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A recent study, led by researchers at NIH's National Institute of Mental Health (NIMH) and published in the American Journal of Psychiatry, revealed that cognitive behavioral therapy (CBT) led to improvements in both clinical symptoms and brain functioning in children. Researchers at the National Institutes of Health (NIH) found that unmedicated children with anxiety disorders exhibit overactivation in various brain regions, including the frontal and parietal lobes and the amygdala. CBT involves changing dysfunctional thoughts and behaviors through gradual exposure to anxiety-provoking stimuli and is considered the gold standard for treating childhood anxiety disorders. This study underscored how effective CBT is at treating anxiety.
Study Overview
The study included 69 unmedicated children diagnosed with anxiety disorders who underwent 12 weeks of CBT. Clinician-rated measures and task-based functional magnetic resonance imaging (fMRI) were used. These were meant to assess changes in anxiety symptoms, clinical functioning, and brain activity. Before treatment, children with anxiety showed increased activity in brain regions associated with cognitive and regulatory functions. Additionally, they saw activity deeper limbic areas like the amygdala. After three months of CBT, there was a significant decrease in anxiety symptoms and improved functioning. This was further accompanied by reduced activation in frontal and parietal brain regions.
However, certain brain regions, including the right amygdala, continued to exhibit higher activity in anxious children even after treatment. This pattern suggests that some brain regions may be less responsive to the acute effects of CBT. The researchers highlighted the importance of understanding the brain circuitry underlying anxiety and tailoring treatments to target specific neural markers.
Future Research
The study also examined brain activity in adolescents at high risk for anxiety based on infant temperament. It provided preliminary evidence that the observed brain changes in children with anxiety were driven by CBT. The findings emphasize the need to enhance treatment outcomes, especially for children who do not significantly improve after short-term CBT. The researchers aim to further investigate factors influencing treatment response and translate their findings into improved clinical practice.
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