Stefanie R. Russman Block

Background: People ascribe mental function to and place more emphasis on the brain than the rest of the body in mental health care. Here, we sought to understand whether this brain-body dualism extends to 1) beliefs about how much people can change their “brain” vs. their “body” and how these beliefs map onto attitudes towards mental health interventions. Methods: We developed a new scale—Beliefs about Biological Malleability (BBM) – to measure beliefs about the malleability of human biology and the extent to which biological malleability affects mental health. Undergraduates ( N = 424) completed a survey with the BBM, reappraisal use and hypothetical mental health treatment preferences for traditional treatment (e.g., medication and psychotherapy) and lifestyle interventions (e.g., exercise and meditation). Results: We found that the BBM separated into two factors: neurogenetics (e.g., perceived gene function and brain structure) and the peripheral body (e.g., heart rate and muscle size). The body was rated as more mutable than neurogenetics, whereas neurogenetics was rated as more likely to affect mental well-being than the body. Higher belief that biology is malleable related to greater reappraisal use. Greater belief that the body impacts mental-wellbeing related to preference for lifestyle interventions over traditional treatment, and preference for combining medication with psychotherapy over medication alone. Greater belief that neurogenetics affects mental well-being related to preference for combining traditional treatment with lifestyle interventions over traditional treatment alone. Conclusions: Our results highlight the significance of essentialist and dualistic beliefs in students’ approaches to mental health care, and that universities may benefit from incorporating lifestyle interventions into treatment.

Objective: Cortical-subcortical hyperconnectivity related to affective-behavioral integration and cortical network hypoconnectivity related to cognitive control have been demonstrated in obsessive-compulsive disorder (OCD); the study objective was to examine whether these connectivity patterns predict treatment response. Methods: Adolescents (ages 12–17) and adults (ages 24–45) were randomly assigned to 12 sessions of exposure and response prevention (ERP) or stress management therapy (SMT), an active control. Before treatment, resting-state connectivity of ventromedial prefrontal cortical (vmPFC), cingulo-opercular, frontoparietal, and subcortical regions was assessed with functional MRI. OCD severity was assessed with the Yale-Brown Obsessive Compulsive Scale before, during, and after treatment. Usable fMRI and longitudinal symptom data were obtained from 116 patients (68 female; 54 adolescents; 60 medicated). Results: ERP produced greater decreases in symptom scores than SMT. ERP was selectively associated with less vmPFC-subcortical (caudate and thalamus) connectivity in both age groups and primarily in unmedicated participants. Greater symptom improvement with both ERP and SMT was associated with greater cognitive-control (cingulo-opercular and frontoparietal) and subcortical (putamen) connectivity across age groups. Developmental specificity was observed across ERP and SMT treatments, such that greater improvements with ERP than SMT were associated with greater frontoparietal-subcortical (nucleus accumbens) connectivity in adolescents but greater connectivity between frontoparietal regions in adults. Comparison of response-predictive connections revealed no significant differences compared with a matched healthy control group. Conclusions: The results suggest that less vmPFC-subcortical connectivity related to affect-influenced behavior may be important for ERP engagement, whereas greater cognitive-control and motor circuit connectivity may generally facilitate response to psychotherapy. Finally, neural predictors of treatment response may differ by age.