Amygdala response to self-critical stimuli and symptom improvement in psychotherapy for depression

Background: Cognitive–behavioural therapy is efficacious in the treatment of major depressive disorder but response rates are still far from satisfactory. Aims: To better understand brain responses to individualised emotional stimuli and their association with outcome, to enhance treatment. Method: Functional magnetic resonance imaging data were collected prior to individual psychotherapy. Differences in brain activity during passive viewing of individualised self-critical material in 23 unmedicated out-patients with depression and 28 healthy controls were assessed. The associations between brain activity, cognitive and emotional change, and outcome were analysed in 21 patients. Results: Patients showed enhanced activity in the amygdala and ventral striatum compared with the control group. Non-response to therapy was associated with enhanced activity in the right amygdala compared with those who responded, and activity in this region was negatively associated with outcome. Emotional but not cognitive changes mediated this association. Conclusions: Amygdala hyperactivity may lessen symptom improvement in psychotherapy for depression through attenuating emotional skill acquisition.

Associations of self-compassion and global self-esteem with positive and negative affect and stress reactivity in daily life: Findings from a smart phone study

The present study examined trait self-compassion and trait self-esteem in relation to positive (PA) and negative affect (NA), as well as their associations with stress reactivity in daily life. One hundred and one subjects completed questionnaires on perceived stress and affect twice a day for 14 consecutive days on smart phones. Results indicated that self-compassion and global self-esteem were positively related to PA and negatively to NA. After controlling for self-esteem, self-compassion remained significantly associated with PA and NA, whereas self-esteem was no longer associated with PA and NA after controlling for self-compassion. Furthermore, results indicated that self-compassion buffered the effect of stress on NA, whereas this was not the case for global self-esteem. Neither self-compassion nor self-esteem moderated the relation of stress on PA in separate models. The results of the present study add to the growing literature regarding beneficial relations of self-compassion and psychological well-being and further emphasize the distinction of self-compassion and global self-esteem.