Neural Functioning Underlying Anxiety and Its Treatment (The INSULA Study)

NCT ID: NCT00947570

Last Updated: 2012-12-31

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2007-10-31
• Study Completion Date: 2012-08-31

Brief Summary

This study will examine the effects of cognitive behavioral therapy on brain function in people with anxiety disorders.

Detailed Description

Anxiety disorders are characterized by excessive and irrational fears of common situations that impair normal functioning. Neuroimaging allows researchers to examine brain functioning as people are presented with tasks that provoke or model anxiety. Neuroimaging research suggests that anxiety is moderated by a neural circuit involving three parts of the brain: the amygdala, the insula, and the prefrontal cortex (PFC). Increased activation of the amygdala and insula is associated with high anxiety, although activation of the PFC is thought to reduce anxiety. Cognitive behavioral therapy (CBT) is the only type of psychotherapy with strong evidence for effectively treating panic disorder (PD) and generalized anxiety disorder (GAD), but it only works about half the time. This study will use neuroimaging to examine when and how CBT affects brain functioning in people with PD and GAD. The long-term goals of the research are to develop neuroimaging as a diagnostic tool, to use neuroimaging to predict treatment response, and to understand which changes in brain functioning are related to successful treatment.

Participation in this study will last approximately 3 months. Four groups of participants will be recruited: healthy controls and people with PD, GAD, or social phobia (SP). All participants will undergo functional magnetic resonance imaging (fMRI) scanning-a measure of brain functioning-at the first visit. During the fMRI scan, participants will be asked to perform computerized tasks that involve responding to images. This will be the only visit that the healthy controls and people with SP complete; their inclusion in the study establishes a comparison point for the brain scans of the other participants. People with PD and GAD will then be asked to complete 10 sessions of CBT over a 10- to 14-week period. After 3 months, these participants will again undergo fMRI scanning. At 3 and 6 months after the completion of CBT, these participants will be asked to complete follow-up questionnaires about their anxiety.

Conditions

Generalized Anxiety Disorder; Panic Disorder; Anxiety Disorders

Keywords

Cognitive Behavioral Therapy; Functional Brain Imaging; Psychotherapy; Treatment; Brain Imaging

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: NONE

Study Groups

Cognitive behavioral therapy

Participants with panic disorder or generalized anxiety disorder (GAD) will receive a course of individual cognitive behavioral therapy targeted at their principal disorder.

Group Type: EXPERIMENTAL

Cognitive behavioral therapy for anxiety

Intervention Type: BEHAVIORAL

10 sessions delivered over the course of 14 weeks and aimed at reducing pathological behaviors and patterns of thought

Interventions

Cognitive behavioral therapy for anxiety

10 sessions delivered over the course of 14 weeks and aimed at reducing pathological behaviors and patterns of thought

Intervention Type: BEHAVIORAL

Other Intervention Names

CBT; Behavior Therapy

Eligibility Criteria

Inclusion Criteria

• High school or higher education
• DSM-IV diagnosis of panic disorder (with ongoing symptoms), generalized anxiety disorder, or both

Exclusion Criteria

• Lifetime diagnosis of psychotic disorder, organic mental disorder, or bipolar I disorder
• Substance dependence within the last 12 months or diagnosis of alcohol or substance abuse within the past month
• Use of psychotropic or anti-epileptic medications within the past 6 weeks
• Heavy caffeine use, defined as drinking more than 6 caffeinated beverages per day
• Current smoker
• Possibility of pregnancy
• History of claustrophobia or difficulty lying flat for long periods
• Ferrous metal in the body

• Lifetime diagnosis of major depressive disorder (MDD), bipolar I or II disorder, panic disorder (PD), agoraphobia without panic, generalized anxiety disorder (GAD), social phobia (SP), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), or an eating disorder

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute of Mental Health (NIMH)

NIH

Sponsor Role: collaborator

University of California, San Diego

OTHER

Sponsor Role: lead

Responsible Party

Murray B. Stein

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Murray B. Stein, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

University of California, San Diego

Countries

United States

Related Links

http://www.veryshy.org/research/

Click here for more information on the UCSD Anxiety Disorders Research Program

Other Identifiers

R01MH065413

Identifier Type: NIH

Identifier Source: secondary_id

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DATR A2-AIA

Identifier Type: -

Identifier Source: secondary_id

R01MH065413

Identifier Type: NIH

Identifier Source: org_study_id

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