RESUMO
AIMS: Although static abnormalities of functional brain networks have been observed in patients with social anxiety disorder (SAD), the brain connectome dynamics at the macroscale network level remain obscure. We therefore used a multivariate data-driven method to search for dynamic functional network connectivity (dFNC) alterations in SAD. METHODS: We conducted spatial independent component analysis, and used a sliding-window approach with a k-means clustering algorithm, to characterize the recurring states of brain resting-state networks; then state transition metrics and FNC strength in the different states were compared between SAD patients and healthy controls (HC), and the relationship to SAD clinical characteristics was explored. RESULTS: Four distinct recurring states were identified. Compared with HC, SAD patients demonstrated higher fractional windows and mean dwelling time in the highest-frequency State 3, representing "widely weaker" FNC, but lower in States 2 and 4, representing "locally stronger" and "widely stronger" FNC, respectively. In State 1, representing "widely moderate" FNC, SAD patients showed decreased FNC mainly between the default mode network and the attention and perceptual networks. Some aberrant dFNC signatures correlated with illness duration. CONCLUSION: These aberrant patterns of brain functional synchronization dynamics among large-scale resting-state networks may provide new insights into the neuro-functional underpinnings of SAD.
Assuntos
Encéfalo , Conectoma , Imageamento por Ressonância Magnética , Rede Nervosa , Fobia Social , Humanos , Masculino , Feminino , Adulto , Fobia Social/fisiopatologia , Fobia Social/diagnóstico por imagem , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Adulto JovemRESUMO
BACKGROUND: Studies comparing the brain functions of major depressive disorder (MDD) and social anxiety disorder (SAD) at the regional and network levels remain scarce. This study aimed to elucidate their pathogenesis using neuroimaging techniques and explore biomarkers that can differentiate these disorders. METHODS: Resting-state fMRI data were collected from 48 patients with MDD, 41 patients with SAD, and 82 healthy controls. Differences in the amplitude of low-frequency fluctuations (ALFF) among the three groups were examined to identify regions showing abnormal regional spontaneous activity. A seed-based functional connectivity (FC) analysis was conducted using ALFF results as seeds and different connections were identified between regions showing abnormal local spontaneous activity and other regions. The correlation between abnormal brain function and clinical symptoms was analyzed. RESULTS: Patients with MDD and SAD exhibited similar abnormal ALFF and FC in several brain regions; notably, FC between the right superior frontal gyrus (SFG) and the right posterior supramarginal gyrus (pSMG) in patients with SAD was negatively correlated with depressive symptoms. Furthermore, patients with MDD showed higher ALFF in the right SFG than HCs and those with SAD. LIMITATION: Potential effects of medications, comorbidities, and data type could not be ignored. CONCLUSION: MDD and SAD showed common and distinct aberrant brain function patterns at the regional and network levels. At the regional level, we found that the ALFF in the right SFG was different between patients with MDD and those with SAD. At the network level, we did not find any differences between these disorders.
Assuntos
Transtorno Depressivo Maior , Imageamento por Ressonância Magnética , Fobia Social , Humanos , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/diagnóstico por imagem , Masculino , Feminino , Adulto , Fobia Social/fisiopatologia , Fobia Social/diagnóstico por imagem , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , Adulto Jovem , Mapeamento Encefálico/métodos , Pessoa de Meia-Idade , Lobo Parietal/fisiopatologia , Lobo Parietal/diagnóstico por imagemRESUMO
Individuals with social anxiety often exhibit atypical processing of facial expressions. Previous research in social anxiety has primarily emphasized cognitive bias associated with face processing and the corresponding abnormalities in cortico-limbic circuitry, yet whether social anxiety influences early perceptual processing of emotional faces remains largely unknown. We used a psychophysical method to investigate the monocular advantage for face perception (i.e., face stimuli are better recognized when presented to the same eye compared to different eyes), an effect that is indicative of early, subcortical processing of face stimuli. We compared the monocular advantage for different emotional expressions (neutral, angry and sad) in three groups (N = 24 per group): individuals clinically diagnosed with social anxiety disorder (SAD), individuals with high social anxiety in subclinical populations (SSA), and a healthy control (HC) group of individuals matched for age and gender. Compared to SSA and HC groups, we found that individuals with SAD exhibited a greater monocular advantage when processing neutral and sad faces. While the magnitudes of monocular advantages were similar across three groups when processing angry faces, individuals with SAD performed better in this condition when the faces were presented to different eye. The former findings suggest that social anxiety leads to an enhanced role of subcortical structures in processing nonthreatening expressions. The latter findings, on the other hand, likely reflect an enhanced cortical processing of threatening expressions in SAD group. These distinct patterns of monocular advantage indicate that social anxiety altered representation of emotional faces at various stages of information processing, starting at an early stage of the visual system.
Assuntos
Emoções , Expressão Facial , Reconhecimento Facial , Fobia Social , Humanos , Feminino , Masculino , Adulto , Emoções/fisiologia , Fobia Social/fisiopatologia , Fobia Social/psicologia , Reconhecimento Facial/fisiologia , Adulto JovemRESUMO
Numerous studies have established a correlation between social anxiety and poor cognitive control. However, little is known about the cognitive control pattern of individuals with high social anxiety (HSAs) and the underlying mechanisms. Based on the Dual Mechanisms of Control framework and the Expected Value of Control theory, this study explored whether HSAs have an impaired cognitive control pattern (Experiment 1) and whether motivational deficiencies underlie the impaired control pattern (Experiment 2). In Experiment 1, 21 individuals with low social anxiety (LSAs) and 21 HSAs completed an AX-Continuous Performance Task. Results showed that HSAs had a smaller P3b amplitude than LSAs, indicating their weakened proactive control in the cue processing stage, but a larger contingent negative variation (CNV) on cue B as compensation for the negative effects of anxiety in the response preparation stage. No group difference was found in N2 and P3a amplitude on probes, suggesting that reactive control in HSAs was not affected compared to LSAs. In Experiment 2, 21 LSAs and 21 HSAs completed a cued-flanker task, where the likelihood of proactive control engagement was manipulated. The results revealed that HSAs exhibited motivation deficiencies in engaging in proactive control, as evidenced by P3b, CNV amplitude, and response times. These findings shed light on the impaired cognitive control pattern of HSAs and suggest that motivational deficiencies may be the crucial underlying factor.
Assuntos
Ansiedade , Eletroencefalografia , Potenciais Evocados , Função Executiva , Motivação , Humanos , Masculino , Feminino , Motivação/fisiologia , Adulto Jovem , Potenciais Evocados/fisiologia , Adulto , Função Executiva/fisiologia , Ansiedade/fisiopatologia , Desempenho Psicomotor/fisiologia , Variação Contingente Negativa/fisiologia , Adolescente , Fobia Social/fisiopatologiaRESUMO
INTRODUCTION: The aim of this study was to examine possible associations of social anxiety (SA) and speaking-related physiological reactivity with the frequencies of a) total disfluencies, b) typical disfluencies, and c) stuttering-like disfluencies, as well as d) stuttering-severity in autistic young adults and controls. METHODS: Thirty-two autistic young adults and 35 controls participated in this study. Participants were presented with video clips (viewing condition) and were then asked to talk about the videos (narrating condition). SA was measured by the self-report Social Phobia and Anxiety Inventory (SPAI). Speaking-related physiological reactivity was measured by the electrodermal activity (EDA), an index of emotional arousal. The speech samples from the narrating condition were analyzed for type and frequency of speech disfluencies and used for determining the stuttering severity. SA and speaking-related physiological reactivity were compared between the groups. Correlation between SA, physiological reactivity, disfluency frequencies, and stuttering severity were tested separately for both groups. RESULTS: No between-group differences were found in the overall SA, yet differences were found in SPAI subscales of social interaction, group interaction, and avoidance, as well as in agoraphobia. Both groups had higher physiological arousal in narrating condition in comparison to the video viewing condition, yet there was no between-group difference in the reactivity. No associations were found between SPAI measures, physiological reactivity, disfluency frequencies, and stuttering severity in the autistic group. In the control group, a negative association was found between physiological reactivity and total and typical disfluency frequencies. CONCLUSIONS: SA or speaking-related physiological reactivity were not associated with disfluency frequencies or stuttering severity in autistic persons. Negative association between physiological reactivity and disfluency frequencies found in the control group may indicate that the physiological arousal may impact the speech production process by reducing the overt disfluencies.
Assuntos
Transtorno Autístico , Fala , Gagueira , Humanos , Masculino , Feminino , Gagueira/fisiopatologia , Gagueira/psicologia , Adulto Jovem , Fala/fisiologia , Transtorno Autístico/fisiopatologia , Transtorno Autístico/psicologia , Ansiedade/fisiopatologia , Ansiedade/psicologia , Adulto , Fobia Social/fisiopatologia , Fobia Social/psicologia , Resposta Galvânica da Pele/fisiologia , Estudos de Casos e Controles , AdolescenteRESUMO
Post-event rumination, the extent to which one engages in persistent, detailed, and negative thinking following social situations, serves as a risk process in the pathophysiology of social anxiety. Although a substantial body of research has assessed post-event rumination and social anxiety, this literature has produced inconsistent results. We conducted a systematic review and meta-analysis to examine whether the magnitude of the association between post-event rumination and social anxiety varied as a function of questionnaire and/or task utilized. We included all studies reporting a correlation between post-event rumination and social anxiety symptomatology. Fisher's z correlation coefficients were calculated through random-effect meta-analyses. Results indicated a moderate association between post-event rumination and social anxiety symptomatology (r = 0.45, p < 0.001, 95%CI [0.40-0.50]). Subgroup meta-analyses indicated that the type of questionnaire used to assess post-event rumination (Q = 44.36, df = 3, p < 0.001) and social anxiety (Q = 26.44, df = 8, p < 0.001), as well as the task conducted prior to assessing post-event rumination (Q = 14.31, df = 2, p < 0.001), influenced the effect size. This study demonstrates a moderate relation between post-event rumination and social anxiety across the anxiety spectrum, illustrating the importance of treatments specifically targeting post-event rumination. Moreover, we highlight the importance of taking care when designing studies to explore relations between post-event rumination and social anxiety.
Assuntos
Ruminação Cognitiva , Humanos , Ruminação Cognitiva/fisiologia , Ansiedade/fisiopatologia , Fobia Social/fisiopatologiaAssuntos
Intervenção Baseada em Internet , Fobia Social , Banheiros , Retenção Urinária , Medicina Geral/métodos , Humanos , Masculino , Fobia Social/fisiopatologia , Fobia Social/terapia , Angústia Psicológica , Apoio Social , Retenção Urinária/etiologia , Retenção Urinária/psicologia , Micção/fisiologiaRESUMO
Neuropeptide Y (NPY) has anxiolytic-like effects and facilitates the extinction of cued and contextual fear in rodents. We previously showed that intracerebroventricular administration of NPY reduces the expression of social fear in a mouse model of social fear conditioning (SFC) and localized these effects to the dorsolateral septum (DLS) and central amygdala (CeA). In the present study, we aimed to identify the receptor subtypes that mediate these local effects of NPY. We show that NPY (0.1 nmol/0.2 µL/side) reduced the expression of SFC-induced social fear in a brain region- and receptor-specific manner in male mice. In the DLS, NPY reduced the expression of social fear by acting on Y2 receptors but not on Y1 receptors. As such, prior administration of the Y2 receptor antagonist BIIE0246 (0.2 nmol/0.2 µL/side) but not the Y1 receptor antagonist BIBO3304 trifluoroacetate (0.2 nmol/0.2 µL/side) blocked the effects of NPY in the DLS. In the CeA, however, BIBO3304 trifluoroacetate but not BIIE0246 blocked the effects of NPY, suggesting that NPY reduced the expression of social fear by acting on Y1 receptors but not Y2 receptors within the CeA. This study suggests that at least two distinct receptor subtypes are differentially recruited in the DLS and CeA to mediate the effects of NPY on the expression of social fear.
Assuntos
Tonsila do Cerebelo/metabolismo , Neuropeptídeo Y/metabolismo , Fobia Social/metabolismo , Septo do Cérebro/metabolismo , Tonsila do Cerebelo/efeitos dos fármacos , Animais , Arginina/análogos & derivados , Arginina/farmacologia , Benzazepinas/farmacologia , Medo , Masculino , Camundongos , Fobia Social/fisiopatologia , Receptores de Neuropeptídeo Y/metabolismo , Septo do Cérebro/efeitos dos fármacosRESUMO
Importance: Cognitive behavioral group therapy (CBGT) and mindfulness-based stress reduction (MBSR) are thought to help patients with social anxiety disorder (SAD) via distinct emotion-regulation mechanisms. However, no study has compared the effects of CBGT and MBSR on brain and negative emotion indicators of cognitive reappraisal and acceptance in patients with SAD. Objective: To investigate the effects of CBGT and MBSR on reappraisal and acceptance in patients with SAD and to test whether treatment-associated brain changes are associated with social anxiety symptoms 1 year posttreatment. Design, Setting, and Participants: In this randomized clinical trial, a total of 108 unmedicated adults diagnosed with generalized SAD were randomly assigned to 12 weeks of CBGT, MBSR, or waitlist. The final sample included 31 patients receiving CBGT, 32 patients receiving MBSR, and 32 waitlist patients. Data were collected at the psychology department at Stanford University from September 2012 to December 2014. Data were analyzed from February 2019 to December 2020. Interventions: CBGT and MBSR. Main Outcomes and Measures: Changes in self-reported negative emotion and functional magnetic resonance imaging (fMRI) blood oxygen level-dependent (BOLD) signal within an a priori-defined brain search region mask derived from a meta-analysis of cognitive reappraisal and attention regulation 1 year posttreatment. Results: Of 108 participants, 60 (56%) were female. The mean (SD) age was 32.7 (8.0) years. Self-reported race and ethnicity data were collected to inform the generalizability of the study to the wider population and to satisfy the requirements of the National Institutes of Health. From the categories provided by the National Institutes of Health, 47 participants selected White (43.5%), 42 selected Asian (38.9%) 10 selected Latinx (9.3%), 1 selected Black (1%), 1 selected Native American (1%), and 7 selected more than 1 race (6.5%). CBGT and MBSR were associated with a significant decrease in negative emotion (partial η2 range, 0.38 to 0.53) with no significant between-group differences when reacting (ß, -0.04; SE, 0.09; 95% CI, -0.11 to 0.08; t92 = -0.37; P = .71), reappraising (ß, -0.15; SE, 0.09; 95% CI, -0.32 to 0.03; t92 = -1.67; P = .10), or accepting (ß, -0.05; SE, 0.08; 95% CI, -0.20 to 0.11; t92 = -0.59; P = .56). There was a significant increase in BOLD percentage signal change in cognitive and attention-regulation regions when reappraising (CBGT = 0.031; MBSR = 0.037) and accepting (CBGT = 0.012; MBSR = 0.077) negative self-beliefs. CBGT and MBSR did not differ in decreased negative emotion and increased reappraisal and acceptance BOLD responses. Reappraisal-associated MBSR (vs CBGT) negative emotions and CBGT (vs MBSR) brain responses were associated with social anxiety symptoms 1 year posttreatment. Conclusions and Relevance: The results of this study suggest that CBGT and MBSR may be effective treatments with long-term benefits for patients with SAD that recruit cognitive and attention-regulation brain networks. Despite contrasting models of therapeutic change, CBT and MBSR may both enhance reappraisal and acceptance emotion regulation strategies. Trial Registration: ClinicalTrials.gov Identifier: NCT02036658.
Assuntos
Córtex Cerebral/fisiopatologia , Terapia Cognitivo-Comportamental , Regulação Emocional/fisiologia , Meditação , Rede Nervosa/fisiopatologia , Fobia Social/fisiopatologia , Fobia Social/terapia , Adulto , Córtex Cerebral/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Atenção Plena , Rede Nervosa/diagnóstico por imagem , Avaliação de Resultados em Cuidados de Saúde , Fobia Social/diagnóstico por imagem , Psicoterapia de Grupo , Adulto JovemRESUMO
Joint performance can lead to the synchronization of physiological processes among group members during a shared task. Recently, it has been shown that synchronization is indicative of subjective ratings of group processes and task performance. However, different methods have been used to quantify synchronization, and little is known about the effects of the choice of method and level of analysis (individuals, dyads, or triads) on the results. In this study, participants performed a decision-making task in groups of three while physiological signals (heart rate and electrodermal activity), positive affective behavior, and personality traits were measured. First, we investigated the effects of different levels of analysis of physiological synchrony on affective behavior. We computed synchrony measures as (a) individual contributions to group synchrony, (b) the average dyadic synchrony within a group, and (c) group-level synchrony. Second, we assessed the association between physiological synchrony and positive affective behavior. Third, we investigated the moderating effects of trait anxiety and social phobia on behavior. We discovered that the effects of physiological synchrony on positive affective behavior were particularly strong at the group level but nonsignificant at the individual and dyadic levels. Moreover, we found that heart rate and electrodermal synchronization showed opposite effects on group members' display of affective behavior. Finally, trait anxiety moderated the relationship between physiological synchrony and affective behavior, perhaps due to social uncertainty, while social phobia did not have a moderating effect. We discuss these results regarding the role of different physiological signals and task demands during joint action.
Assuntos
Afeto/fisiologia , Ansiedade/fisiopatologia , Tomada de Decisões/fisiologia , Resposta Galvânica da Pele/fisiologia , Processos Grupais , Frequência Cardíaca/fisiologia , Personalidade/fisiologia , Fobia Social/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Autism Spectrum Disorder and depression are often co-occurring in young people. However, despite the association between these two disorders, and the fact that females have a higher prevalence of depression than males in the general population, there is little reported evidence regarding the correlates of depression in young autistic females. Several physiological (age, menarche, HPA-axis responses), psychological (social anxiety), and environmental or genetic (mothers' depression) factors were tested for their contribution to depression severity in a sample of 53 autistic girls aged 6 yr to 17 yr. Depression scores were collected from the girls' self-ratings and also from the ratings their mothers gave them. Regression results indicated that girls' social anxiety, age, and mothers' depression were common significant contributors to both sets of depression scores, but with different effects. Autistic girls' self-reports of their depression were significantly associated with their HPA-axis responses but not with their menarche status. Implications for research and clinical settings are discussed.
Assuntos
Transtorno do Espectro Autista/complicações , Depressão/complicações , Fobia Social/complicações , Meio Social , Adolescente , Adulto , Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/psicologia , Criança , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Hidrocortisona/análise , Mães/psicologia , Fobia Social/fisiopatologia , Fobia Social/psicologia , Saliva/químicaRESUMO
Social anxiety is common in psychosis and associated with impaired functioning, poorer quality of life, and higher symptom severity. This study systematically reviewed factors maintaining social anxiety in people with attenuated, transient, or persistent psychotic experiences. Other correlates of social anxiety were also examined. MEDLINE, Embase, CENTRAL, and PsycINFO were searched for relevant literature up to October 19, 2020. Forty-eight articles were eligible for narrative synthesis: 38 cross-sectional studies, 8 prospective studies, 1 uncontrolled trial, and 1 qualitative study. From 12060 participants, the majority was general population (n = 8771), followed by psychosis samples (n = 2532) and those at high risk of psychosis (n = 757). The methodological quality and risk of bias were assessed using the Mixed Methods Appraisal Tool. Ninety percent of studies were rated as high to very-high quality. Poorer quality studies typically failed to adequately control for confounds and provided insufficient information on the measurement validity and reliability. Prominent psychological factors maintaining social anxiety included self-perceptions of stigma and shame. Common correlates of social anxiety included poorer functioning and lower quality of life. In conclusion, stigma and shame could be targeted as a causal mechanism in future interventional studies. The integration of findings from this review lead us to propose a new theoretical model to guide future intervention research.
Assuntos
Fobia Social/fisiopatologia , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Autoimagem , Vergonha , Estigma Social , Humanos , Fobia Social/etiologia , Transtornos Psicóticos/complicações , Esquizofrenia/complicaçõesRESUMO
We investigated how patients with social anxiety disorder (SAD) and patients with borderline personality disorder (BPD) process an increase in the frequency of social interaction. We used an EEG-compatible version of the online ball-tossing game Cyberball to induce an increase in the frequency of social interaction. In the first condition, each player received the ball equally often (inclusion: 33% ball reception). In the following condition, the frequency of the ball reception was increased (overinclusion: 45% ball reception). The main outcome variable was the event-related potential P2, an indicator for social reward processing. Moreover, positive emotions were assessed. Twenty-eight patients with SAD, 29 patients with BPD and 28 healthy controls (HCs) participated. As expected, HCs and patients with BPD, but not patients with SAD, showed an increase in the P2 amplitude from the inclusion to the overinclusion condition. Contrary to our expectations, positive emotions did not change from the inclusion to the overinclusion condition. EEG results provide preliminary evidence that patients with BPD and HCs, but not patients with SAD, process an increase in the frequency of social interaction as rewarding.
Assuntos
Transtorno da Personalidade Borderline/fisiopatologia , Eletroencefalografia , Potenciais Evocados , Fobia Social/fisiopatologia , Interação Social , Adulto , Feminino , Humanos , MasculinoRESUMO
Individuals with Borderline Personality Disorder (BPD) or Social Anxiety Disorder (SAD) suffer from substantial interpersonal dysfunction and have difficulties establishing social bonds. A tendency to form negative first impressions of others could contribute to this by way of reducing approach behavior. We tested whether women with BPD or SAD would show negative impression formation compared to healthy women (HCs). We employed the Thin Slices paradigm and showed videos of 52 authentic target participants to 32 women with BPD, 29 women with SAD, and 37 HCs. We asked participants to evaluate whether different positive or negative adjectives described targets and expected BPD raters to provide the most negative ratings, followed by SAD and HC. BPD and SAD raters both agreed with negative adjectives more often than HCs (e.g., 'Yes, the person is greedy'), and BPD raters rejected positive adjectives more often (e.g., 'No, the person is not humble.'). However, BPD and SAD raters did not differ significantly from each other. Additionally, we used the novel process tracing method mouse-tracking to assess the cognitive conflict (via trajectory deviations) raters experienced during decision-making. We hypothesized that HCs would experience more conflict when making unfavorable (versus favorable) evaluations and that this pattern would flip in BPD and SAD. We quantified cognitive conflict via maximum absolute deviations (MADs) of the mouse-trajectories. As hypothesized, HCs showed more conflict when rejecting versus agreeing with positive adjectives. The pattern did not flip in BPD and SAD but was substantially reduced, such that BPD and SAD showed similar levels of conflict when rejecting and agreeing with positive adjectives. Contrary to the hypothesis for BPD and SAD, all three groups experienced substantial conflict when agreeing with negative adjectives. We discuss therapeutic implications of the combined choice and mouse-tracking results.
Assuntos
Transtorno da Personalidade Borderline/fisiopatologia , Fobia Social/fisiopatologia , Adulto , Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/psicologia , Cognição , Feminino , Humanos , Relações Interpessoais , Pessoa de Meia-Idade , Fobia Social/epidemiologia , Fobia Social/psicologia , Percepção Social , Fatores Socioeconômicos , Adulto JovemRESUMO
The present study is the first to compare the examined electrophysiological activity of facial and textual feedback of students with social anxiety after they finished a visual search task. Compared to textual feedback, facial feedback is much more effective. Specifically speaking, positive facial feedback caused stronger feedback-related negativity (FRN), and negative facial feedback caused late positive potential (LPP) of stronger amplitude. These changes in the FRN component (associated with feedback) and LPP (related to controlled attention engagement) provide clues about the interplay between anxiety and attention allocation in processing facial feedback. The results have implications for identifying the feedback format that will be most helpful for individuals with social anxiety.
Assuntos
Potenciais Evocados/fisiologia , Expressão Facial , Retroalimentação Psicológica/fisiologia , Fobia Social/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Leitura , Adulto JovemRESUMO
BACKGROUND: Affective and interpersonal behavioural patterns characteristic of social anxiety disorder show improvement during treatment with serotonin agonists (e.g., selective serotonin reuptake inhibitors), commonly used in the treatment of social anxiety disorder. The present study sought to establish whether, during community psychopharmacological treatment of social anxiety disorder, changes in positive or negative affect and agreeable or quarrelsome behaviour mediate improvement in social anxiety symptom severity or follow from it. METHODS: Adults diagnosed with social anxiety disorder (n = 48) recorded their interpersonal behaviour and affect naturalistically in an event-contingent recording procedure for 1-week periods before and during the first 4 months of treatment with paroxetine. Participants and treating psychiatrists assessed the severity of social anxiety symptoms monthly. A multivariate latent change score framework examined temporally lagged associations of change in affect and interpersonal behaviour with change in social anxiety symptom severity. RESULTS: Elevated agreeable behaviour and positive affect predicted greater subsequent reduction in social anxiety symptom severity over the following month of treatment. Elevated negative affect, but not quarrelsome behaviour, predicted less subsequent reduction in symptom severity. LIMITATIONS: Limitations included limited assessment of extreme behaviour (e.g., violence) that may have precluded examining the efficacy of paroxetine because of the lack of a placebo control group. CONCLUSION: The present study suggests that interpersonal behaviour and affect may be putative mechanisms of action for serotonergic treatment of social anxiety disorder. Prosocial behaviour and positive affect increase during serotonergic treatment of social anxiety disorder. Specifically, modulating agreeable behaviour, positive affect and negative affect in individuals' daily lives may partially explain and refine clinical intervention.
Assuntos
Afeto/efeitos dos fármacos , Fobia Social/tratamento farmacológico , Fobia Social/fisiopatologia , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Comportamento Social , Interação Social , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Paroxetina/farmacologia , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVES: Individuals with social anxiety disorder show pronounced perceptual biases in social contexts, such as being hypervigilant to threat and discounting positive social cues. Parasympathetic activity influences responses to the social environment and may underlie these biases. This study examined the associations among social anxiety symptoms, heart rate variability (HRV), and vocal emotion recognition. DESIGN AND METHOD: Female undergraduate students (N = 124) self-reported their social anxiety symptoms using the Social Anxiety Disorder Dimensional Scale and completed a computerized vocal emotion recognition task using stimuli from the Ryerson Audio-Visual Database of Emotional Speech and Song stimulus set. HRV was measured at baseline and during the emotion recognition task. RESULTS: Women with more social anxiety symptoms had higher emotion recognition accuracy (p = .021) and rated positive stimuli as less intense (p = .032). Additionally, although those with greater social anxiety symptoms did not have lower resting HRV (p = .459), they did have lower task HRV (p = .026), which mediated their lower positivity bias and greater recognition accuracy. CONCLUSIONS: A parasympathetically-mediated positivity bias may indicate or facilitate normal social functioning in women. Additionally, HRV during a symptom- or disorder-relevant task may predict task performance and reveal parasympathetic differences that are not found at baseline.
Assuntos
Emoções/fisiologia , Frequência Cardíaca/fisiologia , Fobia Social/fisiopatologia , Fobia Social/psicologia , Reconhecimento Psicológico/fisiologia , Percepção da Fala/fisiologia , Adolescente , Adulto , Viés , Feminino , Humanos , Adulto JovemRESUMO
Social anxiety is prevalent in adolescence. Given its role in maintaining fears, reducing social avoidance through cognitive reappraisal may help attenuate social anxiety. We used fMRI-based neurofeedback (NF) to increase 'adaptive' patterns of negative connectivity between the dorsolateral prefrontal cortex (DLPFC) and the amygdala to change reappraisal ability, and alter social avoidance and approach behaviours in adolescents. Twenty-seven female participants aged 13-17 years with varying social anxiety levels completed a fMRI-based NF training task where they practiced cognitive reappraisal strategies, whilst receiving real-time feedback of DLPFC-amygdala connectivity. All participants completed measures of cognitive reappraisal and social approach-avoidance behaviour before and after NF training. Avoidance of happy faces was associated with greater social anxiety pre-training. Participants who were unable to acquire a more negative pattern of connectivity through NF training displayed significantly greater avoidance of happy faces at post-training compared to pre-training. These 'maladaptive' participants also reported significant decreases in re-appraisal ability from pre to post-training. In contrast, those who were able to acquire a more 'adaptive' connectivity pattern did not show these changes in social avoidance and re-appraisal. Future research could consider using strategies to improve the capacity of NF training to boost youth social-approach behaviour.
Assuntos
Tonsila do Cerebelo/fisiopatologia , Ansiedade/fisiopatologia , Aprendizagem da Esquiva/fisiologia , Comportamento de Escolha/fisiologia , Neurorretroalimentação/métodos , Fobia Social/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Adolescente , Feminino , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Vias Neurais/fisiopatologia , Neurorretroalimentação/fisiologiaRESUMO
The direction of the eye gaze of others is a prominent social cue in primates and is important for communication1-11. Although gaze can signal threat and elicit anxiety6,12,13, it remains unclear whether it shares neural circuitry with stimulus value. Notably, gaze not only has valence, but can also serve as a predictor of the outcome of a social encounter, which can be either negative or positive2,8,12,13. Here we show that the neural codes for gaze and valence overlap in primates and that they involve two different mechanisms: one for the outcome and another for its expectation. Monkeys participated in the human intruder test13,14, in which a human participant had either a direct or averted gaze, interleaved with blocks of aversive and appetitive conditioning. We find that single neurons in the amygdala encode gaze15, whereas neurons in the anterior cingulate cortex encode the social context16, but not gaze. We identify a shared population in the amygdala for which the neural responses to direct and averted gaze parallel the responses to aversive and appetitive stimulus, respectively. Furthermore, we distinguish between two neural mechanisms-an overall-activity scheme that is used for gaze and the unconditioned stimulus, and a correlated-selectivity scheme that is used for gaze and the conditioned stimulus. These findings provide insights into the origins of the neural mechanisms that underlie the computations of both social interactions and valence, and could help to shed light on mechanisms that underlie social anxiety and the comorbidity between anxiety and impaired social interactions.
Assuntos
Fixação Ocular/fisiologia , Modelos Neurológicos , Neurônios/fisiologia , Tonsila do Cerebelo/citologia , Tonsila do Cerebelo/fisiologia , Animais , Comportamento Apetitivo , Aprendizagem da Esquiva , Condicionamento Clássico , Giro do Cíngulo/citologia , Giro do Cíngulo/fisiologia , Humanos , Macaca fascicularis , Masculino , Fobia Social/fisiopatologia , Fobia Social/psicologia , RecompensaRESUMO
Social anxiety (SA) is thought to be maintained in part by avoidance of social threat, which exacerbates fear of negative evaluation. Yet, relatively little research has been conducted to evaluate the connection between social anxiety and attentional processes in realistic contexts. The current pilot study examined patterns of attention (eye movements) in a commonly feared social context - public speaking. Participants (N = 84) with a range of social anxiety symptoms gave an impromptu five-minute speech in an immersive 360°-video environment, while wearing a virtual reality headset equipped with eye-tracking hardware. We found evidence for the expected interaction between fear of public speaking and social threat (uninterested vs. interested audience members). Consistent with prediction, participants with greater fear of public speaking looked fewer times at uninterested members of the audience (high social threat) compared to interested members of the audience (low social threat) b = 0.418, p = 0.046, 95% CI [0.008, 0.829]. Analyses of attentional indices over the course of the speech revealed that the interaction between fear of public speaking and gaze on audience members was only significant in the first three-minutes. Our results provide support for theoretical models implicating avoidance of social threat as a maintaining factor in social anxiety. Future research is needed to test whether guided attentional training targeting in vivo attentional avoidance may improve clinical outcomes for those presenting with social anxiety.