title: Cognitive Enhancement Therapy Improves Frontolimbic Regulation of Emotion in Alcohol and/or Cannabis Misusing Schizophrenia: A Preliminary Study.
abstract: Individuals with schizophrenia who misuse substances are burdened with impairments in emotion regulation. Cognitive enhancement therapy (CET) may address these problems by enhancing prefrontal brain function. A small sample of outpatients with schizophrenia and alcohol and/or cannabis substance use problems participating in an 18-month randomized trial of CET (n = 10) or usual care (n = 4) completed posttreatment functional neuroimaging using an emotion regulation task. General linear models explored CET effects on brain activity in emotional neurocircuitry. Individuals treated with CET had significantly greater activation in broad regions of the prefrontal cortex, limbic, and striatal systems implicated in emotion regulation compared to usual care. Differential activation favoring CET in prefrontal regions and the insula mediated behavioral improvements in emotional processing. Our data lend preliminary support of CET effects on neuroplasticity in frontolimbic and striatal circuitries, which mediate emotion regulation in people with schizophrenia and comorbid substance misuse problems.
authors.affiliation: School of Social Work, University of Pittsburgh , Pittsburgh, PA , USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Wojtalik
authors.affiliation: Department of Psychiatry, School of Medicine, University of Pittsburgh , Pittsburgh, PA , USA.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Hogarty
authors.affiliation: Department of Psychiatry, School of Medicine, University of Pittsburgh , Pittsburgh, PA , USA.
authors.forename: Jack R
authors.initials: JR
authors.lastname: Cornelius
authors.affiliation: Department of Psychiatry, School of Medicine, University of Pittsburgh , Pittsburgh, PA , USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Phillips
authors.affiliation: Department of Psychiatry, Harvard Medical School , Boston, MA , USA.
authors.forename: Matcheri S
authors.initials: MS
authors.lastname: Keshavan
authors.affiliation: School of Social Work, University of Pittsburgh , Pittsburgh, PA , USA.
authors.forename: Christina E
authors.initials: CE
authors.lastname: Newhill
authors.affiliation: School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Shaun M
authors.initials: SM
authors.lastname: Eack
keywords: alcohol misuse; brain; cannabis misuse; cognitive enhancement therapy; emotion regulation; schizophrenia