Psychiatry Research: Neuroimaging
Volume 172, Issue 2 , Pages 99-102, 15 May 2009

Long-term effects of cognitive behavior therapy on brain activation in spider phobia☆

  • Anne Schienle

      Affiliations

    • Department of Clinical Psychology, University of Graz, Graz, Austria
    • Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
    • Corresponding Author InformationCorresponding author. University of Graz, Clinical Psychology, Universitätsplatz 2/III, A-8010 Graz, Austria. Tel.: +43 316 380 5086; fax: +43 316 380 9808.
    • ,
  • Axel Schäfer

      Affiliations

    • Department of Clinical Psychology, University of Graz, Graz, Austria
    • ,
  • Rudolf Stark

      Affiliations

    • Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
    • ,
  • Dieter Vaitl

      Affiliations

    • Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany

Received 10 September 2007; received in revised form 27 October 2008; accepted 12 November 2008.

Abstract 

This functional magnetic resonance imaging study investigated long-term effects of cognitive behavior therapy (CBT) in individuals suffering from spider phobia. Ten female patients who had shown positive immediate CBT effects were invited to take part in a 6-month follow-up investigation. Here, the patients, along with eight non-phobic females, were presented with the same pictures depicting spiders, generally disgust-inducing, generally fear-inducing and neutral content, which they had viewed 6 months earlier. Patients' self-report and overt behavior indicated a positive long-term clinical improvement. Related hemodynamic changes included an increase in medial orbitofrontal cortex (OFC) activity. As the medial OFC is involved in emotion-related learning, especially in the representation of positive stimulus-outcome associations, we conclude that the medial OFC effect constitutes the neuronal basis of the lasting positive CBT outcome. Activity to disorder-irrelevant pictures decreased across the sessions in the lateral OFC and in the insula, which most likely reflects general habituation.

Keywords: Spider phobia, Psychotherapy, Follow-up, Pictures, fMRI

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☆ The study was carried out at: Bender Institute of Neuroimaging.

PII: S0925-4927(08)00187-X

doi:10.1016/j.pscychresns.2008.11.005

Psychiatry Research: Neuroimaging
Volume 172, Issue 2 , Pages 99-102, 15 May 2009

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