Trials / Recruiting

RecruitingNCT05549102

CBT and the Neural Circuits of Anxiety

The Impact of CBT on Shock-Potentiated Neural Circuity

Status: Recruiting
Phase: —
Study type: Observational
Enrollment: 174 (estimated)

Sponsor: UCLH/UCL Joint Research Office · Academic / Other
Sex: All
Age: 18 Years – 64 Years
Healthy volunteers: —

Summary

This study will aim to test whether specific neural circuitry changes, proposed on the basis of a neurocognitive model of anxiety, are a mechanism of action for Cognitive Behavioural Therapy (CBT) interventions. This study aims to provide a theoretical model of the neurobiological mechanisms of CBT's therapeutic effect, where there currently is none, and potentially allow for more targeted/specific approaches to anxiety disorders following the identification of key CBT mechanisms. The ultimate aim is to improve the efficacy of CBT, and more generally, psychological interventions for anxiety disorders.

Detailed description

To test the hypothesis that the neural circuitry of the amygdala and prefrontal cortex will respond to CBT, the impact of a course of CBT on cortical-subcortical circuitry will be tested via a case-control study in individuals entering Improving Access to Psychological Therapies (IAPT) services (IAPT step 3; i.e., full CBT) for anxiety disorders and individuals in waiting lists. This design leverages the naturalistic waiting times in the clinical service and does not interfere with treatment as usual. Measures of brain region-specific connectivity and emotion-related behavioural performance will be assessed through testing sessions at the University College London (UCL) Institute of Cognitive Neuroscience and the Birkbeck-UCL Centre for NeuroImaging (BUCNI), involving computerised cognitive/psychological tasks and functional magnetic resonance imaging (fMRI). The aims are to: 1. test whether this circuit responds to a course of CBT, by demonstrating disengagement of the circuit following CBT 2. relate this change in circuit function to behaviour through cognitive measures of emotional processing 3. explore the neurobiological features that distinguish patients who respond to CBT and those who do not 4. compare the data from this study to another on-going study assessing the impact of pharmacological interventions for anxiety, allowing for the comparison of neurobiological mechanisms of psychological vs. pharmacological treatments in anxiety.

Conditions

Interventions

Type	Name	Description
BEHAVIORAL	Cognitive Behavioural Therapy	In the Cognitive Behavioural Therapy group (N=87), patients will undergo CBT as part of their routine care in Step 3 of the IAPT programme. This will be administered by suitably trained clinicians. The specification of CBT is as recommended by the National Institute for Health and Care Excellence (NICE) guidelines (CG113 - Generalised anxiety disorder and panic disorder in adults: management). In these guidelines, patients are offered on average, 12-15 hourly, weekly sessions of CBT with a trained and competent practitioners. Therapy sessions involve discussions that identify patterns in thinking or behaviours which may be problematic, and therapists and patients work to set goals to reduce these using cognitive techniques. The principle is to teach the patient how to use CBT techniques in their day-to-day life to promote a lasting effect on mental health. We will test patients before (T1) and after (T2) a course of treatment.
OTHER	Waiting List	In the control group (N=87), we will test patients who are currently seeking (but not undergoing) treatment before (T1) and after a wait (T2) of equivalent time (i.e. waiting list controls)

Timeline

Start date: 2020-02-02
Primary completion: 2025-12-01
Completion: 2025-12-01
First posted: 2022-09-22
Last updated: 2025-06-29

Locations

1 site across 1 country: United Kingdom

Source: ClinicalTrials.gov record NCT05549102. Inclusion in this directory is not an endorsement.