Cited by 74Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeural and Behavioral Psychology StudiesPsychotherapy Techniques and Applications

Single session real-time fMRI neurofeedback has a lasting impact on cognitive behavioral therapy strategies

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MacDuffie, Katherine E., MacInnes, Jeff, Dickerson, Kathryn C., Eddington, Kari M., Strauman, Timothy J., Adcock, R. Alison·2018·NeuroImage Clinical

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Abstract

To benefit from cognitive behavioral therapy (CBT), individuals must not only learn new skills but also strategically implement them outside of session. Here, we tested a novel technique for personalizing CBT skills and facilitating their generalization to daily life. We hypothesized that showing participants the impact of specific CBT strategies on their own brain function using real-time functional magnetic imaging (rt-fMRI) neurofeedback would increase their metacognitive awareness, help them identify effective strategies, and motivate real-world use. In a within-subjects design, participants who had completed a clinical trial of a standardized course of CBT created a personal repertoire of negative autobiographical stimuli and mood regulation strategies. From each participant's repertoire, a set of experimental and control strategies were identified; only experimental strategies were practiced in the scanner. During the rt-fMRI neurofeedback session, participants used negative stimuli and strategies from their repertoire to manipulate activation in the anterior cingulate cortex, a region implicated in emotional distress. The primary outcome measures were changes in participant ratings of strategy difficulty, efficacy, and frequency of use. As predicted, ratings for unscanned control strategies were stable across observations, whereas ratings for experimental strategies changed after neurofeedback. At follow-up one month after the session, efficacy and frequency ratings for scanned strategies were predicted by neurofeedback during the rt-fMRI session. These results suggest that rt-fMRI neurofeedback created a salient and durable learning experience for patients, extending beyond the scan session to guide and motivate CBT skill use weeks later. This metacognitive approach to neurofeedback offers a promising model for increasing clinical benefits from cognitive behavioral therapy by personalizing skills and facilitating generalization.

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Authors
MacDuffie, K. E., MacInnes, J., Dickerson, K. C., Eddington, K. M., Strauman, T. J., & Adcock, R. A.
Affiliations
  • University of Washington (US)
  • Duke University (US)
  • University of North Carolina at Greensboro (US)
Corresponding author
Adcock, R. Alison
Venue
NeuroImage Clinical
Publisher
Elsevier BV
Published
2018
Volume
19
Pages
868-875
ISSN
2213-1582 (ISSN-L)
OpenAlex
W2950669198
Cited by
74
References
18
Citations by year
2026: 7 · 2025: 5 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 31 · 2020: 8 · 2019: 3 · 2018: 1
FWCI
14.08
Type
journal article
Language
en
Open access
Locations
  • NeuroImage Clinical (publishedVersion, cc-by-nc-nd)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • NC Digital Online Collection of Knowledge and Scholarship (The University of North Carolina at Greensboro) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Center for Advancing Translational Sciences
  • National Institute of Mental Health (R01MH094743)
  • National Science Foundation
  • National Institutes of Health (5KL2TR001115)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
real-time fMRI neurofeedback, cognitive behavioral therapy, metacognitive awareness, strategy generalization, anterior cingulate cortex, emotion regulation, personalized treatment, medication adherence
MeSH terms
Adult, Brain, Depressive Disorder, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Cognitive Behavioral Therapy, Treatment Outcome, Neurofeedback

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