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Author Notes:

Correspondence: Anthony P. King, samadhi@med.umich.edu.

AK designed the study, obtained funding, performed study, analyzed and interpreted data, and wrote the initial draft of paper.

fMRI data collection and analyses were performed by SB and RS.

Clinical psychotherapy was performed by AK, KP, SR, and NG.

AK, IL, SR, and NG were involved in study design and obtaining funding.

IL, SB, RS, SR, NG, KP, and AK were involved in drafting the final manuscript.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Subjects:

Research Funding:

We are grateful for support from U.S. Department of Defense W81XWH-08-2-0208 to AK and IL, and to the Mind and Life Institute for Varela Awards to AK.

Keywords:

  • PTSD
  • amygdala
  • dorsal anterior cingulate cortex
  • exposure therapy
  • fMRI BOLD
  • mindfulness

A pilot study of mindfulness-based exposure therapy in OEF/OIF combat veterans with PTSD: Altered medial frontal cortex and amygdala responses in social-emotional processing

Tools:

Journal Title:

Frontiers in Psychiatry

Volume:

Volume 7, Number SEP

Publisher:

, Pages 154-154

Type of Work:

Article | Final Publisher PDF

Abstract:

Combat-related posttraumatic stress disorder (PTSD) is common among returning veterans, and is a serious and debilitating disorder. While highly effective treatments involving trauma exposure exist, difficulties with engagement and early drop may lead to sub-optimal outcomes. Mindfulness training may provide a method for increasing emotional regulation skills that may improve engagement in trauma-focused therapy. Here, we examine potential neural correlates of mindfulness training and in vivo exposure (non-trauma focused) using a novel group therapy [mindfulness-based exposure therapy (MBET)] in Afghanistan (OEF) or Iraq (OIF) combat veterans with PTSD. OEF/OIF combat veterans with PTSD (N = 23) were treated with MBET (N = 14) or a comparison group therapy [Present-centered group therapy (PCGT), N = 9]. PTSD symptoms were assessed at pre- and post-therapy with Clinician Administered PTSD scale. Functional neuroimaging (3-T fMRI) before and after therapy examined responses to emotional faces (angry, fearful, and neutral faces). Patients treated with MBET had reduced PTSD symptoms (effect size d = 0.92) but effect was not significantly different from PCGT (d = 0.43). Improvement in PTSD symptoms from pre- to post-treatment in both treatment groups was correlated with increased activity in rostral anterior cingulate cortex, dorsal medial prefrontal cortex (mPFC), and left amygdala. The MBET group showed greater increases in amygdala and fusiform gyrus responses to Angry faces, as well as increased response in left mPFC to Fearful faces. These preliminary findings provide intriguing evidence that MBET group therapy for PTSD may lead to changes in neural processing of social-emotional threat related to symptom reduction.

Copyright information:

© 2016 King, Block, Sripada, Rauch, Porter, Favorite, Giardino and Liberzon.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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