Abstract
An imbalance in the neural motivational system may underlie Social Anxiety Disorder (SAD). This study examines social reward and punishment anticipation in SAD, predicting a valence-specific effect: increased striatal activity for punishment avoidance compared to obtaining a reward. Individuals with SAD (n = 20) and age, gender, and education case-matched controls (n = 20) participated in a functional magnetic resonance imaging (fMRI) study. During fMRI scanning, participants performed a Social Incentive Delay (SID) task to measure the anticipation of social reward and punishment. The left putamen (part of the striatum) showed a valence-specific interaction with group after correcting for medication use and comorbidity. The control group showed a relatively stronger activation for reward vs. punishment trials, compared to the social anxiety group. However, post-hoc pairwise comparisons were not significant, indicating that the effect is driven by a relative difference. A connectivity analysis (Psychophysiological interaction) further revealed a general salience effect: SAD patients showed decreased putamen-ACC connectivity compared to controls for both reward and punishment trials. Together these results suggest that the usual motivational preference for social reward is absent in SAD. In addition, cortical control processes during social incentive anticipation may be disrupted in SAD. These results provide initial evidence for altered striatal involvement in both valence-specific and valence-nonspecific processing of social incentives, and stress the relevance of taking motivational processes into account when studying social anxiety.
Highlights
Avoidance motivation is a core aspect of social anxiety disorder (SAD; Neal and Edelmann, 2003; Holtforth, 2008)
Reaction times on neutral trials compared to reward and punishment ones were slower in the social anxiety group than in the control group
Post-hoc tests revealed that the groups differed significantly on punishment vs. neutral trials [t(38) = 2.08, p = 0.044], and within the social anxiety group, reaction times were significantly slower for neutral compared to reward [t(19) = 2.76, p = 0.013] and neutral compared to punishment trials [t(19) = 3.12, p = 0.006]
Summary
Avoidance motivation is a core aspect of social anxiety disorder (SAD; Neal and Edelmann, 2003; Holtforth, 2008). Research over the last decades has identified a dopaminergic-mediated brain circuit involved in motivational processing (Haber and Knutson, 2010). The behavioral inhibition system is linked to punishment or threat sensitivity as well as to the motivation to avoid potentially harmful situations (i.e., harm avoidance Carver and White, 1994). Based on this theory, one may expect that the striatal motivational system shows a differential preference for reward sensitivity and punishment avoidance, either reflecting the absence of a motivational drive to obtain a reward, a heightened motivation to avoid punishments, or both
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