The development and improvement of the neuroimaging techniques Over the last decades it has allowed us to understand the structures and functions of the brain in living subjects.
Before the appearance of these techniques, the study of the brain was considerably limited in such a way that it was difficult to identify the changes that occurred in it over time.
Neuroimaging has opened new lines of research such as the identification of abnormalities in the brain functioning of subjects with psychiatric pathologies, determination of the brain structures involved during the performance of a specific task (such as, for example, remembering a list of names) – or a better understanding of the mechanisms Brains involved in the flight response.
A way to objectively measure the effectiveness of psychological therapy
Psychological therapy produces changes in the emotional state, belief system and behavior of a patient. Thus, It is not strange that these changes also occur at the brain level One of the lines of research that has been developed with the arrival of neuroimaging is the study of brain changes that occur as a consequence of psychological therapy.
Before the arrival of neuroimaging, the effectiveness of psychological therapy was measured based on subjective measures such as the patient’s and therapist’s assessment of the degree of improvement achieved or the comparison of the results of pre- and post-treatment tests. However the neural substrate of this improvement was unknown. Hence the brain was compared to a black box whose contents could not be known. The arrival of neuroscience and, specifically, neuroimaging, has made it possible to open this box and begin to understand the functioning of the most complex organ in the body.
If we can now see the functioning and the transformations that occur in the brain, it becomes possible to objectively measure the changes that occur during the course of psychological treatment , and also those that may occur after the end of therapy. This advance makes it possible to identify those psychological treatments that are most effective for a given disorder. The brain, being a plastic organ, is shaped as a consequence of the experiences that the subject has and responds to psychological treatment through changes in its structure and functions.
Barsaglini et al. (2014) carried out a review of the main research that has analyzed the effects of psychological therapy in patients with mental disorders. In this review, they observed that obsessive-compulsive disorder is characterized by hypermetabolism in different areas of the brain, including the caudate nucleus . Many studies suggest that cognitive-behavioral treatments in patients with obsessive-compulsive disorder produce a “normalization” of the metabolic levels of the caudate nucleus and that this “normalization” is accompanied by an improvement in symptomatology.
On the other hand, patients with specific phobias (such as, for example, a phobia of spiders) experience a reduction in the activity of the limbic system involved in the fear response as a consequence of having participated in a cognitive-behavioral oriented psychological therapy. . In the case of patients with schizophrenia, various studies collected in the review by Barsaglini et al. observe that psychological therapy produces a normalization of the activity pattern in the fronto-cortical areas and, therefore, an improvement in the symptoms.
Towards a design of effective psychological treatments based on neurobiological evidence
In general terms, these results indicate that Psychological therapy produces changes in the functioning of the brain and that these changes are associated with an improvement in the patient’s symptoms In this sense, although to different degrees depending on the disorder in question, both pharmacological therapy and psychological therapy allow normalizing or compensating for abnormal patterns of brain activity.
Although it is still early to draw consistent conclusions (there are divergences in the scientific literature about what are the specific brain changes that psychological therapy produces and also about which methodology is most suitable for measuring these changes), neuroimaging opens the door to a promising line of research: the design of effective psychological treatments based on neurobiological evidence
