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Symposia

Treatment - CBT

The Multi-modal Mechanism of Rumination: Intervention Targets from the Brain to the Family

3 - (SYM 133) Brain Changes During Rumination Fmri Task in Youth: Comparing Rumination Focused Cognitive Behavioral Therapy versus Treatment as Usual

Sunday, November 17, 2024
10:30 AM – 12:00 PM EST
Location: 309/310, Level 3, Downtown Marriott
Abstract Body



Background: Rumination, or repetitive negative thinking, is a common habit in major depressive disorder (MDD). Rumination Focused Cognitive Behavioral Therapy (RF-CBT) specifically targets rumination by encouraging the use of strategies that are active, concrete, and specific. Early evidence highlights that RF-CBT shows promise in treating both adults and adolescents with MDD and reduces likelihood of MDD recurrence. Adolescence is a sensitive period of brain development that may be particularly amenable to interventions. Such interventions may optimize neurobiological trajectories even in the context of psychopathology. To better understand the impacts of RF-CBT, we explore brain changes in the context of a rumination task.



Method: Fifty-five youth aged 14-17 with remitted major depressive disorder completed a rumination induction fMRI task and were then randomized to either RF-CBT (n = 30) or treatment as usual (TAU; n = 25). Participants completed the task a second time after 10-14 sessions of RF-CBT or the equivalent time delay for the TAU group. We examined within-group change in brain activation during rumination and distraction conditions of the task for five brain regions implicated in rumination: left anterior cingulate cortex (ACC) and paracingulate, angular gyrus, inferior frontal gyrus, precuneus, and superior temporal gyrus. We conducted within-group comparisons by extracting the values from these regions during the task conditions and conducting paired-samples t-tests for each group. We will also examine differences using general linear models to identify regions across the whole brain that show change over time for each task condition and compare these changes between RF-CBT and TAU groups.



Results: Within-group differences showed that the RF-CBT group demonstrated a significant increase in activation during rumination in the left precuneus and angular and superior temporal gyri following treatment (p < .01). In contrast, the TAU group showed no significant changes in these brain regions. Data for within- and between-group whole-brain analyses are forthcoming.



Conclusion: RF-CBT is associated with changes in rumination-related brain activation in youth. Such changes may illustrate how RF-CBT could portend lasting clinical change, thereby reducing likelihood of depression recurrence. As we develop a better understanding of the mechanisms of change involving treatment, future research can build upon this knowledge in effort to tailor interventions to optimize clinical and neurobiological outcomes.