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Cited by 307Posttraumatic Stress Disorder ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTraumatic Brain Injury Research

Amygdala and ventral anterior cingulate activation predicts treatment response to cognitive behaviour therapy for post-traumatic stress disorder

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Bryant, R. A., Felmingham, K., Kemp, A., Das, P., Hughes, G., Peduto, A., Williams, L.·2008·Psychological Medicine
DOI 10.1017/s0033291707002231
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Abstract

Background: Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), approximately half of patients do not respond to CBT. No studies have investigated the capacity for neural responses during fear processing to predict treatment response in PTSD. Method: Functional magnetic resonance imaging (fMRI) responses of the brain were examined in individuals with PTSD (n=14). fMRI was examined in response to fearful and neutral facial expressions presented rapidly in a backwards masking paradigm adapted for a 1.5 T scanner. Patients then received eight sessions of CBT that comprised education, imaginal and in vivo exposure, and cognitive therapy. Treatment response was assessed 6 months after therapy completion. Results: Seven patients were treatment responders (defined as a reduction of 50% of pretreatment scores) and seven were non-responders. Poor improvement after treatment was associated with greater bilateral amygdala and ventral anterior cingulate activation in response to masked fearful faces. Conclusions: Excessive fear responses in response to fear-eliciting stimuli may be a key factor in limiting responses to CBT for PTSD. This excessive amygdala response to fear may reflect difficulty in managing anxiety reactions elicited during CBT, and this factor may limit optimal response to therapy.

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Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Breathing interventions using resistance or vibrations likely engage a different mechanism: peripheral activation of vagal lung afferents.

    “The other dimensions of breathing interventions—for example, the use of resistance or vibrations—are likely to engage a different mechanism, the peripheral activation of vagal lung afferents.145,147”

    From Fear and the Defense Cascade (2015) · cites this paper as [147]

  • A subgroup of patients who demonstrate excessive recruitment of the amygdala and intense somatic arousal do not respond therapeutically to CBT interventions.

    “A subgroup of patients—those who demonstrate excessive recruitment of the amygdala and intense somatic arousal—do not respond therapeutically to CBT interventions.189–191”

    From Fear and the Defense Cascade (2015) · cites this paper as [189]

  • In this subgroup, arousal response is paradoxically amplified during CBT, habituation does not occur, reinforcing the aversive nature of the memory and increasing the probability that flight or fight, tonic immobility, or collapsed immobility may be activated.

    “Instead, their arousal response is paradoxically amplified during the intervention—habituation does not occur—thereby reinforcing the aversive nature of the memory and increasing the probability that flight or fight, tonic immobility, or collapsed immobility may be activated.”

    From Fear and the Defense Cascade (2015) · cites this paper as [189]

  • Greater amygdala reactivity toward fearful faces before treatment resulted in worse treatment outcome.

    “greater amygdala reactivity toward fearful faces before treatment resulted in worse treatment outcome (Bryant et al, 2008).”

    From Intranasal oxytocin administration dampens amygdala reactivity towards emotional faces in male and female PTSD patients (2016) · cites this paper as Bryant et al, 2008

  • In PTSD, greater amygdala reactivity to fearful faces and negative pictures before treatment predicted worse treatment outcome.

    “In PTSD, greater amygdala reactivity to fearful faces (Bryant et al, 2008) and negative pictures (van Rooij et al, 2015) before treatment predicted worse treatment outcome.”

    From Intranasal oxytocin administration dampens amygdala reactivity towards emotional faces in male and female PTSD patients (2016) · cites this paper as Bryant et al, 2008

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Authors
Bryant, R. A., Felmingham, K., Kemp, A., Das, P., Hughes, G., Peduto, A., & Williams, L.
Affiliations
Westmead Hospital (AU)
Corresponding author
Bryant, R. A.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2007-11-16
Volume
38
Issue
4
Pages
555-561
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291707002231
OpenAlex
W2166864184
Cited by
307
References
42
Citations by year
2026: 4 · 2025: 8 · 2024: 7 · 2023: 11 · 2022: 6 · 2021: 9 · 2020: 19 · 2019: 25 · 2018: 15 · 2017: 20 · 2016: 20 · 2015: 30 · 2014: 28 · 2013: 21 · 2012: 23
FWCI
14.49
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • eCite Digital Repository (University of Tasmania) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
post-traumatic stress disorder, cognitive behavioral therapy, treatment response prediction, amygdala activation, ventral anterior cingulate cortex, fear processing, fearful faces, exposure therapy
MeSH terms
Adult, Amygdala, Arousal, Desensitization, Psychologic, Dominance, Cerebral, Facial Expression, Fear, Female, Gyrus Cinguli, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Pattern Recognition, Visual, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy, Treatment Outcome

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