Abstract
BackgroundPrevious studies of patients with social anxiety have demonstrated abnormal early processing of facial stimuli in social contexts. In other words, patients with social anxiety disorder (SAD) tend to exhibit enhanced early facial processing when compared to healthy controls. Few studies have examined the temporal electrophysiological event-related potential (ERP)-indexed profiles when an individual with SAD compares faces to objects in SAD. Systematic comparisons of ERPs to facial/object stimuli before and after therapy are also lacking. We used a passive visual detection paradigm with upright and inverted faces/objects, which are known to elicit early P1 and N170 components, to study abnormal early face processing and subsequent improvements in this measure in patients with SAD.MethodsSeventeen patients with SAD and 17 matched control participants performed a passive visual detection paradigm task while undergoing EEG. The healthy controls were compared to patients with SAD pre-therapy to test the hypothesis that patients with SAD have early hypervigilance to facial cues. We compared patients with SAD before and after therapy to test the hypothesis that the early hypervigilance to facial cues in patients with SAD can be alleviated.ResultsCompared to healthy control (HC) participants, patients with SAD had more robust P1–N170 slope but no amplitude effects in response to both upright and inverted faces and objects. Interestingly, we found that patients with SAD had reduced P1 responses to all objects and faces after therapy, but had selectively reduced N170 responses to faces, and especially inverted faces. Interestingly, the slope from P1 to N170 in patients with SAD was flatter post-therapy than pre-therapy. Furthermore, the amplitude of N170 evoked by the facial stimuli was correlated with scores on the interaction anxiousness scale (IAS) after therapy.ConclusionsOur results did not provide electrophysiological support for the early hypervigilance hypothesis in SAD to faces, but confirm that cognitive-behavioural therapy can reduce the early visual processing of faces. These findings have potentially important therapeutic implications in the assessment and treatment of social anxiety.Trial registration HEBDQ2014021
Highlights
Previous studies of patients with social anxiety have demonstrated abnormal early processing of facial stimuli in social contexts
Eighteen outpatients with social anxiety disorder (SAD) were recruited from the Psychology Department of Affiliated Hospital of Harbin Medical University, while 18 healthy control (HC) participants were recruited through advertisements
No differences were found between the HC and SAD pre-therapy groups, or between the SAD pre-therapy and SAD post-therapy groups, ps > 0.19
Summary
Previous studies of patients with social anxiety have demonstrated abnormal early processing of facial stimuli in social contexts. Cognitive models of anxiety [11, 12] have suggested that information processing biases lead patients with social anxiety to view social situations in an excessively negative fashion [13,14,15]. Due to this interpretation bias, patients with SAD tend to judge ambiguous faces as more angry than happy [16]. Considering that many behavioural and neuroimaging studies have provided convincing evidence that social anxiety is linked to attention bias toward threatening facial stimuli [18,19,20,21,22,23], there may be enhanced attention toward neutral faces when compared to those of healthy control subjects
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