The Genetic and Neural Circuitry Predictors of Benefit from Manualized or Open-Ended Psychotherapy

Abstract

Objective: New technologies incorporating genetics and neuroimaging into psychiatric care offer the possibility of illuminating associations among genetic alleles, neural functioning, and patients’ response to various psychotherapeutic modalities. In this review, the authors survey the literature on the emerging field of genetic predictors of psychotherapy response, particularly in relation to the 5-HTTLPR polymorphism and individual response to manualized psychotherapy. Methods: The extant literature was reviewed, with PubMed serving as the primary database. Results: Several polymorphisms have been linked with response or resistance to treatment. Given the number of studies assessing the relevance of the 5-HTTLPR polymorphism to treatment response, this review focuses on this genetic variation. Conclusions: Because individual genetic endowments may predict nonresponse to manualized treatment modalities, it may become possible to identify individuals who would benefit from insight-oriented, open-ended psychotherapy tailoredtotheirindividualdistresstolerancelevels,ratherthan from shorter manualized treatment.