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. 2016 Jan 12:6:186.
doi: 10.3389/fpsyt.2015.00186. eCollection 2015.

Cognitive Enhancement Therapy Improves Frontolimbic Regulation of Emotion in Alcohol and/or Cannabis Misusing Schizophrenia: A Preliminary Study

Jessica A Wojtalik  1 , Susan S Hogarty  2 , Jack R Cornelius  2 , Mary L Phillips  2 , Matcheri S Keshavan  3 , Christina E Newhill  1 , Shaun M Eack  4
Affiliations

Cognitive Enhancement Therapy Improves Frontolimbic Regulation of Emotion in Alcohol and/or Cannabis Misusing Schizophrenia: A Preliminary Study

Jessica A Wojtalik et al. Front Psychiatry. .

Abstract

Individuals with schizophrenia who misuse substances are burdened with impairments in emotion regulation. Cognitive enhancement therapy (CET) may address these problems by enhancing prefrontal brain function. A small sample of outpatients with schizophrenia and alcohol and/or cannabis substance use problems participating in an 18-month randomized trial of CET (n = 10) or usual care (n = 4) completed posttreatment functional neuroimaging using an emotion regulation task. General linear models explored CET effects on brain activity in emotional neurocircuitry. Individuals treated with CET had significantly greater activation in broad regions of the prefrontal cortex, limbic, and striatal systems implicated in emotion regulation compared to usual care. Differential activation favoring CET in prefrontal regions and the insula mediated behavioral improvements in emotional processing. Our data lend preliminary support of CET effects on neuroplasticity in frontolimbic and striatal circuitries, which mediate emotion regulation in people with schizophrenia and comorbid substance misuse problems.

Keywords: alcohol misuse; brain; cannabis misuse; cognitive enhancement therapy; emotion regulation; schizophrenia.

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Figures

Figure 1
Figure 1
Example of a 2-back happy face distracter condition from the emotional faces n-back task. [Reproduced with permission from Ladouceur et al. (34)].
Figure 2
Figure 2
Regions of significantly greater activation in participants completing 18 months of CET, compared to TAU, during the emotional faces n-back task.
See this image and copyright information in PMC

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