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The Neurophysiology Behind Trauma-Focused Therapy Modalities Used to Treat Post-Traumatic Stress Disorder Across the Life Course: A Systematic Review
Trauma, Violence, & Abuse ( IF 5.4 ) Pub Date : 2021-12-06 , DOI: 10.1177/15248380211048446
Zachary P Pierce 1, 2 , Jessica M Black 1, 2
Affiliation  

This review presents the current state of understanding of trauma-informed modalities in light of current research in neuroscience, analyzing which brain structures and processes are impacted by these modalities. Studies included in the present review met the inclusion criteria of 1) addressing post-traumatic stress disorder (PTSD) in a specific population, 2) treatment of PTSD using any of the evidence-based trauma-informed modalities considered in this review, and 3) presenting functional magnetic resonance imagery (fMRI) data, derived from BOLD signals and voxel-compression maps, of brain structures impacted by these trauma-informed modalities. Articles for this review were collated through PubMed and MEDLINE, using key terms in descending order, such as ‘childhood trauma’, ‘adolescent trauma’, and ‘adulthood trauma’, to ‘PTSD’, ‘fMRI’, and so on, depending on the modality in question. Based on these criteria and research methods, 37 studies remained for inclusion in the present review. Among a number of critical findings, this review demonstrates that eye movement desensitization and reprocessing (EMDR) and mindfulness therapy effectively deactivate hindbrain regions implicated in the downregulation of autonomic nervous system (ANS) hyperarousal. This review also shows that trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR activate the hippocampus, anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC)—areas that are implicated in crucial cognitive, affective, and behavioral processes that aid trauma survivors in navigating their challenges.



中文翻译:

用于治疗整个生命过程中的创伤后应激障碍的以创伤为重点的治疗方式背后的神经生理学:系统评价

这篇综述根据当前的神经科学研究,介绍了对创伤知情模式的理解现状,分析了哪些大脑结构和过程受到这些模式的影响。本综述纳入的研究符合纳入标准:1)解决特定人群的创伤后应激障碍(PTSD)问题,2)使用本综述中考虑的任何基于证据的创伤知情方式治疗 PTSD,以及 3 )呈现功能性磁共振成像 (fMRI) 数据,这些数据源自 BOLD 信号和体素压缩图,显示受这些创伤信息模式影响的大脑结构。本综述的文章通过 PubMed 和 MEDLINE 进行整理,使用降序排列的关键术语,例如“童年创伤”、“青少年创伤”和“成年创伤”,到“PTSD”、“fMRI”等,具体取决于关于所讨论的方式。根据这些标准和研究方法,仍有 37 项研究纳入本综述。在许多重要发现中,本次综述表明,眼动脱敏和再处理(EMDR)和正念疗法可以有效地使与自主神经系统(ANS)过度兴奋下调有关的后脑区域失活。本综述还表明,以创伤为中心的认知行为疗法 (TF-CBT) 和 EMDR 会激活海马体、前扣带皮层 (ACC)、内侧前额叶皮层 (mPFC) 和眶额皮层 (OFC),这些区域与关键认知相关帮助创伤幸存者应对挑战的情感和行为过程。

更新日期:2021-12-06
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