Association between Amygdala Hyperactivity to Harsh Faces and Severity of Social Anxiety in Generalized Social Phobia

Learning from other people's fear: amygdala-based social reference learning in social anxiety disorder

“…It has been argued that the amygdala is critical for learning the valence of novel objects from the emotional expressions of others (Blair, 2003) and this has been confirmed in animal and human work (Jeon et al 2010; Meffert et al 2015). This is interesting given consistent reports of elevated responses to emotional, and in particular negative emotional, expressions in adults with social phobia relative to healthy adults (Stein et al 2002; Straube et al 2004, 2005; Phan et al 2006; Blair et al 2008 b , 2011; Evans et al 2008). Considered within a social referencing perspective, these data together could be taken to suggest that an elevated amygdala response may lead patients with social phobia, relative to healthy individuals, to more strongly learn valence information from the facial expressions of others.…”

“…Alternatively, the enhanced activity may represent a heightened attention response to the social referencing trials. Previous studies examining the response to emotional expressions in patients with social anxiety disorder have revealed increased responses within the dorsomedial and lateral frontal cortices (Stein et al 2002; Amir et al 2005; Phan et al 2006; Blair et al 2008 b ). Moreover, behavioral work has shown heightened orientation to face information in social phobia (e.g.…”

“…Previous fMRI work finds that patients with social phobia show heightened amygdala and temporal cortical activity to angry (Stein et al 2002; Straube et al 2004, 2005; Phan et al 2006; Evans et al 2008) and fearful expressions (Blair et al 2008 b , 2011 a ; though see Stein et al 2002). The current study extends this work by considering how responses to facial emotions might influence learning.…”

Social Anxiety in Children and Adolescents

“…Normally, the amygdala responds to facial cues with an increase in activity as perceived social threat increases (Morris et al, 1996). This has been demonstrated both in individuals diagnosed with SP (Phan, Fitzgerald, Nathan, & Tancer, 2006) and in those not yet meeting diagnostic criteria but high in BI, a risk factor for a future SP diagnosis (Pérez-Edgar et al, 2007). As would be expected, research has shown a correlation between the degree of amygdala activity and the severity of social anxiety when presented with social threat cues.…”

“…By adolescence, the amygdala has reached maturity whereas the prefrontal cortex has not. Furthermore, amygdala activation differences can reliably differentiate adults with and without social anxiety (Birbaumer et al, 1998;Lorerbaum et al, 2004;Phan et al, 2006;Stein, Goldin, Sareen, Zorrilla, & Brown, 2002;Straube, Kolassa, Glauer, Mentzel, & Miltner, 2004;Tillfors et al, 2001;Veit et al, 2002). Brain imaging studies have shown that, relative to children and adults, adolescents demonstrate more pronounced amygdala activation when processing emotional information (Ernst et al, 2005;Galvan et al, 2006;Kuhnen & Knutson, 2005;Matthews, Simmons, Lane, & Paulus, 2004;Monk et al, 2003;Montague & Berns, 2002).…”

The role of neuroimaging for the diagnosis and treatment of anxiety disorders

“…Author manuscript; available in PMC 2015 May 13. amygdala in response to harsh (angry, disgusted, fearful) faces was greater in these patients than in controls, and the extent of amygdala activation was positively correlated with severity of social anxiety symptoms [80]. Generalized Social Phobia patients, however, show reduced neural activation related to implicit learning compared with healthy comparison subjects in the left caudate head, left inferior parietal lobe, and bilateral insula [81].…”

Cortico-Limbic Responses to Masked Affective Faces Across Ptsd, Panic Disorder, and Specific Phobia

“…In humans, the amygdala shows increased activation during the acquisition of conditioned fear and this activation is reduced following subsequent fear extinction, suggesting that the amygdala is key to the acquisition and maintenance of fear responses. This model extends well to human anxiety disorders, as considerable research evidence confirms that the amygdala is hyperresponsive to symptom provocation and other emotional challenge tasks in studies of specific phobia, social anxiety disorder (SAD), obsessive‐compulsive disorder (OCD), PD, and PTSD . Consistent with a recent meta‐analysis of neuroimaging studies of fear and anxiety disorders, our results indicate that hyperresponsiveness of the amygdala is a generally common but nonspecific feature that is shared across a broad range of anxiety disorders.…”

Common and distinct neural correlates of facial emotion processing in social anxiety disorder and Williams syndrome: A systematic review and voxel-based meta-analysis of functional resonance imaging studies

“…In general, most of the available studies found greater response of the amygdala to threat-related facial expressions in SAD individuals compared to HC (Blair et al, 2011(Blair et al, , 2008Cooney, Atlas, Joormann, Eugène, & Gotlib, 2006;Evans et al, 2008;Gentili et al, 2008;Klumpp, Angstadt, & Phan, 2012;Klumpp, Angstadt, Nathan, & Phan, 2010;Phan, Fitzgerald, Nathan, & Tancer, 2006;Stein, Goldin, Sareen, Zorrilla, & Brown, 2002;Straube, Kolassa, Glauer, Mentzel, & Miltner, 2004;Straube, Mentzel, & Miltner, 2005;Yoon, Fitzgerald, Angstadt, McCarron, & Phan, 2007); but see (Goldin, Manber, Hakimi, Canli, & Gross, 2009;Ziv, Goldin, Jazaieri, Hahn, & Gross, 2013). However, other paralimbic regions such as the insula and the parahippocampal gyrus also appeared to exhibit greater activation in SAD subjects (Amir et al, 2005;Blair et al, 2008Blair et al, , 2011Evans et al, 2008;Gentili et al, 2008;Goldin et al, 2009;Klumpp et al, 2010Klumpp et al, , 2012Klumpp, Post, Angstadt, Fitzgerald, & Phan, 2013;Phan et al, 2006;Yoon et al, 2007).…”

“…However, other paralimbic regions such as the insula and the parahippocampal gyrus also appeared to exhibit greater activation in SAD subjects (Amir et al, 2005;Blair et al, 2008Blair et al, , 2011Evans et al, 2008;Gentili et al, 2008;Goldin et al, 2009;Klumpp et al, 2010Klumpp et al, , 2012Klumpp, Post, Angstadt, Fitzgerald, & Phan, 2013;Phan et al, 2006;Yoon et al, 2007). Increased activation of limbic/paralimbic regions was the most replicated finding, and has been observed independently of task design (implicit (Blair et al, 2008(Blair et al, , 2011Gentili et al, 2008;Stein et al, 2002), explicit (Amir et al, 2005;Cooney et al, 2006;Klumpp et al, 2010Klumpp et al, , 2012Phan et al, 2006;Yoon et al, 2007), or combined (Klumpp et al, 2013;Straube et al, 2004) paradigms) at different levels of emotion intensity (Klumpp et al, 2010;Yoon et al, 2007), and even when simple-drawing schematic faces are presented (Evans et al, 2008). Using an event-related design, Klumpp et al (2010) found that SAD patients showed increased amygdala activation at both high and moderate threat intensities in comparison to matched controls.…”

Understanding Heterogeneity in Ptsd: Fear, Dysphoria, and Distress

“…Two recurrent findings in individuals with PTSD are decreased mPFC activation and increased amygdala activation . Similar functional differences in the mPFC‐amygdala circuit have been found across the anxiety disorders, including OCD, panic disorder, and generalized social phobia . Similarly, in depression, consistent findings have included hypermetabolism of the amygdala and hypometabolism of the left dorsal lateral prefrontal cortex; however, in contrast to PTSD, depression has also been reliably associated with increased metabolism in the orbital frontal cortex (OFC) and subgenual anterior cingulate cortex (sgACC) .…”

“…[110] Similar functional differences in the mPFC-amygdala circuit have been found across the anxiety disorders, [111] including OCD, [112] panic disorder, [113] and generalized social phobia. [114] Similarly, in depression, consistent findings have included hypermetabolism of the amygdala and hypometabolism of the left dorsal lateral prefrontal cortex; however, in contrast to PTSD, depression has also been reliably associated with increased metabolism in the orbital frontal cortex (OFC) and subgenual anterior cingulate cortex (sgACC). [115,116] In the neurocircuitry of depression, Brodmann Area 25 may be a key node in a network of brain regions involved with mood regulation and increased activity during a sad mood.…”

Serotonergic modulation of face-emotion recognition

“…In seeming contrast to the above conclusion, clinical studies have pointed to higher activation of the amygdala by emotional facial expressions in anxiety-prone healthy volunteers (39) and in patients with anxiety disorders (40) than in controls, and there is evidence from studies with depressive patients that antidepressant treatment normal-C.M. Del-Ben et al…”

The time course of attentional disengagement from angry faces in social anxiety

“…First, in the present study, we used angry faces as socially threatening stimuli; however, it is unclear whether other emotional expressions affect attentional disengagement in people with social anxiety. Some studies showed that socially anxious people were sensitive to angry faces (Mogg et al, 2004;Phan et al, 2006). However, considering that socially anxious people are afraid of rejection and negative evaluation from others, they may even find disgusted or contemptuous faces threatening.…”

“…In the present study, we investigated attentional disengagement from threatening stimuli in high socially anxious people, where the participants were undergraduate students. We used angry faces as threatening stimuli because some studies have shown that socially anxious people are sensitive to angry faces (Mogg et al, 2004;Phan, Fitzgerald, Nathan, & Tancer, 2006).…”

Modeling a Negative Response Bias in the Human Amygdala by Noradrenergic–Glucocorticoid Interactions

“…In experimental settings, a negative cognitive bias becomes evident when MDD patients exhibit more intense psychophysiological responses to emotionally negative stimuli and less intense responses to emotionally positive stimuli (Chamberlain and Sahakian, 2006). Paralleling these behavioral observations, neuroimaging studies have demonstrated a hyperresponsiveness (i.e., relative to healthy controls) of the amygdala toward emotionally negative stimuli in patients with AXD (Stein et al, 2002;Phan et al, 2006;Etkin and Wager, 2007;Stein et al, 2007) and MDD (Siegle et al, 2002;Dannlowski et al, 2007). Despite enormous implications for an advanced understanding and pharmacological treatment of these disorders, little is known about the neurochemical underpinnings of a negative response bias in the amygdala.…”

Toward a Mechanistic Understanding of How Variability in Neurobiology Shapes Individual Differences in Behavior

“…In one study, Stein et al (2007) report that high trait anxiety is associated with greater amygdala reactivity not only to angry and fearful but also happy facial expressions. Consistent with this pattern of normal variability, various mood and anxiety disorders (e.g., unipolar and bipolar depression, generalized anxiety disorder, social phobia) have been linked with greater amygdala responses to facial expressions depicting fear and anger, as well as sadness and disgust, and, more variably, to emotionally neutral facial expressions (Cooney et al 2006;Evans et al 2008;Phan et al 2006;Phillips et al 2003;Stein et al 2002;Whalen et al 2002). Such findings demonstrate that anxiety-related psychopathology is associated with a heightened amygdala response to diverse affective stimuli.…”