Research Digest

Kumari, V. (2006). Do psychotherapies produce neurobiological effects?  Acta Neuropsychiatrica,  18:  61-70.

This is a review paper that surveys the literature on functional imaging studies comparing the outcome of psychotherapy to pharmacotherapy. There is, of course, an increasing body of knowledge about the extent to which “psychological” treatments can produce brain changes, and I suspect that most readers of this journal will be aware of the existence of this newly developing literature. One advantage of this paper is that it summarizes a large body of work—thus saving the reader the effort of tracking down many individual scientific papers, spread across many journals. More importantly, the paper demonstrates how variable the effects are across studies. In many cases, the effects of psychotherapy and of pharmacotherapy are roughly similar in “magnitude” (efficacy being a variable that is, of course, difficult to define …). In other cases, one or other approach appears to be more “effective.” However, of greater interest are the likely differential effects of one approach on particular brain regions. For example, brain changes in frontal cortex and cingulate gyrus appear to be, in many cases, selective to the psycho-therapeutic approach. These findings are clearly open to interpretation about the differences in treatment “mechanism” between psychotherapy and pharmacotherapy—whether one chooses to label these as bottom-up vs. top-down, or core-emotion vs. emotion-regulation effects. Plainly, the findings are of substantial theoretical and practical significance. Of course, these studies are almost invariably undertaken using cognitive behavioral therapy, rather than psychoanalysis. Nevertheless, the general findings uncovered in this research are likely to be applicable to many, or all, classes of “talking cure” and have obvious implications for our field.

Frank, M. J., O'Reilly, R. C., & Curran, T. (2006). When memory fai