Abstract
BackgroundSocial anxiety disorder (SAD) is widely thought to be characterized by heightened behavioral and limbic reactivity to socio-emotional stimuli. However, although behavioral findings are clear, neural findings are surprisingly mixed.MethodsUsing functional magnetic resonance imaging (fMRI), we examined behavioral and brain responses in a priori emotion generative regions of interest (amygdala and insula) in 67 patients with generalized SAD and in 28 healthy controls (HC) during three distinct socio-emotional tasks. We administered these socio-emotional tasks during one fMRI scanning session: 1) looming harsh faces (Faces); 2) videotaped actors delivering social criticism (Criticism); and 3) written negative self-beliefs (Beliefs).ResultsIn each task, SAD patients reported heightened negative emotion, compared to HC. There were, however, no SAD versus HC differential brain responses in the amygdala and insula. Between-group whole-brain analyses confirmed no group differences in the responses of the amygdala and insula, and indicated different brain networks activated during each of the tasks. In SAD participants, social anxiety symptom severity was associated with increased BOLD signal in the left insula during the Faces task.ConclusionsThe similar responses in amygdala and insula in SAD and HC participants suggest that heightened negative emotion responses reported by patients with SAD may be related to dysfunction in higher cognitive processes (e.g., distorted appraisal, attention biases, or ineffective cognitive reappraisal). In addition, the findings of this study emphasize the differential effects of socio-emotional experimental tasks.
Highlights
Social anxiety disorder (SAD) is widely thought to be characterized by heightened behavioral and limbic reactivity to socio-emotional stimuli
As suggested by the literature, we focused on the amygdala and the insula regions, and performed whole-brain analyses to examine the involvement of other brain networks in SAD
We examined the differential effect of each socio-emotional task on negative emotion reactivity and neural responses in SAD and healthy controls (HC), and whether – among SAD participants – negative emotion reactivity and neural responses were associated with social anxiety symptom severity
Summary
Social anxiety disorder (SAD) is widely thought to be characterized by heightened behavioral and limbic reactivity to socio-emotional stimuli. Social anxiety disorder (SAD) is defined by a marked and persistent fear of social or performance situations in which the person is exposed to unfamiliar people, or possible scrutiny by others [1]. Exaggerated emotional responses are thought to arise from maladaptive appraisals of the social situation that transform innocuous social cues into interpersonal threats [5]. This hyper-reactivity often leads to attempts to escape from or avoid the anxiety-provoking object or situation [2]
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