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Single Session Real-time fMRI Neurofeedback has a Lasting Impact on Cognitive Behavioral Therapy Strategies

Katherine E. MacDuffie, Jeff MacInnes, Kathryn C. Dickerson, Kari M. Eddington, Timothy J. Strauman, R. Alison Adcock
doi: https://doi.org/10.1101/258095
Katherine E. MacDuffie
1Department of Speech and Hearing Sciences, University of Washington, Seattle, WA
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  • For correspondence: kmacd@uw.edu
Jeff MacInnes
2Department of Psychology, University of Washington, Seattle, WA
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Kathryn C. Dickerson
3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC.
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Kari M. Eddington
4Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC.
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Timothy J. Strauman
5Department of Psychology and Neuroscience, Duke University, Durham, NC.
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R. Alison Adcock
3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC.
5Department of Psychology and Neuroscience, Duke University, Durham, NC.
6Department of Neurobiology, Duke University, Durham, NC.
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Abstract

To benefit from cognitive behavioral therapy (CBT), individuals must not only learn new skills but also strategically implement them outside of session. Here, we tested a novel technique for personalizing CBT skills and facilitating their generalization to daily life. We hypothesized that showing participants the impact of specific CBT strategies on their own brain function using real-time functional magnetic imaging (rt-fMRI) neurofeedback would increase their metacognitive awareness, help them identify effective strategies, and motivate real-world use. In a within-subjects design, participants who had completed a clinical trial of a standardized course of CBT created a personal repertoire of negative autobiographical stimuli and mood regulation strategies. From each participant’s repertoire, a set of experimental and control strategies were identified; only experimental strategies were practiced in the scanner. During the rt-fMRI neurofeedback session, participants used negative stimuli and strategies from their repertoire to manipulate activation in the anterior cingulate cortex, a region implicated in emotional distress. The primary outcome measures were changes in participant ratings of strategy difficulty, efficacy, and frequency of use. As predicted, ratings for unscanned control strategies were stable across observations, whereas ratings for experimental strategies changed after neurofeedback. At follow-up one month after the session, efficacy and frequency ratings for scanned strategies were predicted by neurofeedback during the rt-fMRI session. These results suggest that rt-fMRI neurofeedback created a salient and durable learning experience for patients, extending beyond the scan session to guide and motivate CBT skill use weeks later. This metacognitive approach to neurofeedback offers a promising model for increasing clinical benefits from cognitive-behavioral therapy by personalizing skills and facilitating generalization.

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The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted February 01, 2018.
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Single Session Real-time fMRI Neurofeedback has a Lasting Impact on Cognitive Behavioral Therapy Strategies
Katherine E. MacDuffie, Jeff MacInnes, Kathryn C. Dickerson, Kari M. Eddington, Timothy J. Strauman, R. Alison Adcock
bioRxiv 258095; doi: https://doi.org/10.1101/258095
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Single Session Real-time fMRI Neurofeedback has a Lasting Impact on Cognitive Behavioral Therapy Strategies
Katherine E. MacDuffie, Jeff MacInnes, Kathryn C. Dickerson, Kari M. Eddington, Timothy J. Strauman, R. Alison Adcock
bioRxiv 258095; doi: https://doi.org/10.1101/258095

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