Amygdala response to self-critical stimuli and symptom improvement in psychotherapy for depression

Doerig, Nadja; Krieger, Tobias; Altenstein, David; Schlumpf, Yolanda; Spinelli, Simona; Späti, Jakub; Brakowski, Janis; Quednow, Boris B.; Seifritz, Erich; Grosse Holtforth, Martin (2016). Amygdala response to self-critical stimuli and symptom improvement in psychotherapy for depression. British journal of psychiatry, 208(2), pp. 175-181. Royal College of Psychiatrists 10.1192/bjp.bp.114.149971

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Background: Cognitive–behavioural therapy is efficacious in the treatment of major depressive disorder but response rates are still far from satisfactory. Aims: To better understand brain responses to individualised emotional stimuli and their association with outcome, to enhance treatment. Method: Functional magnetic resonance imaging data were collected prior to individual psychotherapy. Differences in brain activity during passive viewing of individualised self-critical material in 23 unmedicated out-patients with depression and 28 healthy controls were assessed. The associations between brain activity, cognitive and emotional change, and outcome were analysed in 21 patients. Results: Patients showed enhanced activity in the amygdala and ventral striatum compared with the control group. Non-response to therapy was associated with enhanced activity in the right amygdala compared with those who responded, and activity in this region was negatively associated with outcome. Emotional but not cognitive changes mediated this association. Conclusions: Amygdala hyperactivity may lessen symptom improvement in psychotherapy for depression through attenuating emotional skill acquisition.

Item Type:

Journal Article (Original Article)


07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy
07 Faculty of Human Sciences > Institute of Psychology

UniBE Contributor:

Krieger, Tobias and grosse Holtforth, Martin


100 Philosophy > 150 Psychology
600 Technology > 610 Medicine & health




Royal College of Psychiatrists




Adriana Biaggi

Date Deposited:

28 Jan 2016 10:49

Last Modified:

02 Feb 2016 01:30

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PubMed ID:





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