TY - JOUR
T1 - How Psychosocial Alcohol Interventions Work
T2 - A Preliminary Look at What fMRI Can Tell Us
AU - Feldstein Ewing, Sarah W.
AU - Filbey, Francesca M.
AU - Sabbineni, Amithrupa
AU - Chandler, Lindsay D.
AU - Hutchison, Kent E.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/4
Y1 - 2011/4
N2 - Background: Current work in motivational interviewing (MI) has supported the role of in-session client and therapist language in predicting postintervention substance use outcomes. In particular, a relationship has been found between specific therapist language (e.g., MI-consistent behaviors), specific types of client speech (e.g., change talk; CT and counterchange talk; CCT), and subsequent drinking outcomes. One hypothesis to explain this phenomenon is that CT is an indication of a neurocognitive shift that happens during the course of a psychosocial intervention. And, it is possible that this shift is responsible for catalyzing and maintaining changes in drinking behaviors following MI interventions. To investigate this question, the effect of CT on blood oxygen level-dependent (BOLD) response during the presentation of alcohol cues was evaluated using functional magnetic resonance imaging. Methods: To examine changes in neural response to alcohol cues following client language, 10 adults with alcohol dependence (50% men; 40% Caucasian; 40% Hispanic; M age=42.6; M years of education=13.3) were presented with CT and CCT derived from their prescan MI session during the presentation of alcohol cues. Results: Following CCT, there was significant neural response to alcohol cues in several key reward areas (cluster-corrected p<0.05, z>2.3; orbitofrontal cortex, nucleus accumbens, anterior insula, posterior insula, caudate, and putamen). On the contrary, there were no areas of significant reward activation following CT. Conclusions: These results indicate that CT may be effectively inhibiting activation in brain regions that respond to the salience of alcohol cues. These findings provide preliminary biological support of the psychosocial literature findings, highlighting the critical importance of change talk during psychosocial interventions.
AB - Background: Current work in motivational interviewing (MI) has supported the role of in-session client and therapist language in predicting postintervention substance use outcomes. In particular, a relationship has been found between specific therapist language (e.g., MI-consistent behaviors), specific types of client speech (e.g., change talk; CT and counterchange talk; CCT), and subsequent drinking outcomes. One hypothesis to explain this phenomenon is that CT is an indication of a neurocognitive shift that happens during the course of a psychosocial intervention. And, it is possible that this shift is responsible for catalyzing and maintaining changes in drinking behaviors following MI interventions. To investigate this question, the effect of CT on blood oxygen level-dependent (BOLD) response during the presentation of alcohol cues was evaluated using functional magnetic resonance imaging. Methods: To examine changes in neural response to alcohol cues following client language, 10 adults with alcohol dependence (50% men; 40% Caucasian; 40% Hispanic; M age=42.6; M years of education=13.3) were presented with CT and CCT derived from their prescan MI session during the presentation of alcohol cues. Results: Following CCT, there was significant neural response to alcohol cues in several key reward areas (cluster-corrected p<0.05, z>2.3; orbitofrontal cortex, nucleus accumbens, anterior insula, posterior insula, caudate, and putamen). On the contrary, there were no areas of significant reward activation following CT. Conclusions: These results indicate that CT may be effectively inhibiting activation in brain regions that respond to the salience of alcohol cues. These findings provide preliminary biological support of the psychosocial literature findings, highlighting the critical importance of change talk during psychosocial interventions.
KW - Alcohol Dependence
KW - Client Statements
KW - FMRI
KW - Motivational Interviewing
KW - Neuroimaging
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U2 - 10.1111/j.1530-0277.2010.01382.x
DO - 10.1111/j.1530-0277.2010.01382.x
M3 - Article
C2 - 21223301
AN - SCOPUS:79953055804
VL - 35
SP - 643
EP - 651
JO - Alcoholism: Clinical and Experimental Research
JF - Alcoholism: Clinical and Experimental Research
SN - 0145-6008
IS - 4
ER -