Commentary: Neural Changes Associated with Treatment Outcome in Children with Externalizing Problems

In a 2011 study published in the journal Biological Psychiatry, Steven Woltering and colleagues demonstrate that children with externalizing behaviors who respond to cognitive behavioral therapy show electroencephalogram-defined neural markers of improved self-regulation (1). In this commentary, I review this study and the rationale for my proposal that children with externalizing behaviors who respond to psychoanalytic psychotherapy may also show similar neural markers of improved self-regulation. The intent is to help psychoanalytically oriented providers, who may have reservations toward evidence-based medicine and mainstream psychiatric care, to see the value of a brain-based dimensional model of recovery and of hypothesis testing to create an evidence base for practice.