The More Hemispheric Lateralization, the Better Thinking Performance

By examining activity of the living human brain at rest via fMRI, NIMH intramural scientists have discovered a secret to how it enhances thinking ability. It turns out that left brain regions are biased to talk more to each other, while right brain regions talk more evenly with both hemispheres. These biases are most pronounced in brain regions associated with the specialized functions of the two hemispheres – e.g., language and motor control on the left and visual/spatial attention on the right. Such lateralization is associated with enhanced cognition, say Drs. Stephen Gotts, Hang Joon Jo, Alex Martin, and colleagues of the NIMH Cognitive Neuropsychology Section, Laboratory of Brain and Cognition. The more such lateral specialization subjects showed at rest, the better they performed on verbal and spatial tasks later. For more information, see PNAS Blog: Brain Halves Interact Differently with Each Other CBT - How to Implement Trauma-Focused Cognitive Behavioral Therapy Two types of lateralization

Reference Two distinct forms of functional lateralization in the human brain. Gotts SJ, Jo HJ, Wallace GL, Saad ZS, Cox RW, Martin A. Proc Natl Acad Sci U S A. 2013 Aug 19. [Epub ahead of print] PMID: 23959883

Research at UH finds cognitive-behavioral therapy effective in combatting anxiety disorders

Combination of treatments provides improvement for disorders such as fear of flying, public speaking or spiders Whether it is a phobia like a fear of flying, public speaking or spiders, or a diagnosis such as obsessive compulsive disorder, new research finds patients suffering from anxiety disorders showed the most improvement when treated with cognitive-behavioral therapy (CBT) in conjunction with a "transdiagnostic" approach – a model that allows therapists to apply one set of principles across anxiety disorders Anxiety Disorders CE Course The combination was more effective than CBT combined with other types of anxiety disorder treatments, like relaxation training according to Peter Norton, associate professor in clinical psychology and director of the Anxiety Disorder Clinic at the University of Houston (UH) CADC I & II Continuing Education Norton concludes that therapists treating people with anxiety disorders may effectively use a treatment that applies one set of principals across all types of anxiety disorders. The findings are the result of a decade of research, four separate clinical trials and the completion of a five-year grant funded by the National Institute of Mental Health. Norton defines anxiety disorders as when anxiety and fear are so overwhelming that it can start to negatively impact a person's day-to-day life. He notes anxiety disorders include: panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, specific phobias and generalized anxiety disorder. Often anxiety disorders occur with a secondary illness, such as depression, substance or alcohol abuse. Norton says there are targeted treatments for each diagnosis, but there has been little recognition that the treatments don't differ much, and they only differ in very specific ways. IMAGE:This is Peter Norton, associate professor in clinical psychology and director of the Anxiety Disorder Clinic at the University of Houston. Click here for more information. "The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been an important breakthrough in understanding mental health, but people are dissatisfied with its fine level of differentiation," said Norton. "Panic disorders are considered something different from social phobia, which is considered something different from PTSD. The hope was that by getting refined in the diagnosis we could target interventions for each of these diagnoses, but in reality that just hasn't played out." As a graduate student in Nebraska, Norton couldn't get enough people together on the same night to run a group treatment for social phobia, and that marked the beginning 10 years of work on the transdiagnostic treatment approach. "What I realized is that I could open a group to people with anxiety disorders in general and develop a treatment program regardless of the artificial distinctions between social phobia and panic disorder, or obsessive-compulsive disorder, and focus on the core underlying things that are going wrong," said Norton. Norton finds cognitive-behavioral therapy (CBT), a type of treatment with a specific time frame and goals, helps patients understand the thoughts and feelings that influence behaviors to be the most effective treatment. The twist for him was using CBT in conjunction with the transdiagnostic approach. The patients receiving the transdiagnostic treatment showed considerable improvement, especially with treating comorbid diagnoses, a disease or IMAGE:This is the cover of "Group Cognitive-Behavioral Therapy of Anxiety. A Transdiagnostic Treatment Manual, " by Peter J. Norton. Click here for more information. condition that co-exists with a primary disease and can stand on its own as a specific disease, like depression. "What I have learned from my past research is that if you treat your principal diagnosis, such as social phobia and you hate public speaking, you are going to show improvement on some of your secondary diagnosis. Your mood is going to get a little better, your fear of heights might dissipate. So there is some effect there, but what we find is when we approach things with a transdiagnostic approach, we see a much bigger impact on comorbid diagnoses," said Norton. "In my research study, over two-thirds of comorbid diagnoses went away, versus what we typically we find when I'm treating a specific diagnosis such as a panic disorder, where only about 40 percent of people will show that sort of remission in their secondary diagnosis. The transdiagnostic treatment approach is more efficient in treating the whole person rather than just treating the diagnosis, then treating the next diagnoses." Norton notes the larger contributions of the studies are to guide further development and interventions for how clinical psychologists, therapists and social workers treat people with anxiety disorders. The data collected will be useful for people out on the front lines to effectively and efficiently treat people to reduce anxiety disorders. ### Norton is the author of the book, "Group Cognitive-Behavioral Therapy of Anxiety. A Transdiagnostic Treatment Manual," and co-author of "The Anti-Anxiety Workbook: Proven Strategies to Overcome Worry, Phobias, Panic and Obsessions." He has authored more than 90 research papers on such topics as anxiety disorders, CBT and chronic pain, and he serves on the editorial boards of two scientific journals. He has received early career awards and research grants for his work on studying and treating anxiety from the National Institute of Mental Health, the University of Nebraska – Lincoln, UH, the Anxiety Disorders Association of America and the American Psychological Association. About the Anxiety Disorder Clinic The Anxiety Disorder Clinic (ADC) is a specialty treatment and research clinic at the University of Houston. The goal of the ADC is to help clients overcome their problems with anxiety without medication by using the most effective psychological therapies available. Both research opportunities and low-cost clinical services based on the latest scientific evidence are offered to individuals. For more information about research opportunities and clinical services at ADC, please call 713-743-8600 or visit the ADC website www.uh.edu/anxiety About the University of Houston The University of Houston is a Carnegie-designated Tier One public research university recognized by The Princeton Review as one of the nation's best colleges for undergraduate education. UH serves the globally competitive Houston and Gulf Coast Region by providing world-class faculty, experiential learning and strategic industry partnerships. Located in the nation's fourth-largest city, UH serves more than 39,500 students in the most ethnically and culturally diverse region in the country.

Cognitive Behavioral Therapy CBT and PTSD

CMHS Consumer Affairs E-News
November 27, Vol. 07-187
Internet-Based PTSD Therapy May Help Overcome Barriers to Care

for more on PTSD and CBT,click link below
PTSD CEUs CBT CEUs

NIMH-funded researchers recently completed a pilot study showing that an Internet-based, self-managed cognitive behavioral therapy (CBT) can help reduce symptoms of post-traumatic stress disorder (PTSD) and depression, with effects that last after treatment has ended. This study supports further development of PTSD therapies that focus on self-management and innovative methods of providing care to large numbers of people who do not have access to mental health care or who may be reluctant to seek care due to stigma. The researchers published their study in the November 2007 issue of the American Journal of Psychiatry.

Brett Litz, Ph.D., of the National Center for PTSD at the VA Boston Healthcare System and Boston University, and colleagues recruited service members from the Department of Defense who had developed PTSD following the September 11, 2001, attack on the Pentagon or from recent combat exposure. Forty-five participants first met with a therapist to determine their baseline PTSD and depression symptoms, and then were randomly assigned to one of two 8-week long, therapist-assisted, Internet-based treatments.

One treatment used strategies from CBT, which previous research has shown to be effective in relieving symptoms of PTSD. This CBT-based therapy aimed to first help participants identify situations that triggered their PTSD symptoms by working with a therapist and then improve their ability to manage those symptoms through on-line homework assignments. The other therapy, called supportive counseling, asked participants to monitor their own current, non-trauma-related problems, and then write about those experiences online. These participants also received periodic phone calls or emails from their therapist, who provided supportive but non-directed counseling. Participants in both groups were asked to log on daily to a Web site specific to their assigned treatment. After rating their PTSD and depression symptoms using a checklist, participants were allowed access to the Web site where they could find information about PTSD, stress, trauma, and other related health topics; communicate with their therapist; or complete treatment-specific activities.

After eight weeks of treatment, participants in both groups had fewer or less severe PTSD and depression symptoms, but those in CBT-based therapy showed greater improvements than those in supportive counseling therapy. Six months after their first meeting with a study therapist, participants who received CBT-based therapy showed continued improvements, while those in the supportive therapy group experienced an increase in PTSD and depression symptoms.

These findings suggest the CBT-based online therapy may be an efficient, effective, and low-cost method of providing PTSD treatment following a traumatic event to a large number of people. The researchers noted that fewer people completed the CBT-based therapy than the supportive counseling therapy. However, regardless of therapy group, the discontinuation rate among study participants was similar to the 30 percent discontinuation rate reported in studies of face-to-face treatment. Further study is needed to improve treatment use and completion and to test Internet-based PTSD therapies in a larger study population.

Reference

Litz BT, Engel CC, Bryant R, Papa A. A Randomized Controlled Proof-of-Concept Trial of an Internet-Based, Therapist-Assisted Self-Management Treatment for Posttraumatic Stress Disorder. Am J Psychiatry. 2007 Nov;164(11):1676-84.