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Meta-Analytical Evidence for Segregating and Integrating Brain Activation to Symptom Provocation in Social Anxiety Disorder, Specific Phobia and Post Traumatic Stress Disorder
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
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2011 (English)Conference paper, Published paper (Other academic)
Abstract [en]

Background: In PTSD increased amygdala activity is found in parallel to decreased anterior cingulate activity and this imbalance relate to symptomatology. Consistently, in healthy controls enhanced vmPFC activity suppress fear conditioning and enhance extinction similar to reappraisal studies where dPFC activation supports emotional down regulation through amygdala attenuation. It is not established if phobic disorders display a similar pattern and if treatment induced changes affect “top-down” and/or “bottom-up” mechanisms.

Methods: Using a meta-analytical approach, we review brain-imaging studies using symptom provocation in patients with specific or social phobia as well as PTSD to evaluate reactivity in the ACC and the amygdala and its correlation to symptomatology. Further, amygdala ACC connectivity and the effect of CBT will be covered.

Results: Functional brain imaging studies reveal increased amygdala reactivity that is correlated with symptomatology across the anxiety disorders. In phobic patients enhanced ACC responsivity is observed. The correlation between symptomatology and prefrontal brain activity is consistently negative and ACC related in PTSD while in phobic patients the relation is positive and encompass prefrontal areas outside the ACC, particularly in SAD. Connectivity patterns suggest couplings between amygdala and PFC, limited to ACC in PTSD but not in phobic disorders. Finally, CBT-treatment is associated both with increased and decreased activity in the ACC and other prefrontal areas.

Conclusions: A tentative conclusion is that, even though the pattern of activity and connectivity both segregate and integrate different anxiety disorders, the ACC has a prominent role in coding and controlling affect.

Place, publisher, year, edition, pages
2011. Vol. 69
National Category
Social Sciences
Research subject
Psychology
Identifiers
URN: urn:nbn:se:uu:diva-163062OAI: oai:DiVA.org:uu-163062DiVA: diva2:462600
Conference
66th Annual Meeting of the Society of Biological Psychiatry, San Francisco, CA, MAY 12-14, 2011
Note
Paper presentationAvailable from: 2011-12-07 Created: 2011-12-07 Last updated: 2012-01-18Bibliographically approved

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Fredrikson, MatsFaria, VandaÅgren, ThomasEngman, JonasFurmark, Tomas

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