Abstract
Social anxiety disorder (SAD) is characterized by a fear of negative evaluation, negative self-belief and extreme avoidance of social situations. These recurrent symptoms are thought to maintain the severity and substantial impairment in social and cognitive thoughts. SAD is associated with a disruption in neuronal networks implicated in emotional regulation, perceptual stimulus functions, and emotion processing, suggesting a network system to delineate the electrocortical endophenotypes of SAD. This paper seeks to provide a comprehensive review of the most frequently studied electroencephalographic (EEG) spectral coupling, event-related potential (ERP), visual-event potential (VEP), and other connectivity estimators in social anxiety during rest, anticipation, stimulus processing, and recovery states. A search on Web of Science provided 97 studies that document electrocortical biomarkers and relevant constructs pertaining to individuals with SAD. This study aims to identify SAD neuronal biomarkers and provide insight into the differences in these biomarkers based on EEG, ERPs, VEP, and brain connectivity networks in SAD patients and healthy controls (HC). Furthermore, we proposed recommendations to improve methods of delineating the electrocortical endophenotypes of SAD, e.g., a fusion of EEG with other modalities such as functional magnetic resonance imaging (fMRI) and magnetoencephalograms (MEG), to realize better effectiveness than EEG alone, in order to ultimately evolve the treatment selection process, and to review the possibility of using electrocortical measures in the early diagnosis and endophenotype examination of SAD.
Highlights
The diagnosis of social anxiety disorder (SAD or; social phobia) was first introduced in the Third Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 (Nathan, 2019)
The results showed that people with Social anxiety disorder (SAD) recalled significantly more negative and embarrassing memories than healthy controls (HC), regardless of the type of post-treatment (Field et al, 2004)
Contemporary electrocortical indices indicate that the mid-frontal theta (4–8 Hz) oscillation in the electroencephalogram provides new insights into the processing of social repudiation by the brain (Knyazev et al, 2019). These findings demonstrated that mid-frontal theta (4– 8 Hz) oscillation is very responsive to social repudiation but only when peer repudiation is unpredicted, which indicates that the frontal theta is controlled by a widely different neural network implicated in saliency perception and conflict detection
Summary
The diagnosis of social anxiety disorder (SAD or; social phobia) was first introduced in the Third Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 (Nathan, 2019). People with SAD suffer anxiety from the potential risk of embarrassment or humiliation due to inadequate social performance (Langer et al, 2019). They often avoid social situations, and Electrophysiological Investigation in Social Anxiety Disorder when the situation is unavoidable, they experience severe anxiety and stress. A large British epidemiological statistic (Ford et al, 2003) reported that only 0.32% of children aged 5–15 years had this disorder, which is higher than the incidence rates of other mental illnesses, such as post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD), but lower than that of panic disorder, specific phobia, and generalized anxiety. European epidemiological data is highly correlated with US data, confirming the high prevalence, comorbidity, and morbidity of SAD (Perna et al, 2020)
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