Monday, December 12, 2016

Possibility of PTSD treatment without exposure

Anxiety disorders are one of the mental diseases frequently seen in community patients. Some of them are fearful to a specific theme, while others tend to be afraid of negative results possibly occur in the near future. And acute stress disorder and PTSD are believed to have an etiology shared with other anxiety disorders.

In general, cognitive behavioral therapy (CBT) is often adopted to treat the patients with anxiety disorders. The core of CBT is exposing the issues the patient would like to avoid. Patients can learn that it is totally safe to confront the situation which has been recognized as dangerous for them through the therapy. At first, it is tough for patients to attend the therapy because it raises the level of fear. But through repeated exposing session, the physiological reaction to the exposure is gradually lowered. Finally, they become feel free from abnormal fear to the event they had hardly dealt.

However, exposure therapy is so irritating for the patients that many patients refuse to take it. Development of less-invasive treatment has been a challenge for clinicians.

In Japan, a unique attempt to modify the painful memory of participants was conducted. The researchers at the ARW Computational Neuroscience Lab did an experiment in which the participants was given an electric shock during watching at a certain visual pattern. The researchers confirmed that fear conditioning was acquired with observing the stimulation of a particular region of the brain using functional MRI. And then, researchers gave a reward to the participants when the region relevant to their painful memories was stimulated. As a result, the response of the region was lowered. Thus, participants became less vulnerable to the painful memory, as the researchers estimated.

The Guardian: Tests raise hopes for radical new therapy for phobias and PTSD

This study was published in a prominent academic journal. At a glance, there seem no critical flaws in the method of this study.

Nature Human Behaviour: Fear reduction without fear through reinforcement of neural activity that bypasses conscious exposure

This experiment is conducted in a highly artificial surrounding. Therefore, it is not certain that the result applies to the clinical setting. Nonetheless, it seems that the result is rational in terms both of psychopathology and brain neuroscience.

The other days, psychiatrists hypothesized that fearful emotion rose from the subconscious region of the human mind. Freud and his successors were eager to analyze the deep layer of patients to help them overcoming the psychiatric symptoms. Unfortunately, most of their attempts resulted in failure. I think this result shed light to the existence of nonconsciousness in human.

Recently, similar therapeutic strategies are often discussed, as I reported previously. The combination of traditional psychotherapy and latest neuroimaging will be an innovation in clinical psychiatry.

My past entry: Trauma deleting therapy with electric shock

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