title: Brain-based origins of change language: a beginning.
abstract: Motivational interviewing (MI) is a promising treatment for heavy drinking. Client change talk (CT), a critical component of MI, has been associated with differential brain activation. The goal of this study was to begin to deconstruct how and why CT may affect the brain. Specifically, we sought to determine whether simply repeating statements in favor of change would cause differential brain activation, or whether client statements must be spontaneously generated within a therapeutic milieu in order to influence brain activation. We therefore examined blood oxygenation level dependent (BOLD) response following two types of client language (CT; and sustain talk, ST) across two conditions: (1) Self-Generated: CT and ST were elicited during an MI session vs. (2) Experimenter-Selected: a pre-established list of CT and ST was provided to the individual in the absence of an MI session. Across both conditions, participants' CT and ST were visually and aurally presented during fMRI. We enrolled 39 recent binge drinkers (41% male; M age=19.9; n=18 in Self-Generated group; n=21 in Experimenter-Selected group). We found that both types of client language (CT and ST) elicited greater BOLD activation in the Self-Generated vs. the Experimenter-Selected group in the left inferior frontal gyrus/anterior insula and superior temporal gyri (p≤0.001). These findings indicate that the nature of client language matters. It appears that it is not just the words themselves, but the origin (naturally generated within a therapeutic session) that influences brain-based effects.
authors.affiliation: University of New Mexico, Department of Psychiatry, 1 University of New Mexico, MSC09 5030, Albuquerque, NM 87131, USA. Electronic address: swfeld@salud.unm.edu.
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Feldstein Ewing
authors.affiliation: Advance MRI, Frisco, TX 75035, USA. Electronic address: uma.yezhuvath@advancemri.com.
authors.forename: Uma
authors.initials: U
authors.lastname: Yezhuvath
authors.affiliation: University of New Mexico, Center on Alcoholism, Substance Abuse and Addiction (UNM CASAA), 2650 Yale Blvd SE, Albuquerque, NM 87106, USA. Electronic address: jhouck@unm.edu.
authors.forename: Jon M
authors.initials: JM
authors.lastname: Houck
authors.affiliation: Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA. Electronic address: Francesca.filbey@utdallas.edu.
authors.forename: Francesca M
authors.initials: FM
authors.lastname: Filbey
mesh_terms: D000293:Adolescent; D000328:Adult; D063425:Binge Drinking / Q000523:psychology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D007802:Language; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D062405:Motivational Interviewing / Q000379:methods*; D011369:Professional-Patient Relations; D016896:Treatment Outcome; D055815:Young Adult
keywords: Alcohol; Client language; Motivational interviewing; fMRI