; B. M. Phillips
Cognitive Bias Modification: Dissemination and Expansion to New Populations C. Beard; C. Beard; R. B. Weisberg; N. Amir; C. A. Schofield; E. Clerkin; H. Boettcher; A. Perry; P. M. Enock; S. G. Hofmann; R. J. McNally; B. Riemann; N. Amir; P. M. Lake; N. Amir; C. Taylor; S. Najmi; K. Thompson; R. Lale; K. A. Hawkins; J. R. Cougle; R. J. McNally
Missed the NT/TR SIG Meeting at the 2011 ABCT convention? You can still get all of this year's news and updates online. Click the link on the right to see Dr. Greg Siegle's presentation, "Translational Research Updates: Tools, toys, theories, and trying to get funded."