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An fMRI Pilot Study of Cognitive Reappraisal in Children: Divergent Effects on Brain and Behavior.

ABSTRACT: Although neuroimaging studies in adults demonstrate that cognitive reappraisal effectively down-regulates negative affect and results in increased prefrontal and decreased amygdala activity, very limited empirical data exist on the neural basis of cognitive reappraisal in children. This study aimed to pilot test a developmentally-appropriate guided cognitive reappraisal task in order to examine the effects of cognitive reappraisal on children's self-reports of affect and brain responses. Study 1 (N =19, 4-10 years-old) found that children successfully employed guided cognitive reappraisal to decrease subjective ratings of negative affect, supporting the effectiveness of the guided cognitive reappraisal task. Study 2 (N =15, ages 6-10 years-old) investigated the neural responses to guided cognitive reappraisal and found that the neural responses showed increased activation in the amygdala and ventromedial prefrontal cortex during the cognitive reappraisal condition compared to the no regulation condition. In addition, amygdala activity was positively correlated with ventromedial prefrontal cortex activation during cognitive reappraisal. Findings suggest that the neural networks supporting cognitive reappraisal in children involve similar brain regions but brain responses deviate from findings in adults. Our findings suggest that the neural networks supporting emotion regulation are still developing during middle childhood, and future research is necessary to delineate age-related development of the neural network involved in cognitive reappraisal.

SUBMITTER: Dougherty LR

PROVIDER: S-EPMC4675347 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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An fMRI Pilot Study of Cognitive Reappraisal in Children: Divergent Effects on Brain and Behavior.

Dougherty Lea R LR Blankenship Sarah L SL Spechler Philip A PA Padmala Srikanth S Pessoa Luiz L

Journal of psychopathology and behavioral assessment 20150519 4

Although neuroimaging studies in adults demonstrate that cognitive reappraisal effectively down-regulates negative affect and results in increased prefrontal and decreased amygdala activity, very limited empirical data exist on the neural basis of cognitive reappraisal in children. This study aimed to pilot test a developmentally-appropriate guided cognitive reappraisal task in order to examine the effects of cognitive reappraisal on children's self-reports of affect and brain responses. Study 1 ...[more]

PMID: 26692636

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Project description:BackgroundTraumatic experiences are associated with neurofunctional dysregulations in key regions of the emotion regulation circuits. In particular, amygdala responsivity to negative stimuli is exaggerated while engagement of prefrontal regulatory control regions is attenuated. Successful application of emotion regulation (ER) strategies may counteract this disbalance, however, application of learned strategies in daily life is hampered in individuals afflicted by posttraumatic stress disorder (PTSD). We hypothesized that a single session of real-time fMRI (rtfMRI) guided upregulation of prefrontal regions during an emotion regulation task enhances self-control during exposure to negative stimuli and facilitates transfer of the learned ER skills to daily life.MethodsIn a cross-over design, individuals with a PTSD diagnosis after a single traumatic event (n = 20) according to DSM-IV-TR criteria and individuals without a formal psychiatric diagnosis (n = 21) underwent a cognitive reappraisal training. In randomized order, all participants completed two rtfMRI neurofeedback (NF) runs targeting the left lateral prefrontal cortex (lPFC) and two control runs without NF (NoNF) while using cognitive reappraisal to reduce their emotional response to negative scenes. During the NoNF runs, two %%-signs were displayed instead of the two-digit feedback (FB) to achieve a comparable visual stimulation. The project aimed at defining the clinical potential of the training according to three success markers: (1) NF induced changes in left lateral prefrontal cortex and bilateral amygdala activity during the regulation of aversive scenes compared to cognitive reappraisal alone (primary registered outcome), (2) associated changes on the symptomatic and behavioral level such as indicated by PTSD symptom severity and affect ratings, (3) clinical utility such as indicated by perceived efficacy, acceptance, and transfer to daily life measured four weeks after the training.ResultsIn comparison to the reappraisal without feedback, a neurofeedback-specific decrease in the left lateral PFC (d = 0.54) alongside an attenuation of amygdala responses (d = 0.33) emerged. Reduced amygdala responses during NF were associated with symptom improvement (r = -0.42) and less negative affect (r = -0.63) at follow-up. The difference in symptom scores exceeds requirements for a minimal clinically important difference and corresponds to a medium effect size (d = 0.64). Importantly, 75% of individuals with PTSD used the strategies in daily life during a one-month follow-up period and perceived the training as efficient.ConclusionOur findings suggest beneficial effects of the NF training indicated by reduced amygdala responses that were associated with improved symptom severity and affective state four weeks after the NF training as well as patient-centered perceived control during the training, helpfulness and application of strategies in daily life. However, reduced prefrontal involvement was unexpected. The study suggests good tolerability of the training protocol and potential for clinical use in the treatment of PTSD.

Dataset Information

An fMRI Pilot Study of Cognitive Reappraisal in Children: Divergent Effects on Brain and Behavior.

Publications

An fMRI Pilot Study of Cognitive Reappraisal in Children: Divergent Effects on Brain and Behavior.

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