The importance of how brain networks function together to create brain states has become increasingly recognized. Therefore, an investigation of eyes-open resting-state dynamic functional network ...connectivity (dFNC) of healthy controls (HC) versus that of schizophrenia patients (SP) via both functional magnetic resonance imaging (fMRI) and a novel magnetoencephalography (MEG) pipeline was completed. The fMRI analysis used a spatial independent component analysis (ICA) to determine the networks on which the dFNC was based. The MEG analysis utilized a source space activity estimate (minimum norm estimate MNE/dynamic statistical parametric mapping dSPM) whose result was the input to a spatial ICA, on which the networks of the MEG dFNC were based. We found that dFNC measures reveal significant differences between HC and SP, which depended on the imaging modality. Consistent with previous findings, a dFNC analysis predicated on fMRI data revealed HC and SP remain in different overall brain states (defined by a k-means clustering of network correlations) for significantly different periods of time, with SP spending less time in a highly connected state. The MEG dFNC, in contrast, revealed group differences in more global statistics: SP changed between meta-states (k-means cluster states that are allowed to overlap in time) significantly more often and to states that were more different, relative to HC. MEG dFNC also revealed a highly connected state where a significant difference was observed in interindividual variability, with greater variability among SP. Overall, our results show that fMRI and MEG reveal between-group functional connectivity differences in distinct ways, highlighting the utility of using each of the modalities individually, or potentially a combination of modalities, to better inform our understanding of disorders such as schizophrenia.
Objective
Counselor and client language have been identified as mechanisms of change in motivational interviewing (MI) counseling sessions. This study evaluated whether language patterns exhibited ...during MI sessions with substance users in the community would also be found during MI sessions with substance users in the criminal justice system.
Method
Forty audio recordings of MI sessions with substance‐using probationers were coded and analyzed sequentially using the Motivational Interviewing Skills Code (MISC) 2.5. Analyses examined the relationship between counselor and client language, and the relationship between client language and client substance use after 2 months.
Results
Counselor MI inconsistent language was associated with decreased change talk (lnOR = − 0.76, p < .05) though not with increased sustain talk. Both sustain talk (b = − 4.591, t = − 18.634 p < .001) and MI inconsistent language MIIN (b = − 4.419, t = − 19.886, p < .001) were positively associated with substance use at 2 months. Sustain talk early in the session (i.e., during deciles 1 and 2) was significantly greater among clients who reported using substances at 2 months, compared to clients who did not use substances.
Conclusion
These findings are broadly consistent with previous literature documenting the association between counselor language, client language, and client outcome.
Background: Identifying in‐session indicators of client outcomes is important in determining the mechanisms of psychotherapeutic treatments, including Motivational Interviewing (MI). The current ...studies sought to determine if clinician behavior influences client speech, and the extent to which client speech predicted treatment outcome in clients receiving treatment for substance abuse.
Methods: Study 1 examined 38 sessions from 5 sites in Project MATCH. Sessions were coded using the Sequential Code for Process Exchanges (SCOPE) behavioral coding system. Transition probabilities and inter‐rater reliability were calculated. Study 2 examined 45 sessions from the New Mexico site in Project MATCH. Sessions were coded using the MISC 1.0 behavioral coding system. Distal outcome measures were calculated for proportion of days abstinent (PDA) and drinks per drinking day (DDD). Hierarchical multiple regression and hierarchical logistic regression were used to characterize the relationship between client speech and outcome.
Results: In Study 1, inter‐rater reliability estimates indicate that coders reliably distinguished between the categories within the SCOPE. Behaviors consistent with MI (MICO) were significantly likely to be followed by client Change Talk (CT) and behaviors inconsistent with MI (MIIN) were significantly likely to be followed by Counterchange Talk (CCT). There was also a significant negative transition probability between MICO and CCT. In Study 2, CT was found to account for significant portions of outcome variability beyond that attributable to baseline measures of problem severity.
Conclusions: Client speech during early therapy sessions appears to be a powerful predictor of substance abuse outcome. The pattern of therapist behaviors and subsequent client language found in this data supports the intervention test in the causal chain we have described for motivational interviewing. These studies provide preliminary support for a causal chain between therapist behaviors, subsequent client speech, and drinking outcomes within motivational interviewing sessions. The results of both studies provide further support to the proposition that client speech impacts the likelihood of behavioral change, and that the occurrence of such speech is influenced by the therapist.
Previous research has suggested that motivational interviewing (MI) may affect client language, which in turn predicts client drinking outcome. In this study, we examined the relationship between ...counselor language and client language, personalized feedback and client language, and client language and client drinking outcome, in a sample of heavy-drinking college students. MI was delivered in a single session with or without a personalized feedback report (MI with feedback MIF; MI only). Sessions were coded using the Motivational Interviewing Skill Code 2.1. A composite drinking outcome score was used, consisting of drinks per week, peak blood alcohol concentration, and protective drinking strategies. We found three main results. First, in the MIF group, MI consistent counselor language was positively associated with client change talk. Second, after receiving feedback, MIF clients showed lower levels of sustain talk, relative to MI only clients. Finally, in the MIF group, clients with greater change talk showed improved drinking outcomes at 3 months, while clients with greater sustain talk showed poorer drinking outcomes. These results highlight the relationship between counselor MI skill and client change talk, and suggest an important role for feedback in the change process.
Abstract Auditory sensory gating, assessed in a paired-click paradigm, indicates the extent to which incoming stimuli are filtered, or “gated”, in auditory cortex. Gating is typically computed as the ...ratio of the peak amplitude of the event related potential (ERP) to a second click (S2) divided by the peak amplitude of the ERP to a first click (S1). Higher gating ratios are purportedly indicative of incomplete suppression of S2 and considered to represent sensory processing dysfunction. In schizophrenia, hallucination severity is positively correlated with gating ratios, and it was hypothesized that a failure of sensory control processes early in auditory sensation (gating) may represent a larger system failure within the auditory data stream; resulting in auditory verbal hallucinations (AVH). EEG data were collected while patients ( N = 12) with treatment-resistant AVH pressed a button to indicate the beginning (AVH-on) and end (AVH-off) of each AVH during a paired click protocol. For each participant, separate gating ratios were computed for the P50, N100, and P200 components for each of the AVH-off and AVH-on states. AVH trait severity was assessed using the Psychotic Symptoms Rating Scales AVH Total score (PSYRATS). The results of a mixed model ANOVA revealed an overall effect for AVH state, such that gating ratios were significantly higher during the AVH-on state than during AVH-off for all three components. PSYRATS score was significantly and negatively correlated with N100 gating ratio only in the AVH-off state. These findings link onset of AVH with a failure of an empirically-defined auditory inhibition system, auditory sensory gating, and pave the way for a sensory gating model of AVH.
Abstract Few studies have investigated the impact of adolescent change language on substance use treatment outcomes and even fewer have examined how adolescents respond to normative feedback. The ...purpose of this study was to understand the influence normative feedback has on adolescent change language and subsequent alcohol and cannabis use 3 months later. We examined how percent change talk (PCT) was associated with subsequent alcohol and drug use outcomes. Adolescents (N = 48) were randomly assigned to receive brief motivational interviewing (MI) or MI plus normative feedback (NF). Audio recordings were coded with high interrater reliability. Adolescents with high PCT who received MI + NF had significantly fewer days of alcohol and binge drinking at follow up. There were no differences between groups on cannabis use or treatment engagement. Findings indicate that NF may be useful for adolescents with higher amount of change talk during sessions and may be detrimental for individuals with higher sustain talk.
Highlights • Influencing what clients say about change is a goal of motivational interviewing. • Specialized training was used to train therapists to influence client language. • Statements opposing ...change were lower in clients of specially trained therapists. • Statements in favor of change did not increase. • Client language can be influenced during motivational interviewing sessions.
Background: Brief addiction treatments including motivational interviewing (MI) have shown promise with adolescents, but the factors that influence treatment efficacy in this population remain ...unknown. One candidate is working memory, the ability to hold a fact or thought in mind. This is relevant, as in therapy, a client must maintain and manipulate ideas while working with a clinician. Working memory depends upon brain structures and functions that change markedly during neurodevelopment and that can be negatively impacted by substance use.
Objectives: In a secondary analysis of data from a clinical trial for adolescent substance use comparing alcohol/marijuana education and MI, we evaluated the relationship between working memory and three-month treatment-outcomes with the hypothesis that the relationship between intervention conditions and outcome would be moderated by working memory.
Methods: With a diverse sample of adolescents currently using alcohol and/or marijuana (N = 153, 64.7% male, 70.6% Hispanic), we examined the relationship between baseline measures of working memory and alcohol and cannabis-related problem scores measured at the three-month follow-up.
Results: The results showed that lower working memory scores were associated with poorer treatment response only for alcohol use, and only within the education group. No relationship was found between working memory and treatment outcomes in the MI group.
Conclusion: The results suggest that issues with working memory capacity may interfere with adolescents' ability to process and implement didactic alcohol and marijuana content in standard education interventions. These results also suggest that MI can be implemented equally effectively across the range of working memory functioning in youth.
Abstract Objective Introduction: While many have identified the important role of the developing brain in youth risk behavior, few have examined the relationship between salient cognitive factors ...(response inhibition) and different types of real-world adolescent health risk behaviors such as substance use and risky sex, within the same sample of youth. Methods We therefore sought to examine these relationships with 95 high-risk youth (ages 14–18; M age = 16.29 years). We examined blood oxygen level dependent (BOLD) response to an fMRI-based cognitive task designed to assess response inhibition (Go/NoGo) and past month risk behavior (number of substance use days; number of unprotected sex days). Results For this sample of youth, we found significant negative correlations between past month substance use and response inhibition within the left inferior frontal gyrus (IFG) and right insula (uncorrected p < .001; extent threshold ≥ 10 voxels). In addition, in the same contrast, we found significant positive correlations between past month risky sex and activation within the right IFG and left middle occipital gyrus (uncorrected p < .001; extent threshold ≥ 10 voxels). Conclusions These results suggest the particular relevance of these regions in this compelling, albeit slightly different, pattern of response for adolescent risky behaviors.
PDF
