Using Neurofeedback as a Means of Treating Feelings of Self-Blame in Depression

Summary: Neurofeedback can help to alleviate some of the key symptoms of self-blame in people with non-anxious major depressive disorder.

Source: King’s College London

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has suggested that using neurofeedback to address self-blame in people experiencing non-anxious major depressive disorder (MDD) can help to lessen key symptoms.

While the study, published in Psychological Medicine, didn’t explicitly find neurofeedback to be a more effective approach than the comparative psychological intervention group, it was found to be a safe approach to managing depressive symptoms that warrants further investigation.

The investigation recruited 43 participants placed into two groups. One would receive guided therapy as a means of tackling self-blame, while the other group received similar care, but with the added aid of Functional MRI neurofeedback (fMRI).

Functional MRI (fMRI) neurofeedback provides individuals with a visual representation of their brain activity, giving participants information which would otherwise be outside of their awareness. A magnetic field is placed around a participant’s head, allowing investigators to read the blood flow signals emitted by the brain.

During the course of three sessions completed by 35 participants, they were asked to try and tackle their feelings of self-blame while thinking about personal memories. They were asked to select from a list of possible strategies such as thinking about why they might not have been able to control the outcome, or be responsible for the outcome of an event, or to think about being forgiven by a specific person or forgiving themselves.

The neurofeedback gives the individual an indication of which of these strategies has the best chance of changing their brain signals in the desired way.

The investigation established that both approaches were found to be an effective means of reducing depressive feelings.

Dr Roland Zahn, the study’s lead investigator from King’s IoPPN said, “Excitingly, we saw that symptom remission was associated with increases in self-esteem and this correlated with the frequency with which participants employed the psychological strategies in daily life.

“What needs further investigation, however, is that the neurofeedback was not found to be more effective than the simple psychological intervention.”

The researchers suggest that the existence of sub-types of depression could be the reason why. Patients with non-anxious depression found that neurofeedback was much more effective at reducing their depressive symptoms, while those with anxious distress, a newer sub-type that has had little research conducted into it, responded better to solely psychological interventions.

Dr Zahn says, “While it is disappointing that we weren’t able to establish a clear difference between interventions, we have a good basis upon which to further our study. We must now look to connect the right neurofeedback to the right depression sub-type.

“What our results do demonstrate is that self-blame-related neurofeedback is a safe intervention with clear clinical potential in current depression.”

While the study, published in Psychological Medicine, didn’t explicitly find neurofeedback to be a more effective approach than the comparative psychological intervention group, it was found to be a safe approach to managing depressive symptoms that warrants further investigation.

The investigation recruited 43 participants placed into two groups. One would receive guided therapy as a means of tackling self-blame, while the other group received similar care, but with the added aid of Functional MRI neurofeedback (fMRI).

Functional MRI (fMRI) neurofeedback provides individuals with a visual representation of their brain activity, giving participants information which would otherwise be outside of their awareness. A magnetic field is placed around a participant’s head, allowing investigators to read the blood flow signals emitted by the brain.

During the course of three sessions completed by 35 participants, they were asked to try and tackle their feelings of self-blame while thinking about personal memories. They were asked to select from a list of possible strategies such as thinking about why they might not have been able to control the outcome, or be responsible for the outcome of an event, or to think about being forgiven by a specific person or forgiving themselves.

The neurofeedback gives the individual an indication of which of these strategies has the best chance of changing their brain signals in the desired way.

This is a painting of a person falling
Functional MRI (fMRI) neurofeedback provides individuals with a visual representation of their brain activity, giving participants information which would otherwise be outside of their awareness. Image is in the public domain

The investigation established that both approaches were found to be an effective means of reducing depressive feelings.

Dr Roland Zahn, the study’s lead investigator from King’s IoPPN said, “Excitingly, we saw that symptom remission was associated with increases in self-esteem and this correlated with the frequency with which participants employed the psychological strategies in daily life.

“What needs further investigation, however, is that the neurofeedback was not found to be more effective than the simple psychological intervention.”

The researchers suggest that the existence of sub-types of depression could be the reason why. Patients with non-anxious depression found that neurofeedback was much more effective at reducing their depressive symptoms, while those with anxious distress, a newer sub-type that has had little research conducted into it, responded better to solely psychological interventions.

Dr Zahn says, “While it is disappointing that we weren’t able to establish a clear difference between interventions, we have a good basis upon which to further our study. We must now look to connect the right neurofeedback to the right depression sub-type.

“What our results do demonstrate is that self-blame-related neurofeedback is a safe intervention with clear clinical potential in current depression.”

About this depression and neurotech research news

Author: Press Office
Source: King’s College London
Contact: Press Office – King’s College London
Image: The image is in the public domain

Original Research: Closed access.
Self-blame in major depression: a randomised pilot trial comparing fMRI neurofeedback with self-guided psychological strategies” by Roland Zahn et al. Psychological Medicine


Abstract

Self-blame in major depression: a randomised pilot trial comparing fMRI neurofeedback with self-guided psychological strategies

Background

Overgeneralised self-blame and worthlessness are key symptoms of major depressive disorder (MDD) and have previously been associated with self-blame-selective changes in connectivity between right superior anterior temporal lobe (rSATL) and subgenual frontal cortices. Another study showed that remitted MDD patients were able to modulate this neural signature using functional magnetic resonance imaging (fMRI) neurofeedback training, thereby increasing their self-esteem. The feasibility and potential of using this approach in symptomatic MDD were unknown.

Method

This single-blind pre-registered randomised controlled pilot trial probed a novel self-guided psychological intervention with and without additional rSATL-posterior subgenual cortex (BA25) fMRI neurofeedback, targeting self-blaming emotions in people with insufficiently recovered MDD and early treatment-resistance (n = 43, n = 35 completers). Participants completed three weekly self-guided sessions to rebalance self-blaming biases.

Results

As predicted, neurofeedback led to a training-induced reduction in rSATL-BA25 connectivity for self-blame v. other-blame. Both interventions were safe and resulted in a 46% reduction on the Beck Depression Inventory-II, our primary outcome, with no group differences. Secondary analyses, however, revealed that patients without DSM-5-defined anxious distress showed a superior response to neurofeedback compared with the psychological intervention, and the opposite pattern in anxious MDD. As predicted, symptom remission was associated with increases in self-esteem and this correlated with the frequency with which participants employed the psychological strategies in daily life.

Conclusions

These findings suggest that self-blame-rebalance neurofeedback may be superior over a solely psychological intervention in non-anxious MDD, although further confirmatory studies are needed. Simple self-guided strategies tackling self-blame were beneficial, but need to be compared against treatment-as-usual in further trials.

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