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Brain Scan Predicts the Success of Social Anxiety Disorder Treatment

Posted by samzenpus on from the take-a-green-pill dept.

jan_jes writes: MIT researchers performed brain scans on 38 SAD patients and were able to predict with about 80% accuracy which patients would do well in cognitive behavioral therapy (CBT). Use of the scans to predict treatment outcomes improved predictions fivefold over use of a clinician's assessment alone. The researchers used a form of brain imaging that scans patients in a state of rest. Resting-state images can be done quickly and reliably, so they have the potential to be used in a clinical setting. “Choice of therapy is like a wheel of chance,” says first author Susan Whitfield-Gabrieli, a research scientist in the McGovern Institute for Brain Research at MIT. “We’re hoping to use brain imaging to help provide more reliable predictors of treatment response.”

39 comments

  1. Huh by Anonymous Coward · · Score: 0

    I just use cannibus. Done. No shrinks, no medications wrecking my liver.

    1. Re:Huh by bobbied · · Score: 1

      I just use cannibus. Done. No shrinks, no medications wrecking my liver.

      How do you think your body processes THC though your system?

      --
      "File to fit, pound to insert, paint to match" - Aircraft Maintenance 101
    2. Re:Huh by Anonymous Coward · · Score: 0

      Long answer: it depends on the route of administration. Levels of the metabolite 11-Hydroxy-THC are apparently dramatically higher for oral doses than for smoked cannabis.

    3. Re:Huh by Anonymous Coward · · Score: 0

      nothing in cannabis is hepatotoxic...

      Of course, that's true for many medications as well.

  2. So... by Anonymous Coward · · Score: 1

    ... what's wrong with social anxiety?

    Most people are assholes so it seems quite reasonable as a general attitude, doesn't it?

    1. Re:So... by Austerity+Empowers · · Score: 1

      This feels like the Star Trek episode that was a metaphor for curing homosexuality. I can't remember the name of that episode, nor did I identify with it overly much, but now it hits closer to home.

      I don't want to be cured of SAD, I want to be cured of the externally imposed need to social.

    2. Re:So... by Ol+Olsoc · · Score: 1

      This feels like the Star Trek episode that was a metaphor for curing homosexuality. I can't remember the name of that episode, nor did I identify with it overly much, but now it hits closer to home.

      I don't want to be cured of SAD, I want to be cured of the externally imposed need to social.

      Are you certain you actually have SAD? Sounds more like you are more a normal person who doesn't need to be around others for self validation.

      Here in America, it's unfortunate that not needing other people to validate ourselves is looked at as some sort of mental defect. You hear all the stupid truisms, like "You have to watch out for the quite ones, or noting that some psycho who went crazy and shot up a restaurant "was a loner". As if the cause of the loner's going crazy was that he wasn't talkative, rather than he was pathological and could not get along with anyone.

      Whne in fact, there are cultures who venerate the quiet introspective, thoughtful type.

      While here in the US, we are drifting toward veneration of reality show, over the top weirdos paradigm.

      --
      The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
    3. Re:So... by fishybell · · Score: 1

      The episode you're thinking of is The Outcast. For the lazy, this episode features an alien from an androgynous race that illegally identifies as female. She is forced to undergo "psychotectic treatment" by her people and then no longer identifies as female, going as far as agreeing that she had a "sickness" before. The tone of the episode is clearly in favor of her having the choice to identify as she wished.

      That said, I'm not sure I agree that treating social anxiety disorder is the same as "curing homosexuality;" it's a leap too far for me.

      --
      ><));>
    4. Re:So... by Anonymous Coward · · Score: 0

      But there is a basic minimum of human interaction that you need to function in this society. Unless you are some kind of very privileged person (I'm thinking royalty or hikikomori), you will have to interact with others at least a little bit in order to feed yourself and keep a roof over your head. If that basic minimum of obligatory interaction freaks you out, you have SAD, and it is your problem, not society's.

    5. Re:So... by dissy · · Score: 4, Informative

      ... what's wrong with social anxiety?
      Most people are assholes so it seems quite reasonable as a general attitude, doesn't it?

      My problem with my social anxiety is that I can't choose who or when it gets applied to.

      Even my close friends whom aren't assholes have had to put up with me "disappearing" for weeks or months on end during attacks, and while those friends are all pretty understanding of my problem it still has to be pretty hard on them as well as myself.

      I've only so far found one medication that, sorta kind technically fixes the problem.
      Mainly, while I don't feel anxiety while on it thus it technically works, I also don't feel anything else at all. No happiness, no sadness, no empathy, no looking forward to anything, etc.

      While not under an attack I can see that given the choice between feeling only bad and feeling nothing, at least nothing is arguably better in that the bad is gone and nothing else changes.
      But during an attack it's typically quite the battle convincing myself there is any point in living life without anything good to look forward to.

      While CBT hasn't worked on me, I do hope this tech gets to the point to identify other treatments that would have a higher (or any) success rate.

    6. Re:So... by Austerity+Empowers · · Score: 1

      there is a basic minimum of human interaction that you need to function in this society

      Emphasis mine, and that is exactly my point. It wasn't always necessary, but the trend is that it will become more necessary, not less. That is my point.

      Most of our technology development is headed in the wrong direction, it's designed to hold us hostage to each other rather than liberate us of each other. Curing SAD may be necessary in this future society, I would rather live in one where it is not necessary.

    7. Re:So... by danlip · · Score: 1

      I believe there is a big difference between being introverted and having social anxiety - I think I qualify for both descriptions but I see them as two separate things. Being introverted just means you need alone time and don't crave so much social interaction. Social anxiety is a paralyzing fear that prevents you from being able to interact socially even when you want/need to. Lots of introverts are happy being introverts but I have a hard time believing that anyone with social anxiety wouldn't desire a cure.

    8. Re: So... by Anonymous Coward · · Score: 0

      I completely understand what you're saying. I'm the same way. I tried multiple different medications, finally found one that takes enough of the edge off that I can go to work, but it totally eliminates all emotions. I've never tried cbt, mostly because I can't find a doctor that understands and considers SAD a real problem. Most just tell me to keep taking my meds and it will pass. Been waiting 30 years. It hasn't passed yet.

    9. Re:So... by Anonymous Coward · · Score: 0

      They "put you in your place", you refuse to accept it and you escape into solitude instead, then they hunt you down and "cure" you of your "wicked ways".

    10. Re:So... by CanadianMacFan · · Score: 1

      I think that technology is sending up farther apart. It's possible to go through life with barely any human contact now. You can order most things online and have them delivered to your door. When you go shopping there are some places you can check out yourself. You don't ask people how to do things anymore because you look it up online. Sure we may know what fifty of our "friends" had for dinner last night but when was the last time we sat down and had a proper talk with one of them? Well, there might be a couple and a few members of family that we would do that with but it's a short list of people that we have meaningful interactions with.

    11. Re:So... by Ol+Olsoc · · Score: 1

      They "put you in your place", you refuse to accept it and you escape into solitude instead, then they hunt you down and "cure" you of your "wicked ways".

      For me at least, I need to recharge the batteries every so often, and that requires getting away from people. It's when I do a lot of thinking and problem solving. Otherwise, I can socialize just fine until I need my next recharge. But you are not wrong. A lot of people who aren't social adepts get punished for it. And that just ain't right.

      --
      The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
    12. Re:So... by Anonymous Coward · · Score: 0

      Your experience is like mine almost exactly.

    13. Re:So... by Anonymous Coward · · Score: 0

      > Even my close friends whom aren't assholes...

      Use grammar like that around me and you've got good reason to be anxious.

    14. Re:So... by MagickalMyst · · Score: 1

      I wish I had mod points. Your comment just made my day! :)

      +1

      --
      Political correctness is really just herd psychology pushed by insecure people who desperately seek social conformity.
    15. Re:So... by edtice1559 · · Score: 1

      You must be younger than me. I would love a medicine that made my not feel anything. I'll probably get modded as Funny (or ridiculous), but I'd really like to know what it is so I can ask my doctor. Do you mind sending me a message?

    16. Re: So... by Anonymous Coward · · Score: 0

      finally found one that takes enough of the edge off that I can go to work, but it totally eliminates all emotions.

      Awesome. Does it have any negative side effects?

    17. Re:So... by dissy · · Score: 1

      The medicine I was on is called Citalopram (it used to be brand name Celexa), which after a few months I was at 40mg per day for almost 5 years.

      I was 31 or 32 when I started taking it, and stopped taking it just a year ago or so. I'm 37 now.

      The bulk of the effects took a week or so to kick in, but a bit longer to stop since they lower your dose over a period before stopping to avoid withdraw symptoms.

      The only big difference I've noticed since I stopped taking it completely is depression kicking in more often and stronger than I remember, however I can't say for sure what (if anything) might be responsible for that.
      I have been on other medications in that time for other things, and at the beginning I remember them trying a number of anti-anxiety medications for a couple months each before finding this one.
      I've also been hospitalized and on medications for other unrelated things in that time (prior intestinal problems) so who really knows what single thing or combination of things may have caused that.
      Or maybe life just legitimately sucks more now than almost a decade ago :}

      Still, the more you know and all that.

      I wish you good luck, and hope you end up finding the right balance of meds for your needs.

  3. screwed up enough to get a scan = can't be fixed by Anonymous Coward · · Score: 0

    ACCEPT IT

  4. Re:screwed up enough to get a scan = can't be fixe by alhead · · Score: 1

    "screwed up enough to get a scan = can't be fixed"

    Except that the scan identifies who will respond well to treatment...

  5. Actually by Ol+Olsoc · · Score: 3, Interesting

    They ought to do some brain scans of people who can't function away from people while they are at it. As a person who doesn't need a lot of social interaction, but is completely comfortablle in social situations, I'm closer to understanding the recluse than the social butterfly.

    --
    The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
    1. Re:Actually by rmdingler · · Score: 1

      They ought to do some brain scans of people who can't function away from people while they are at it.

      If you keep that kind of talk up, and it catches on, you're going to have to account for an Imperial fuck tonne of Kardashians on the Welfare.

      As a person who doesn't need a lot of social interaction, but is completely comfortablle in social situations, I'm closer to understanding the recluse than the social butterfly.

      My 2 cents and YMMV: An ability to light up the room in social situations is typically good for those with ladder climbing intentions. Individuals who can accomplish that and still prefer the general absence of human interaction have only figured out how superficial social skills actually are.

      --
      Happiness in intelligent people is the rarest thing I know.

      Ernest Hemingway

  6. Re:screwed up enough to get a scan = can't be fixe by Anonymous Coward · · Score: 1

    What about those who have so much anxiety that they wouldn't be able to get the scan?

  7. Anxiety sucks by Anonymous Coward · · Score: 0

    Everybody has a bit of anxiety from time to time, but I don't know what happened, I GAINED severe anxiety issues about 6 years ago, just out of the blue. Now I'm in a anxiety / depression cycle because anxiety is blocking me from doing things I want to do, and then I feel isolated and alone because I've isolated myself and pushed away human contact.

    Seriously, fuck this shit, and why does it seem like so many people are in the same boat? Has it always been this way (shut-ins, etc) argh

    1. Re:Anxiety sucks by digsbo · · Score: 1

      It has always been this way. I honestly think the martini culture was people self-medicating. I think much more of the population is prone to anxiety and/or depression than is generally accepted. Also, since it's a continuum of dysfunction, some people may struggle along not quite needing/getting a diagnosis, whereas others may be profound obvious cases. Lots of people probably hover around some line of "functional" by using various avoidance tactics and/or substances.

    2. Re: Anxiety sucks by Anonymous Coward · · Score: 0

      I agree with your statement. I have horrible anxiety, and about 8 years ago, I discovered that if I was drunk, I felt great. Emotionally that is. I could talk, interact, go out, laugh etc. So for 6 years that's how I handled it. Then it started interfering with work, then I had 3 rounds of hospital stays for pancreatitis, the last one, nearly fatal. So I got on some meds and quit the sauce. Nowhere near as effective, but I'm still alive. Now I just say screw the human race, and only interact when unavoidable. Work, purchasing goods, etc.

    3. Re:Anxiety sucks by Anonymous Coward · · Score: 0

      ^^ This. I was a fairly quiet, introverted kid and young adult, but I still enjoyed hanging out with people and going out.

      But when I hit my 30s, that seemed to change like a switch had been flipped. For the past decade or so, the simplest things that require human interaction are both large sources of anxiety for me and very tiring (because of the effort to overcome that anxiety... on those instances where I actually do).

      I'm just thankful that my wife is both understanding and amazing.

  8. Potentially revolutionary for psychiatric medicine by Anonymous Coward · · Score: 1

    The article doesn't mention anything about it, but this opens the possibility that there might be an objective way to determine if a person really needs drugs for their mental issues. Are depression and ADHD over-medicated? We might be able to tell, with a real test for if you need Prozac or a new hobby, or if a kid actually needs Adderall or just more exercise.

  9. Re:Potentially revolutionary for psychiatric medic by Fwipp · · Score: 1

    My worry with this thinking (determining who "really needs it") is that no test is perfect, and it needs to be really really good before it's okay to use it as diagnosis (and refuse care to those who don't pass the test).

    Even if it's 95% effective, I'd hate to be the one-in-twenty person who is wrongly told "Nope, you're faking it, no brain medicine for you."

  10. Re:screwed up enough to get a scan = can't be fixe by rainmaestro · · Score: 1

    It isn't about "fixing" someone, any more than you "fix" an alcoholic or "fix" a schizophrenic. That latent trait will always persist. Treatment is about managing the condition, keeping it controlled to the point that it no longer presents a severely negative impact on your quality of life.

    There are different treatment methods, but which one a person will respond to is largely a guess, even for an experienced therapist. The goal is avoid the process of spending months trying Method A to no effect, then months of Method B, then three years later finally finding a winner with Treatment G. The goal is to predict which treatment they are likely to respond positively to.

    The scan ties to CBT in particular because right now that is the preferred treatment for SAD and is usually the first one tried.

  11. Give me pizza instead by Tablizer · · Score: 1

    Me. no. leave. basement.

    --
    Table-ized A.I.
  12. I use that medication too! by Anonymous Coward · · Score: 0

    I've only so far found one medication that, sorta kind technically fixes the problem.

    Beer is proof that God loves us and wants us to be happy.

  13. Ooo! That's a good idea! by sabbede · · Score: 1

    I wonder how else it could be applied... I don't know why it's the first thing to come to mind, but if you could screen for a propensity to suffer PTSD the DoD would find it rather handy.

  14. Fivefold more accurate than what? by pepty · · Score: 1

    MIT researchers performed brain scans on 38 SAD patients and were able to predict with about 80% accuracy which patients would do well in cognitive behavioral therapy (CBT). Use of the scans to predict treatment outcomes improved predictions fivefold over use of a clinician's assessment alone.

    If the scan is both 80% accurate and five fold better than the clinicians' assessments, then the clinicians' assessments are only 16% accurate. Unless it has already been shown that only a small percentage of SAD patients respond well to CBT, clinicians would be much better off just flipping a coin than using their own judgement. But if the percentage is small, then you can't determine the accuracy of the test by looking at just 38 patients.

    Article is fucked.