Optimizing real time fMRI neurofeedback for therapeutic discovery and development.

While reducing the burden of brain disorders remains a top priority of organizations like the World Health Organization and National Institutes of Health, the development of novel, safe and effective treatments for brain disorders has been slow. In this paper, we describe the state of the science for an emerging technology, real time functional magnetic resonance imaging (rtfMRI) neurofeedback, in clinical neurotherapeutics. We review the scientific potential of rtfMRI and outline research strategies to optimize the development and application of rtfMRI neurofeedback as a next generation therapeutic tool. We propose that rtfMRI can be used to address a broad range of clinical problems by improving our understanding of brain-behavior relationships in order to develop more specific and effective interventions for individuals with brain disorders. We focus on the use of rtfMRI neurofeedback as a clinical neurotherapeutic tool to drive plasticity in brain function, cognition, and behavior. Our overall goal is for rtfMRI to advance personalized assessment and intervention approaches to enhance resilience and reduce morbidity by correcting maladaptive patterns of brain function in those with brain disorders.

Representations of attachment in mothers and their one-year-old infants.

Attachment classifications in mothers and their 1-year-old infants were independently and concurrently assessed using the Adult Attachment Interview and the Strange Situation Procedure. Overall concordance was significant (k = 0.62), with strong links apparent between mothers classified dismissing and infants classified avoidant and between mothers classified autonomous and infants classified secure. Mothers' classified preoccupied were not more likely to have infants classified resistant. Mothers' perceptions and interpretations of the emotional distress of an infant observed in a 4-minute videotape were related to both infant and mother attachment classifications. These results are compatible with the suggestion that attachment classification reflect differences in internal working models of relationships. Other measures of maternal psychosocial adjustment were not related to infant attachment classifications.

When infants look to their parents: II. Twelve-month-olds' response to conflicting parental emotional signals.

12-months-olds were seen in a laboratory procedure in which they were given happy, fearful, and conflicting emotional signals by their mothers and fathers with reference to 5 unusual toy stimuli. Measures included: positive and negative affect, affect lability, and approach and proximity behavior toward the toy. Infants did not "select" a signal on the basis of a maternal or paternal primacy in emotional referencing, but responded to both signals and experienced conflict. They showed increased negative affect and decreased positive affect and toy exploration with conflicting signals compared with both happy and with fearful signals alone. Greater levels of lability were not found with conflicting signals. Marked differences among infants in capacity and style of coping with conflict were observed, as were a variety of specific conflict responses, such as agitated sucking, rocking, avoidance, extreme motor inhibition, aimless or disoriented behavior, and transient, unintegrated affect expressions.

When infants look to their parents: I. Infants' social referencing of mothers compared to fathers.

12-month-olds were seen with their mothers and fathers in a laboratory procedure designed to compare infants' solicitation of, emotional resonance to, and self-regulation on the basis of happy, fearful, and conflicting emotional signals from mothers versus fathers. Measures of positive and negative affect and affect lability; of look, approach, and proximity behavior; and of overall response pattern were obtained. Infants showed more positive and less negative affect and greater toy proximity with happy compared to fearful signals. Few differences emerged in infants' referencing response to mothers versus fathers. Infants looked more to mothers than fathers when no signals were given but did not differentiate between parents when only one was signaling or when both were signaling (conflict). In affective state and behavioral regulation, they were not differentially responsive to maternal versus paternal signals either when only one parent was signaling or when both were giving signals.