AI Article Synopsis

  • Rumination is a common issue in major depressive disorder (MDD) and RF-CBT specifically addresses this problem by targeting ruminative thoughts in adolescents who have remitted from MDD.
  • A study involving 55 adolescents used fMRI to assess brain activation changes during a rumination task, comparing those who underwent RF-CBT to those receiving standard treatment.
  • Results showed increased brain activation in RF-CBT participants in areas linked to rumination, but this group's task reliability was notably poorer compared to the treatment-as-usual group, indicating potential challenges in measuring rumination progress after RF-CBT.

Article Abstract

Background: Rumination is a transdiagnostic problem that is common in major depressive disorder (MDD). Rumination Focused Cognitive Behavioral Therapy (RF-CBT) explicitly targets the ruminative habit. This study examined changes in brain activation during a rumination induction task in adolescents with remitted MDD following RF-CBT. We also evaluated the reliability of the rumination task among adolescents who received treatment as usual (TAU).

Method: Fifty-five adolescents ages 14-17 completed a self-relevant rumination induction fMRI task and were then randomized to either RF-CBT (n = 30) or TAU (n = 25). Participants completed the task a second time either following 10-14 sessions of RF-CBT or the equivalent time delay for the TAU group. We assessed activation change in the RF-CBT group using paired-samples t-tests and reliability by calculating intraclass correlation coefficients (ICCs) of five rumination-related ROIs during each of three blocks for the TAU and RF-CBT groups separately (Rumination Instruction, Rumination Prompt, and Distraction).

Results: Following treatment, participants in the RF-CBT group demonstrated an increase in activation of the left precuneus during Rumination Instruction and the left angular and superior temporal gyri during Rumination Prompt ( < .01). The TAU group demonstrated fair to excellent reliability ( = .52, range = .27-.86) across most ROIs and task blocks. In contrast, the RF-CBT group demonstrated poor reliability across most ROIs and task blocks ( = .21, range = -.19-.69).

Conclusion: RF-CBT appears to lead to rumination-related brain change. We demonstrated that the rumination induction task has fair to excellent reliability among individuals who do not receive an intervention that explicitly targets the ruminative habit, whereas reliability of this task is largely poor in the context of RF-CBT. This has meaningful implications in longitudinal and intervention studies, particularly when conceptualizing it as an important target for intervention. It also suggests one of many possible mechanisms for why fMRI test-retest reliability can be low that appears unrelated to the methodology itself.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10592982PMC
http://dx.doi.org/10.1101/2023.10.09.23296759DOI Listing

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