Changes in neural activity following a randomized trial of cognitive behavioral therapy for hoarding disorder.

Tolin, DF; Levy, HC; Hallion, LS; Wootton, BM; Jaccard, J; Diefenbach, GJ; Stevens, MC

Changes in neural activity following a randomized trial of cognitive behavioral therapy for hoarding disorder.

Tolin, DF Levy, HC Hallion, LS Wootton, BM Jaccard, J Diefenbach, GJ Stevens, MC

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Publisher:: AMER PSYCHOLOGICAL ASSOC
Publication Type:: Journal Article
Citation:: J Consult Clin Psychol, 2023, 91, (4), pp. 242-250
Issue Date:: 2023-04

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Field	Value	Language
dc.contributor.author	Tolin, DF
dc.contributor.author	Levy, HC
dc.contributor.author	Hallion, LS
dc.contributor.author	Wootton, BM
dc.contributor.author	Jaccard, J
dc.contributor.author	Diefenbach, GJ
dc.contributor.author	Stevens, MC
dc.date.accessioned	2024-02-13T00:30:38Z
dc.date.available	2024-02-13T00:30:38Z
dc.date.issued	2023-04
dc.identifier.citation	J Consult Clin Psychol, 2023, 91, (4), pp. 242-250
dc.identifier.issn	0022-006X
dc.identifier.issn	1939-2117
dc.identifier.uri	http://hdl.handle.net/10453/175621
dc.description.abstract	OBJECTIVE: Cognitive behavioral therapy (CBT) is efficacious for hoarding disorder (HD), though results are modest. HD patients show an increase in activity in the dorsal anterior cingulate cortex (dACC) when making decisions. The aim of this study is to determine whether CBT's benefits follow improvements in dACC dysfunction or abnormalities previously identified in other brain regions. METHOD: In this randomized clinical trial of 64 treatment-seeking HD patients, patients received group CBT, delivered weekly for 16 weeks, versus wait list. Functional magnetic resonance imaging was used to examine neural activity during simulated decisions about whether to acquire and discard objects. RESULTS: During acquiring decisions, activity decreased in several regions, including right dorsolateral prefrontal, right anterior intraparietal area, both right and left medial intraparietal areas, left and right amygdala, and left accumbens. During discarding decisions, activity decreased in right and left dorsolateral prefrontal, right and left rostral cingulate, left anterior ventral insular cortex, and right medial intraparietal areas. None of the a priori brain parcels of interest significantly mediated symptom reduction. Moderation effects were found for left rostral cingulate, right and left caudal cingulate, and left medial intraparietal parcels. CONCLUSIONS: Therapeutic benefits of CBT for HD do not appear to be mediated by changes in dACC activation. However, pretreatment dACC activation predicts outcome. Findings suggest the need to re-evaluate emerging neurobiological models of HD and our understanding of how CBT affects the brain in HD, and perhaps shift focuses to new neural target discovery and target engagement trials. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
dc.format	Print-Electronic
dc.language	eng
dc.publisher	AMER PSYCHOLOGICAL ASSOC
dc.relation.ispartof	J Consult Clin Psychol
dc.relation.isbasedon	10.1037/ccp0000804
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1701 Psychology
dc.subject.classification	Clinical Psychology
dc.subject.classification	5201 Applied and developmental psychology
dc.subject.classification	5203 Clinical and health psychology
dc.subject.classification	5205 Social and personality psychology
dc.subject.mesh	Humans
dc.subject.mesh	Hoarding Disorder
dc.subject.mesh	Cognitive Behavioral Therapy
dc.subject.mesh	Brain
dc.subject.mesh	Gyrus Cinguli
dc.subject.mesh	Decision Making
dc.subject.mesh	Brain
dc.subject.mesh	Gyrus Cinguli
dc.subject.mesh	Humans
dc.subject.mesh	Decision Making
dc.subject.mesh	Hoarding Disorder
dc.subject.mesh	Cognitive Behavioral Therapy
dc.title	Changes in neural activity following a randomized trial of cognitive behavioral therapy for hoarding disorder.
dc.type	Journal Article
utslib.citation.volume	91
utslib.location.activity	United States
utslib.for	1701 Psychology
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Clinical Psychology
utslib.copyright.status	closed_access	*
dc.date.updated	2024-02-13T00:30:37Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	91
utslib.citation.issue	4

Abstract:

OBJECTIVE: Cognitive behavioral therapy (CBT) is efficacious for hoarding disorder (HD), though results are modest. HD patients show an increase in activity in the dorsal anterior cingulate cortex (dACC) when making decisions. The aim of this study is to determine whether CBT's benefits follow improvements in dACC dysfunction or abnormalities previously identified in other brain regions. METHOD: In this randomized clinical trial of 64 treatment-seeking HD patients, patients received group CBT, delivered weekly for 16 weeks, versus wait list. Functional magnetic resonance imaging was used to examine neural activity during simulated decisions about whether to acquire and discard objects. RESULTS: During acquiring decisions, activity decreased in several regions, including right dorsolateral prefrontal, right anterior intraparietal area, both right and left medial intraparietal areas, left and right amygdala, and left accumbens. During discarding decisions, activity decreased in right and left dorsolateral prefrontal, right and left rostral cingulate, left anterior ventral insular cortex, and right medial intraparietal areas. None of the a priori brain parcels of interest significantly mediated symptom reduction. Moderation effects were found for left rostral cingulate, right and left caudal cingulate, and left medial intraparietal parcels. CONCLUSIONS: Therapeutic benefits of CBT for HD do not appear to be mediated by changes in dACC activation. However, pretreatment dACC activation predicts outcome. Findings suggest the need to re-evaluate emerging neurobiological models of HD and our understanding of how CBT affects the brain in HD, and perhaps shift focuses to new neural target discovery and target engagement trials. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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http://hdl.handle.net/10453/175621