Citation

Feldstein Ewing SW, Houck JM, Yezhuvath U, Kojori ES, Truitt D, Filbey FM. Behav. Brain Res. 2015; 297: 359-369.

Affiliation

Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA. Electronic address: francesca.filbey@utdallas.edu.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.bbr.2015.09.041

PMID

26455873

Abstract

Despite foundational work, we still do not know how therapist behaviors influence brain response and related treatment outcomes for alcohol-using adolescents. Therefore, we examined this question with 17 binge drinking youth (mean age = 16.62 years; 64.3% female; 42.9% Hispanic; 28.6% bi-/multi-racial). In this within-subjects design, all youth completed a baseline assessment, two therapy sessions, an fMRI scan, and were re-evaluated for behavior change at one-month post-treatment. During the fMRI session, youth were presented with two types of therapist responses from their treating therapist: higher-skill therapeutic statements prescribed in an empirically-supported addiction treatment (complex reflections) versus language standard within addiction treatment more broadly (closed questions). In terms of behavior change, at the one-month follow-up, youth showed significant reductions in their number of drinking days and binge drinking days post-treatment. Further, we found main effects for complex reflections and closed questions across the superior middle temporal gyrus and middle temporal gyrus (FWE-corrected, p<.05). Complex questions showed a relatively stronger response than closed questions within the bilateral anterior cingulate gyrus. Additionally, greater BOLD response in the parietal lobe during closed questions was significantly associated with less post-treatment drinking. Finally, lower BOLD responses during both complex reflections and closed questions in the precuneus were associated with greater post-treatment ratings of importance of changing drinking. This study represents a first step in understanding how certain therapist behaviors influence the developing adolescent brain and how that neural response may be associated with youth treatment outcomes in the context of addiction treatment.

Language: en