Emma Fishbein
Pronouns: she/hers
Research Mentor(s): David Fresco
Research Mentor School/College/Department: Psychiatry / Medicine
Program: UROP
Session: Session 3 (11:00am – 11:50am)
Authors: Emma Fishbein, Patrick Eagen, Kathryn Torok, Jung Park, Anthony King, David M. Fresco
Abstract
Post Traumatic Stress Disorder (PTSD) is an extremely debilitating yet prevalent mental disorder with great public health significance. PTSD occurs after an especially frightening or traumatic event and is distress which is increasingly regarded as a transdiagnostic characteristic marked by internal suffering that can range from intensely aversive and prolonged emotional states to self-focused processing of negative emotions that leads to the chronic load exceeding available self-regulatory capacity. Building on our prior findings, this NIH-funded randomized clinical trial sought to identify the neural mechanisms associated with clinical response attributable to Mindfulness-Based Cognitive Therapy (MBCT) in resolving distress for individuals with PTSD. Specifically, we randomized 41 patients to either MBCT, an 8-week group therapy treatment with a focus on learning to develop an increased awareness of one’s breath along with bodily sensations, emotions, and thoughts through exercises such as mindful movement and 3-minute breathing space or Progressive Muscle Relaxation (PMR), a well-equated comparator with the same group format, duration, and intensity of home-practice engagement, but lacking any mindfulness meditation elements. We hypothesized that clinical improvement with MBCT as compared to PMR would arise via gains in decentering, the capacity to observe one’s feelings and thoughts as temporary, objective events in the mind, which, we operationally defined as increases in the functional connectivity between the posterior cingulate cortex (PCC; a node of the default mode network) and the dorsolateral prefrontal cortex (DLPFC; a node of central executive network) would indicate a greater capacity for decentering and in turn clinical improvement. In support of this hypothesis, patients receiving MBCT as compared to PMR demonstrated this specific change in functional connectivity which in turn was associated with self-reported gains in decentering as well as meaningful improvement in PTSD symptom severity. The findings of this trial contribute to the growing body of work indicating the role of decentering in achieving and maintaining relief from distress.
