Zusammenfassung
Erst in jüngster Zeit werden zunehmend funktionelle bildgebende Verfahren in der Psychotherapieforschung ein gesetzt. Es soll ein Überblick über die Verfahren, methodischen Grundlagen und für die Psychotherapie relevanten Forschungsansätze der Bildgebung mit funktioneller Kernspintomographie (fMRT) und Positronen-Emissionstomographie (PET) gegeben werden. Aktuelle Befunde zu Veränderungen von Hirnfunktionen durch Psychotherapie werden dargestellt und im Hinblick auf ihre Aussagekraft und den möglichen Stellenwert bildgebender Verfahren in der Psychotherapieforschung kritisch diskutiert. Nachgewiesen wurden systematische Veränderungen der Aktivierung bestimmter Hirnregionen nach erfolgreicher psychotherapeutischer, kognitivbehavioraler und psychodynamischer Behandlung von Zwangsstörungen, Depressionen, Phobien, Panik und Borderline-Persönlichkeitsstörungen, die teils Veränderungen nach psychopharmakologi scher Therapie ähnelten, sich teils aber auch deutlich unterschieden. Damit ist die traditionelle Trennung zwischen pharmakologischen Verfahren, die „auf das Gehirn wirken“, und psychologischen Verfahren, die bewirken, dass sich „der Patient besser fühlt“, obsolet. Verfahren der funktionellen Bildgebung haben sich so weit entwickelt, dass sie genutzt werden können, um Fragen zu untersuchen, die von großer Bedeutung für Psychotherapien sind, v. a. Fragen zu den biologischen Grundlagen psychischer Störungen, zur Plastizität neuronaler Netzwerke sowie zu Veränderungsmechanismen und Prognosefaktoren von Psychotherapie etc.
Abstract
Only recently has functional neuroimaging been used increasingly in the context of psychotherapy research. Based on a literature survey, procedures, methodological underpinnings and paradigms relevant for psychotherapy research are explored regarding functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). Current studies on changes of brain functions and potential mechanisms are presented based on obsessive-compulsive disorders, depression, phobia, panic and borderline personality disorders. Findings and implications are discussed regarding the use of functional neuroimaging in psychotherapy research. Systematic changes of brain activation were demonstrated following successful psychotherapy, partially resembling and partially differing from those induced by psychopharmacological treatments. Thus the traditional split between pharmacological procedures „acting on the brain“ and psychological procedures making the patient „feel better“ has been rendered obsolete. Procedures of functional neuroimaging have been developed to such an extent that they can be used to study issues of great relevance for psychotherapy, e. g. biological underpinnings of psychiatric disorders, plasticity of neural networks, mechanisms of change and prognostic factors of psychotherapy, etc.
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Beutel, M.E. Psychische Störungen und Psychotherapieeffekte in der funktionellen Bildgebung. Bundesgesundheitsbl. 49, 749–758 (2006). https://doi.org/10.1007/s00103-006-0005-9
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DOI: https://doi.org/10.1007/s00103-006-0005-9
Schlüsselwörter
- Psychotherapieforschung
- Funktionelle Kernspintomographie (fMRT)
- Positronen- Emissionstomographie (PET)
- Wirksamkeit