Stijn Michielse1, Jindra Bakker1, Iris Lange1, Liesbet Goossens1, Koen Schruers1,2, Ritsaert Lieverse1, Therese van Amelsvoort1, Marieke Wichers3, Jim van Os1,4,5, and Machteld Marcelis1,6
1Psychiatry & Neuropsychology, Maastricht University, Maastricht, Netherlands, 2Faculty of Psychology, University of Leuven, Leuven, Belgium, 3Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands, 4Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, United Kingdom, 5f. Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands, 6Institute for Mental Health Care, Eindhoven, Netherlands
Synopsis
This project is an RCT in
51 individuals with
mild psychopathology
randomly assigned to Acceptance and Commitment Therapy
(ACT) or topic discussion group conditions. Participants underwent Diffusion Weighted Imaging (DWI), Experience Sampling Method (ESM) and a Community Assessment of Psychic Experiences (CAPE) questionnaire before and after intervention. Results show no differences between conditions after the intervention in the white matter (DWI) or the amount of psychotic experiences (CAPE). The suspicious mood ESM item showed was significantly changed due to ACT-intervention. Therefore white matter changes do not seem to occur, while mood changes as a result after 12 week intervention.
Background
During adolescence, vulnerability to psychopathology
is relatively high and this is an important time window for early
interventions. These early interventions may impact brain white matter
plasticity. Acceptance and commitment therapy (ACT) has been shown to be
effective in reducing depression, anxiety and psychosis related symptoms. The
current study examined structural white matter and symptom alterations before
and after ACT intervention in adolescents with mild psychopathology.
Material & methods
A sample of 45 individuals with mild psychopathology
(CAPE distress score ≥2 or MADRS > 10) with an average age of 21
years old was included. Double blinded, random allocation to the intervention
(ACT (n=20)) and the control condition (film discussion (FILM, n=25)) was done.
The ACT intervention and FILM intervention lasted six weekly meetings. 3T
anatomical and DWI scans were obtained and further processed in ExploreDTI. DWI
white matter measures were fractional anisotropy (ΔFA), axial diffusivity
(ΔAXD), radial diffusivity (ΔRAD) and mean diffusivity (ΔMD). Tract-based
spatial statistics (TBSS) was applied to statistically compare ACT and FILM
conditions. Furthermore regression analyses on the interactions between
condition and respectively ΔFA, ΔAXD, ΔRAD and ΔMD in the model of CAPE
positive and CAPE total (both frequency and distress) symptom scores were
conducted. The Experience Sample Method (ESM) was applied to assess suspicious
mood, feeling unreal and feeling calm headed in daily life. Statistical
analyses were conducted using multilevel regression models. All measurements
were conducted at baseline T0 and repeated after the intervention at T1 with 12
weeks between time points.
Results
Whole brain TBSS analyses did not show any
differences on ΔFA, ΔAXD, ΔRAD and ΔMD measures between the two conditions and did
not differ with respect to the change of symptoms (T1 – T0 on the CAPE and
MADRS scales). There was a significant interaction between condition and ΔFA in
the ΔCAPE total frequency score model (Chi2=2.9479, p=0.0860). Stratified
analyses per condition revealed a non-significant association for both
conditions (ACT-condition; B=0.0000000, p=0.7372 and FILM-condition;
B=0.0000000, p=0.1366). A significant interaction was found between condition
and ΔAXD in the ΔCAPE total distress score model (Chi2=3.1697, p=0.0750).
Stratified analyses per condition revealed a non-significant association in the
ACT-condition (B=0.0000000, p=0.1061) and FILM-condition (B=0.0000000,
p=0.9739). ESM analyses showed for the ACT-condition significantly (B=0.5953,
p=0.00383) increased suspicious mood at T1 compared to FILM-condition, while
the items feeling unreal and calm headed were not statistically different.
Discussion and conclusion
The ACT intervention showed no difference in
symptoms over time (T1-T0) compared to the control condition, and no white
matter structural changes. In daily life functioning, as measured via ESM, a
significant increase in suspicious mood was found related to the ACT
intervention. This might indicate that mood changes before white matter
alterations happen. It can be speculated that this increase in suspicious mood may
indicate more awareness of the surrounding environment which needs further
investigation.Acknowledgements
No acknowledgement found.References
No reference found.