title: Changing views of emotion regulation and neurobiological models of the mechanism of action of psychotherapy.
abstract: Influential neurobiological models of the mechanism of action of psychotherapy attribute its success to increases of activity in prefrontal areas and decreases in limbic areas, interpreted as the successful and adaptive recruitment of controlled processes to achieve emotion regulation. In this article, we review the behavioral and neuroscientific evidence in support of this model and its applicability to explain the mechanism of action of psychotherapy. Neuroimaging studies of explicit emotion regulation, evidence on the neurobiological substrates of implicit emotion regulation, and meta-analyses of neuroimaging studies of the effect of psychotherapy consistently suggest that areas implicated in coding semantic representations play an important role in emotion regulation not covered by existing models based on controlled processes. We discuss the findings that implicate these same areas in supporting working memory, in encoding preferences and the prospective outcome of actions taken in rewarding or aversive contingencies, and show how these functions may be integrated into process models of emotion regulation that depend on elaborate semantic representations for their effectiveness. These alternative models also appear to be more consistent with internal accounts in the psychotherapeutic literature of how psychotherapy works.
authors.affiliation: Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany. Irene-messina@hotmail.com.|Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Via Belzoni 84, 35121, Padua, Italy. Irene-messina@hotmail.com.
authors.forename: Irene
authors.initials: I
authors.lastname: Messina
authors.affiliation: Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Via Belzoni 84, 35121, Padua, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Sambin
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Beschoner
authors.affiliation: Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany.|Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
authors.forename: Roberto
authors.initials: R
authors.lastname: Viviani
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D004644:Emotions / Q000502:physiology*; D006801:Humans; D001523:Mental Disorders / Q000473:pathology / Q000523:psychology / Q000534:rehabilitation; D008959:Models, Neurological; D059906:Neuroimaging; D011613:Psychotherapy; D012660:Semantics
keywords: Avoidance; Emotion regulation; Neuroimaging; Psychotherapy; Semantics; Suppression