2006
DOI: 10.1016/j.biopsych.2005.08.012
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Association between Amygdala Hyperactivity to Harsh Faces and Severity of Social Anxiety in Generalized Social Phobia

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Cited by 461 publications
(362 citation statements)
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“…These findings do not replicate previous studies showing either increased (e.g., Phan et al, 2006) or decreased (Lorberbaum et al, 2004) magnitude of dorsal anterior cingulate activation in socially anxious individuals in response to threat. One possibility is that increasing dorsal anterior cingulate activity in this context reflects an adaptive increase in cognitive control and preparation for the upcoming speech in healthy controls as the end of the task nears (Aarts et al, 2008), though more evidence is needed.…”
Section: Discussioncontrasting
confidence: 99%
“…In addition to amygdala and insula, anterior cingulate cortex and medial prefrontal cortex regions are also implicated in fear and anxiety neural circuitry (Etkin, 2012), and SAD individuals exhibit altered functioning in these areas in response to threatening or negative stimuli (Brühl et al, 2014). Specifically, studies largely show increased activity in anterior cingulate regions (e.g., Amir et al, 2005; Labuschagne et al, 2012; Phan et al, 2006; but see Pujol et al, 2013) and medial prefrontal cortex areas (e.g., Stein et al, 2002; Straube et al, 2004; Labuschagne et al, 2012) compared to controls, consistent with evidence for these regions in identifying and expressing negative emotion (Etkin et al, 2011). …”
Section: Introductionmentioning
confidence: 58%
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“…We found that anxiety disorders displayed increased activation in the bilateral amygdala, anterior cingulate gyrus, parahippocampal gyrus, and common decreased activation mainly in the posterior cingulate, lingual gyrus, and precuneus. These conclusions are consistent with the previous studies [14,[20][21][22][23][24][25][26][27][28][29][30].…”
Section: Discussionsupporting
confidence: 94%
“…Although activations in the amygdala always appear in anxiety disorders involving emotional stimulations, there was a divergence in the activation of the left and right amygdala. For instance, some studies have highlighted the hyperactivity of the two-sided amygdala in anxiety disorders [23,24,27,29,[31][32][33], while other studies have only found it in the unilateral amygdala. This may be related to the different functions of the left and right amygdala [34].…”
Section: Discussionmentioning
confidence: 99%
“…Of note, only right amygdala connectivity was found to be associated with LOC in the present study. This is consistent with previous studies which reported that only the right amygdala was involved in anxiety and borderline personality disorders (Minzenberg, Fan, New, Tang, & Siever, 2007; Phan, Fitzgerald, Nathan, & Tancer, 2006). However, the lateralized effects of amygdala connectivity require further replication, considering the smaller sample size in the current study.…”
Section: Discussionsupporting
confidence: 93%
“…Study 2 also revealed that participants with higher SPAI scores were more accurate than participants with lower SPAI scores when the target faces were negative and the distractors were positive. This result is consistent with previous work showing that socially anxious individuals show a deeper neural processing of negative versus positive emotional faces [ 50 ] which could lead these individuals to attend more to negative than positive emotions. Taken together, these results demonstrate that participants high in traits related to social anxiety show different patterns of responses to emotional faces varying in emotion complexity and emotion valence.…”
Section: Discussionsupporting
confidence: 93%
“…That is, socially anxious individuals are impaired in understanding complex emotions [ 49 ], although less research has examined emotion identification. Socially anxious individuals also tend to show differences in processing emotions based on valence, such that they demonstrate more amygdala activation from negative than positive emotions [ 50 ], which may lead to greater attention to negative emotions. The social components of ASD and the symptoms of social anxiety are correlated yet distinguishable constructs that yield unique electrophysiological activation during social cognitive tasks [ 51 ] and each construct contributes unique variance to the success of certain social interventions [ 52 ].…”
Section: Introductionmentioning
confidence: 99%
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“…In terms of imaging, individuals with multiple disorders activated more fear encoding and expression regions (amygdala, insular cortex, and dACC) during conditioning. This finding is consistent with studies that have shown hyperactivation of fear-promoting regions during emotional tasks. During early conditioning, the vmPFC was less activated in the anxiety group compared with healthy controls.…”
Section: Discussionsupporting
confidence: 93%
“…This is also in accord with previous results that showed an involvement of the amygdala in threat processing in SAD patients (e.g. Stein et al, 2002;Tillfors et al, 2002;Lorberbaum et al, 2004;Straube et al, 2004;Phan et al, 2006;Yoon et al, 2007;Schmidt et al, 2010).…”
Section: Discussionsupporting
confidence: 93%
“…The fearrelated hyperactivity is consistent with a number of previous studies in GSAD where exaggerated amygdala reactivity has been reported to aversive social cues including fearful faces and to 'harsh' (fearful, angry, and contemptuous) faces ; Oxytocin and social anxiety disorder I Labuschagne et al Stein et al, 2002). However, we did not observe similar amygdala hyperactivity to angry faces, which has previously been reported in a number of studies (Evans et al, 2008;Phan et al, 2006;Stein et al, 2002;Straube et al, 2004). While we expected amygdala hyperactivity to 'harsh' (angry and fearful) faces, as each convey social signals of threat, the lack of hyperactivity to angry faces and the apparent inconsistency may be explained by a number of factors.…”
Section: Discussioncontrasting
(Expert classified)
“…Notably, patients with GSAD have deficits in emotion processing, and specifically exhibit attentional bias for critical/aversive faces and threatening social signals (Amir et al, 2003;Clark and McManus, 2002;Foa et al, 2000;Mogg et al, 2004), and tend to avert their gaze from salient facial features such as the eyes (Bogels and Mansell, 2004;Garner et al, 2006;Horley et al, 2004) to reduce excessive anxiety during social interactions. These deficits have been strongly linked to areas in the limbic system including the amygdala (Birbaumer et al, 1998;Blair et al, 2008;Etkin and Wager, 2007;Evans et al, 2008;Phan et al, 2006;Stein et al, 2002;Straube et al, 2004Straube et al, , 2005Veit et al, 2002;Yoon et al, 2006), where threat-related hyperactivity is a cardinal pathophysiological feature in patients with GSAD (Etkin and Wager, 2007;Shin and Liberzon, 2010).…”
Section: Introductionmentioning
confidence: 99%
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“…Moreover, in accord with our current results, Phan et al [2006] showed that the magnitude of right amygdala activation to harsh faces in the SAD group was significantly positively correlated with severity of SAD as measured by the LSAS. Although exaggerated left amygdalar activation in SAD was reported by Stein et al [2002], the right amygdalar findings from this study and those by Phan et al [2006] parallel earlier imaging studies of other anxiety disorders, where the magnitude of right amygdala activation to emotional faces [Armony et al, 2005;Rauch et al, 2000] or symptom provocation [Fredrikson and Furmark, 2003] have been found to be correlated with symptom severity.…”
Section: Discussionsupporting
confidence: 92%
“…Given the ACCs known role in emotional information processing [Whalen et al, 1998b], its reciprocal connections with the amygdala and its hypothesized dysfunction within a prevailing model of cortico-limbic dysfunction in anxiety disorders , we speculate that the observed relative deactivation may represent insufficient cortical regulation of the exaggerated amygdalar responses. We hesitate to further emphasize our post hoc dACC finding as there are many inconsistencies among prefrontal findings in the SAD neuroimaging literature with regard to identified regions of interest, laterality and direction of change in brain activity [see, Van Ameringen et al, 2004;Amir et al, 2005;Phan et al, 2006]. Moreover, the study by Straube et al [2004], which also employed schematic (and photographic face) stimuli, found no between-group differences within the prefrontal cortex.…”
Section: Discussionmentioning
confidence: 91%
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“…The finding of a hypersensitive amygdala in patients and a positive association between amygdala activation and disorder severity concur with several other studies [8] , [9] , [12] , [14] , [17] , [19] , [23] , [32] . In accordance with the results from Schmidt and colleagues [22] , our data underline the appropriateness of linguistic stimuli in clinical research.…”
Section: Discussionsupporting
(Expert classified)
“…The socially relevant stimuli are frequently operationalized as faces with aversive expressions [8] [16] , for review see [7] . Studies reporting correlations between amygdala activation and symptom severity underlined the crucial role of this brain region [12] , [17] – [19] .…”
Section: Introductionmentioning
confidence: 99%
“…Our findings replicate previous studies that reported an association of social anxiety symptoms and amygdala response in adults 33 and adolescents 32 with SAD. Furthermore, recent neural models demonstrate that fear-related amygdala activity can directly modulate attentional process 68 .…”
Section: Discussionsupporting
confidence: 92%
“…These results converge with prior findings of recognition bias and negative emotion reactivity to harsh faces in SAD 28, 33, 5759 , and neural bases of emotion processing in primates 6062 . Medial PFC and parahippocampal activations have been observed in a previous study of reactivity to harsh faces 28 and may be related to higher-order neural representations of self-focused attention, perspective taking 63 , and greater emotion intensity 26 that may be exaggerated in SAD.…”
Section: Discussionsupporting
confidence: 90%
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