How psychotherapy changes the brain in panic disorder and social anxiety

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A new investigation published in the current issue of Psychotherapy and Psychosomatics disclosed important brain mechanisms for the action of psychotherapy in panic disorder. Patients with panic disorder (PD) and agoraphobia (AG) often suffer from other mental disorders especially social anxiety disorder. Neurally, both disorders exhibit substantial neurofunctional overlap within the defensive system network. Those networks might be crucial in social anxiety due to the high relevance of detecting social cues.

Fear conditioning serves as a model for the development, maintenance and treatment of anxiety disorders via CBT. It involves several neural pathways that have been partly identified as pathophysiological correlates of panic, agoraphobia and . The aim of this study was to investigate whether CBT specifically tailored to target and agoraphobia, also targets clinical and neurofunctional correlates of secondary social anxiety.

Results suggested a signature associated with secondary social anxiety, encompassing two functional systems: first, this signature extends throughout the ventral object recognition pathway, which is related to the recognition of social cues and thus social anxiety symptomatology; second, comorbid social anxiety further amplifies the activation of defensive system structures (e.g., hippocampus and IFO) possibly indicating stronger conditionability as a function of comorbidity. Findings showed that both systems were effectively targeted by CBT, resulting in attenuated activation patterns to the level of patients with panic disorder, agoraphobia and comorbid social anxiety.

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More information: Fabian Seeger et al. Clinical and Neurofunctional Substrates of Cognitive Behavioral Therapy on Secondary Social Anxiety Disorder in Primary Panic Disorder: A Longitudinal fMRI Study, Psychotherapy and Psychosomatics (2018). DOI: 10.1159/000493756
Journal information: Psychotherapy and Psychosomatics

Provided by Journal of Psychotherapy and Psychosomatics
Citation: How psychotherapy changes the brain in panic disorder and social anxiety (2019, May 2) retrieved 19 August 2019 from
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May 02, 2019
Personally Ive always suffered with panic disorder. But the few times it went away was when I was accepted as part of a group. I was never part of the community I grew up in and in college I was alienated from society as a whole. But I had jobs with a strong sense of community among the employees, and also a 12 step program, and in those situations my social anxiety largely disappeared.

It could be that our desire and need to belong to a tribe is so strong and so essential that without it we develop all sorts of mental and emotional problems.

This is precisely why 12 step programs work so well - they offer a sense of community based on shared experiences and interests that therapists simply cannot offer.

Unfortunately psychotherapists have trouble investigating things which would render them largely irrelevant.

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