Neurobiological Changes Resulting from Psychotherapy

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​The effects of psychotherapy and the tools related to its effect have typically been investigated by measuring changes in symptoms, psychological abilities, personality, and social functioning. Many psychiatrists presumed that psychotherapy treated psychological based disorders and pharmacology treated biological based disorders. However, with the introduction of neuroimaging procedures the ability to examine the biological effects of psychotherapy has become attainable. Neuroimaging has allowed the effectiveness of psychotherapy to be documented, tracked, and further developed for application purposes. Beyond its practical uses integrating neurobiology with psychotherapy permits linking specific mental functions with specific brain structures and functions.   ​The advances in non-invasive brain imaging techniques has increased the number of studies investigating cognitive functioning, emotional experience, placebo effects, and psychotherapeutic related changes. Positron emission tomography (PET) measures the metabolic activity within different regions and functional magnetic resonance imaging (fMRI) measures blood oxygenation of vessels within the surrounding neural tissues. By comparing brain metabolic activity in individuals with and without psychiatric disorders, it is possible to identify how the functional neural circuitry is possible (Jokic-Begic, 2010). ​During the 1970s, the adult brain was considered to be fixed and organized; each brain region dominated particular functions. Research has shown in the last 30 years that growth and variation in the brain are not only determined by genetics, but also environment interaction. The existence of a gene does not mean that it is active. There are many variables that determine whether a gene will express itself and its psychological impact. For example, predisposition to post-traumatic stress disorder (PTSD) is related to whether certain stress genes are active or inactive during a traumatic event. A person whose genotype has variations of the stress related gene FKBP5 are more likely to develop PTSD following a traumatic event than a person that does not carry these variations (Feinstein & Church, 2010). ​The Center of Disease Control and Prevention (CDC) conducted a study that identified 1,058 genes involved in networks between the nervous, endocrine, and immune systems and whose expression can be assessed with clinical test. Inflated limbic system responses to harmless stimuli, misrepresentations in learning and memory, imbalances between sympathetic and parasympathetic nervous system activity, elevated levels of cortisol and other stress hormones, and impaired immune functioning are biological markers that depend upon gene expression. In order for psychotherapy to be successful, genes must be modified to create positive impacts in these areas of biological functioning (Feinstein & Church, 2010). ​Most stress-related hormonal responses occur in the hypothalamus. The prefrontal cortex, hippocampus, and amygdala monitor the hypothalamus which links these brain structures to a person’s overall perception of stress. When a person is experiencing a threat, the amygdala is activated stimulating the flight-or-flight response controlled by the hypothalamus. The hippocampus and prefrontal cortex have opposite effects on the hypothalamus; both structures inhibit the sympathetic nervous system reducing anxious behavior. If the homeostatic balance between the parasympathetic nervous system (PNS) and sympathetic nervous system (SNS) are not maintained the ability for the individual to manage threats effectively and avoid clinical levels of anxiety and depression are lessened. Prolonged stress suppresses the PNS and increases activity in the SNS. High sympathetic/ low parasympathetic ratios are linked to psychological and physiological disorders (Sharpley, 2010). ​Dramatic elevations of cortisol in the bloodstream are a major contributor to the efficiency and balance of prefrontal...
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